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Chen S, Ying Z, Liu Y, Li Y, Yu Y, Huang M, Huang Z, Ou Z, Liao Y, Zhang Y, Liu G, Zhao W, Fu R, Shou Q, Zheng M, Liao X, Tu Y, Stek J, Hartzel J, Li C, Zhang J. A phase 3 randomized, open-label study evaluating the immunogenicity and safety of concomitant and staggered administration of a live, pentavalent rotavirus vaccine and an inactivated poliomyelitis vaccine in healthy infants in China. Hum Vaccin Immunother 2024; 20:2324538. [PMID: 38509699 PMCID: PMC10962606 DOI: 10.1080/21645515.2024.2324538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
This open-label, randomized, phase 3 study in China (V260-074; NCT04481191) evaluated the immunogenicity and safety of concomitant and staggered administration of three doses of an oral, live, pentavalent rotavirus vaccine (RV5) and three doses of an intramuscular, inactivated poliomyelitis vaccine (IPV) in 400 healthy infants. The primary objective was the non-inferiority of neutralizing antibody (nAb) responses in the concomitant- versus the staggered-use groups. Antibody responses were measured at baseline and 1-month post-dose 3 (PD3). Parents/legal guardians recorded adverse events for 30 or 15 d after study vaccinations in the concomitant-use or staggered-use groups, respectively. At PD3, >98% of participants seroconverted to all three poliovirus types, and the primary objective was met as lower bounds of the two-sided 95% CI for between-group difference in nAb seroconversion percentages ranged from - 4.3% to - 1.6%, for all poliovirus types, p < .001. At PD3, geometric mean titers (GMTs) of nAb responses to poliovirus types 1, 2, and 3 in the concomitant-use group and the staggered-use group were comparable; 100% of participants had nAb titers ≥1:8 and ≥1:64 for all poliovirus types. Anti-rotavirus serotype-specific IgA GMTs and participants with ≥3-fold rise in postvaccination titers from baseline were comparable between groups. Administration of RV5 and IPV was well tolerated with comparable safety profiles in both groups. The immunogenicity of IPV in the concomitant-use group was non-inferior to the staggered-use group and RV5 was immunogenic in both groups. No safety concerns were identified. These data support the concomitant use of RV5 and IPV in healthy Chinese infants.
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Affiliation(s)
- Shaomin Chen
- Biological Products Surveillance and Evaluation, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
| | - Zhifang Ying
- Respiratory Virus Vaccine, National Institutes for Food and Drug Control, Beijing, China
| | - Yan Liu
- Division of Hepatitis Virus and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Yuan Li
- Biological Products Surveillance and Evaluation, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
| | - Yebin Yu
- Vaccine Clinical Research Office, Yangchun Center for Disease Control and Prevention, Yangchun, Guangdong, China
| | - Meilian Huang
- Vaccine Clinical Research Office, Yangchun Center for Disease Control and Prevention, Yangchun, Guangdong, China
| | - Zhuhang Huang
- Biological Products Surveillance and Evaluation, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
| | - Zhiqiang Ou
- Biological Products Surveillance and Evaluation, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
| | - Yuyi Liao
- Biological Products Surveillance and Evaluation, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
| | - Yong Zhang
- Division of Hepatitis Virus and Enterovirus Vaccines, National Institutes for Food and Drug Control, Beijing, China
| | - Guixiu Liu
- Clinical Research, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Weiwei Zhao
- Biostatistics and Research Decision Sciences, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Rong Fu
- Biostatistics and Research Decision Sciences, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Qiong Shou
- Biostatistics and Research Decision Sciences, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Minghuan Zheng
- Clinical Research, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Xueyan Liao
- Clinical Research, MSD Research and Development (China) Co. Ltd., Beijing, China
| | - Yingmei Tu
- Infectious Diseases/Vaccines Clinical Research, Merck & Co. Inc., Rahway, NJ, USA
| | - Jon Stek
- Infectious Diseases/Vaccines Clinical Research, Merck & Co. Inc., Rahway, NJ, USA
| | - Jonathan Hartzel
- Biostatistics and Research Decision Sciences, Merck & Co. Inc., Rahway, NJ, USA
| | - Changgui Li
- Institute for Control of Biological Products, National Institutes for Food and Drug Control, Beijing, China
| | - Jikai Zhang
- Directors Office, Guangdong Provincial Institute of Biological Products and Materia Medica, Guangzhou, Guangdong, China
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Haq ZU, Yunus S, Jafri N. Building confidence in the COVID-19 vaccine in a polio-endemic country: strategic communication lessons from Pakistan. BMJ Glob Health 2024; 9:e015200. [PMID: 38599665 PMCID: PMC11015175 DOI: 10.1136/bmjgh-2024-015200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/31/2024] [Indexed: 04/12/2024] Open
Abstract
In a health emergency, governments rely on public trust in their policy, and anticipate its compliance to protect health and save lives. Vaccine hesitancy compromises this process when an emergency involves infections. The prevailing discourse on vaccine hesitancy often describes it as a static phenomenon, ignoring its expanse and complexity, and neglecting the exploration of tools to address it. This article diverges from the conventional perspective by explaining the case of Pakistan and its communication strategy for the COVID-19 vaccine. Decades of polio vaccine hesitancy, rooted in the country's fight against terrorism, constitute its history. On the other hand, the first-ever launch of typhoid conjugate vaccine involving 35 million kids during 2019-2021 was a success. Against this backdrop, the country considered vaccine hesitancy as a dynamic phenomenon, interwoven with the social ecology and the responsiveness of the healthcare system. Its communication strategy facilitated those willing to receive the vaccine, while being responsive to the information needs of those still in the decision-making process. In the face of both hesitancy and a scarcity of vaccine doses, the country successfully inoculated nearly 70% (160 million) of its population in just over 1 year. People's perceptions about the COVID-19 vaccine also improved over time. This achievement offers valuable insights and tools for policymakers and strategists focused on the demand side of vaccine programmes. The lessons can significantly contribute to the global discourse on improving vaccine confidence and bolstering global health security.
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Affiliation(s)
| | | | - Naveed Jafri
- Expanded Programme on Immunisation, Pakistan Ministry of National Health Services Regulations and Coordination, Islamabad, Pakistan
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Emanuele CA, Jean Baptiste AE, Chévez AE, Magarinos M, Antelo MV, Arza S, Cain E, Rey-Benito G, Velandia-Gonzalez M, Salas D. Maintaining the Region of the Americas free of polio: best practices for incident management support teams. Rev Panam Salud Publica 2024; 48:e23. [PMID: 38562959 PMCID: PMC10984221 DOI: 10.26633/rpsp.2024.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/04/2024] [Indexed: 04/04/2024] Open
Abstract
The Pan American Health Organization (PAHO) and its Member States have been leading the efforts to eradicate wild poliovirus in the Region of Americas since smallpox's successful elimination in 1971. The region became the first to be certified free of wild poliovirus in 1994. However, in July 2022, an unvaccinated patient with no recent travel history was diagnosed with poliomyelitis in the United States of America. In response to the emergence of a circulating vaccine-derived poliovirus in the United States, PAHO established the Polio Incident Management Support Team. This team has been coordinating response efforts, focusing on: coordination, planning, and monitoring; risk communication and community engagement; surveillance and case investigation; vaccination; and rapid response. In this paper, we identified and documented best practices observed following establishment of the Incident Management Support Team (September 2022-2023) through a comprehensive review and analysis of various data sources and country-specific data from the polio surveillance dashboard. The aim was to share these best practices, highlighting technical support and implementation of polio measures by Member States. Despite several challenges, the Americas region remains polio-free. Polio risk is declining, with a July 2023 assessment showing fewer countries at medium, high, and very high risk. This progress reflects improved immunization coverage, surveillance, containment, health determinants, and outbreak preparedness and response. The PAHO Polio Incident Management Support Team has played a key role in supporting these efforts.
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Affiliation(s)
- Carlos A. Emanuele
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Anne E. Jean Baptiste
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Ana E. Chévez
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Mirta Magarinos
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Maite V. Antelo
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Sonia Arza
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Emilia Cain
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Gloria Rey-Benito
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Martha Velandia-Gonzalez
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
| | - Daniel Salas
- Pan American Health OrganizationRegional Office of the World Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Regional Office of the World Health Organization, Washington, D.C., United States of America.
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Estrella-Porter P, Fernández Dueñas A, Olmedo Lucerón C, Cantero Gudino E, Limia Sánchez A. [Eradication of poliomyelitis in Spain: What has happened in the last decade?]. Rev Esp Salud Publica 2024; 98:e202403028. [PMID: 38533995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
On the 60th anniversary of the initiation of the polio vaccination campaign in Spain, the significant milestone in achieving disease control is highlighted. There has been a shift from an incidence of over 2,000 yearly cases in the 1960s to a sustained absence of wild poliovirus (WPV) since 1988. Despite the observed negative impact on polio vaccination coverage at the onset of the COVID-19 pandemic, these rates gradually recovered, reaching 98.2% in primary vaccination in 2022. Over the past decade, two essential elements have been identified to maintain the goal of polio elimination and that reinforces the importance of sustaining high vaccination coverage: robust epidemiological surveillance systems and a swift response to alerts to protect the vulnerable population and prevent virus reintroduction. In order to achieve eradication, it is crucial to interrupt international transmission and maintain continuous high-quality surveillance and effective coordination across different levels in response to any detection of PV, wild or vaccine derived. This article aimed to provide a comprehensive view of the polio eradication situation in Spain, focusing on the key events that occurred in the last decade and the present and future challenges.
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Affiliation(s)
- Pablo Estrella-Porter
- Servicio de Medicina Preventiva; Hospital Clínico Universitario de Valencia. Valencia. España
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Ballester R. [Compassionate culture in addressing polio in healthcare settings. The spanish case (1940-1970)]. Rev Esp Salud Publica 2024; 98:e202402009. [PMID: 38385484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/11/2024] [Indexed: 02/23/2024] Open
Abstract
The presence of epidemic outbreaks of poliomyelitis in the initial and central decades of the last century constituted an important Public Health problem due to the absence of effective treatments because it preferentially affected children, in environments with acceptable levels of health, and the fear of the paralytic sequelae. This work attempted to reconstruct some of the responses that were given in the Spanish state, both in professional health settings and from alternative heterodox approaches such as the Kenny method, taking as a reference axis the compassionate culture that was behind the development of the measures. adopted and their critical analysis, in the period before the implementation of anti-polio vaccines.
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Affiliation(s)
- Rosa Ballester
- Catedrática emérita de Historia de la Ciencia; Universidad Miguel Hernández. Elche. España
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van Duijnhoven E, van der Veen M, Koopman FS, Nollet F, Bruijn SM, Brehm MA. Gait stability and the relationship with energy cost of walking in polio survivors with unilateral plantarflexor weakness. Gait Posture 2024; 107:104-111. [PMID: 37801868 DOI: 10.1016/j.gaitpost.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Polio survivors often exhibit plantarflexor weakness, which impairs gait stability, and increases energy cost of walking. Quantifying gait stability could provide insights in the control mechanisms polio survivors use to maintain gait stability and in whether impaired gait stability is related to the increased energy cost of walking. RESEARCH QUESTION Is gait stability impaired in polio survivors with plantarflexor weakness compared to able-bodied individuals, and does gait stability relate to energy cost of walking? METHODS We retrospectively analyzed barefoot biomechanical gait data of 31 polio survivors with unilateral plantarflexor weakness and of 24 able-bodied individuals. We estimated gait stability by calculating variability (SD) of step width, step length, double support time, and stance time, and by the mean and variability (SD) of the mediolateral and anteroposterior margin of stability (MoSML and MoSAP). In addition, energy cost of walking (polio survivors only) at comfortable speed was analyzed. RESULTS Comfortable speed was 31% lower in polio survivors compared to able-bodied individuals (p < 0.001). Corrected for speed differences, step width variability was significantly larger in polio survivors (+41%), double support time variability was significantly smaller (-27%), MoSML (affected leg) was significantly larger (+80%), and MoSAP was significantly smaller (affected leg:-17% and non-affected leg:-15%). Step width and step length variability (affected leg) were positively correlated with energy cost of walking (r = 0.502 and r = 0.552). MoSAP (non-affected leg) was negatively correlated with energy cost of walking (r = -0.530). SIGNIFICANCE Polio survivors with unilateral plantarflexor weakness demonstrated an impaired gait stability. Increased step width and step length variability and lower MoSAP could be factors related to the elevated energy cost of walking in polio survivors. These findings increase our understanding of stability problems due to plantarflexor weakness, which could be used for the improvement of (orthotic) interventions to enhance gait stability and reduce energy cost in polio survivors.
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Affiliation(s)
- Elza van Duijnhoven
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands.
| | - Marit van der Veen
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands
| | - Fieke S Koopman
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Frans Nollet
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
| | - Sjoerd M Bruijn
- Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands; Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Merel-Anne Brehm
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Rehabilitation & Development, Amsterdam, the Netherlands
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Liu Q, Liu Z, Huang B, Teng Y, Li M, Peng S, Guo H, Wang M, Liang J, Zhang Y. Global trends in poliomyelitis research over the past 20 years: A bibliometric analysis. Hum Vaccin Immunother 2023; 19:2173905. [PMID: 36803526 PMCID: PMC10038019 DOI: 10.1080/21645515.2023.2173905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Poliomyelitis is an acute infectious disease caused by poliovirus. This bibliometric analysis aims to examine the status of poliomyelitis research in the past 20 years. Information regarding polio research was obtained from the Web of Science Core Collection database. CiteSpace, VOSviewer, and Excel were used to perform visual and bibliometric analysis with respect to countries/regions, institutions, authors, journals and keywords. A total of 5,335 publications on poliomyelitis were published from 2002 to 2021. The USA was the county with the majority of publications. Additionally, the most productive institution was the Centers for Disease Control and Prevention. Sutter, RW produced the most papers and had the most co-citations. Vaccine was the journal with the most polio-related publications and citations. The most common keywords were mainly about polio immunology research ("polio," "immunization," "children," "eradication" and "vaccine"). Our study is helpful for identifying research hotspots and providing direction for future research on poliomyelitis.
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Affiliation(s)
- Qi Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ze Liu
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Biling Huang
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuanyuan Teng
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mingliu Li
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shuqin Peng
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Min Wang
- Department of Endocrinology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Seytre B. [Failure of poliomyelitis eradication campaign with oral vaccine: there's no vaccination without adherence]. Med Trop Sante Int 2023; 3:mtsi.v3i4.2023.402. [PMID: 38390018 PMCID: PMC10879885 DOI: 10.48327/mtsi.v3i4.2023.402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/02/2023] [Indexed: 02/24/2024]
Abstract
Thirty-five years after its launch, the Global Polio Eradication Initiative has yet to reach its original goal of 2000. Not only is the wild type 1 polio virus still endemic in two countries, but a new outbreak due to viruses derived from the live attenuated virus used for the oral vaccine has been spreading since 2016. The National Immunization Days (NID), during which teams go door-to-door and attract children to be vaccinated, have provoked violent opposition particularly in Northern Nigeria and in the area of India, Pakistan, Afghanistan. In both regions, the same rumor has developed that the vaccine contains sterilizing products, in order to limit the Muslim population. The organizers of the campaign multiplied in vain the NIDs to overcome the resistance, but pockets of insufficiently vaccinated population have persisted. This has allowed the wild virus to remain endemic and the new outbreak of vaccine-derived viruses to progress. We can wonder what the campaign would have become if its organizers had taken the time to reflect and reorient their strategy to rely on the routine vaccination of the Expanded Program on Immunization that does not arouse such opposition.
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Zhao FX, Lu XB, Fu WH. [Recalling the history of the prevention and treatment during the epidemics of four infectious diseases, including botulism in Xinjiang]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:1229-1232. [PMID: 38238960 DOI: 10.3760/cma.j.cn501113-20231017-00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- F X Zhao
- Xinjiang Medical University, Wulumuqi 830054, China
| | - X B Lu
- The First Affiliated Hospital, Xinjiang Medical University, Wulumuqi 830011
| | - W H Fu
- Xinjiang Uygur Autonomous Region Center for Disease Prevention and Control, Wulumuqi 830002, China; China
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Bessing B, Dagoe EA, Tembo D, Mwangombe A, Kanyanga MK, Manneh F, Matapo BB, Bobo PM, Chipoya M, Eboh VA, Kayeye PL, Masumbu PK, Muzongwe C, Bakyaita NN, Zomahoun D, Tuma JN. Evaluation of the Acute flaccid paralysis surveillance indicators in Zambia from 2015-2021: a retrospective analysis. BMC Public Health 2023; 23:2227. [PMID: 37951902 PMCID: PMC10640734 DOI: 10.1186/s12889-023-17141-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND The resurgence of poliovirus infection in previously polio free regions and countries calls for renewed commitment to the global polio eradication efforts including strengthening of Acute Flaccid Paralysis (AFP) surveillance systems. Zambia is one of the countries substantially at risk for the importation of poliovirus infection from neighbouring countries including Malawi, Mozambique, and Democratic Republic of the Congo (DRC). This study describes a seven-year AFP surveillance, assesses the surveillance indicators, and highlights areas for improvement. METHODS We conducted retrospective analysis of the routinely collected AFP surveillance data from January 2015 to December 2022. The AFP surveillance indicators performance was assessed using the World Health Organisation's recommended minimum AFP surveillance indicators performance. RESULTS Cumulatively, a total of 1715 AFP cases were reported over the study period. More than half, 891 (52%) of reported cases were aged < 5 years with 917 (53.5%) of males. More than half, 1186 (69.2%) had fever at onset, 718 (41.9%) had asymmetric paralysis and 1164 (67.9%) had their paralysis progressed within 3 days of onset. The non-polio AFP rate ranges from 3.4 to 6.4 per 100,000 children < 15 years old and stool adequacy ranging from 70.9% to 90.2% indicating sensitive surveillance with late detection of cases. The percentage of cases with early stool collection, timely transportation was above the World Health Organisation (WHO) minimum of 80% but with declining proportion of stools arriving in the laboratory in optimal condition. Completeness of 60-days follow-up evaluation was suboptimal ranging from 0.9% to 28.2%. CONCLUSION The AFP surveillance system in Zambia is doing well. However, additional efforts are needed to improve early detection of cases; stool sample collection, transportation and monitoring to ensure arrival in good condition in the laboratory; and improve 60-days follow-up evaluation for evidenced-based classification of inadequate AFP cases and proper care.
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Affiliation(s)
| | - Edward A Dagoe
- United States Centers for Disease Control and Prevention, Atlanta, USA
| | - Deborah Tembo
- Zambia National Public Health Institute, Lusaka, Zambia
| | | | | | - Fadinding Manneh
- World Health Organization Africa Regional Office, Congo Brazzaville, Republic of Congo
| | - Belem B Matapo
- World Health Organization Country Office, Lusaka, Zambia
| | | | | | | | | | | | | | | | - Delayo Zomahoun
- United States Centers for Disease Control and Prevention, Atlanta, USA
- World Health Organization Headquarters, Geneva, Switzerland
| | - Jude N Tuma
- United States Centers for Disease Control and Prevention, Atlanta, USA
- World Health Organization Headquarters, Geneva, Switzerland
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Ughasoro MD, Nnakenyi I, Echendu N, Akpeh JO, Oji-Onuoha S, Anyaoha U, Mbanefo N, Ofodile K. Neutralizing anti-polio antibody titre in newborn babies in post-polio eradication period in Nigeria. Vaccine 2023:S0264-410X(23)01116-7. [PMID: 37806806 DOI: 10.1016/j.vaccine.2023.09.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND According to Polio Eradication and Endgame Strategic Plan 2019-2023 (PEESP), countries that achieved wild polio elimination is expected to replace oral polio vaccine (OPV) which has a risk of vaccine-derived poliovirus, Inactivated Polio Vaccine (IPV). It is important to determine the earliest time in the age of a child at which IPV could be introduced into the country's routine immunization schedule for effectiveness especially as it concerns neutralizing effect of trans-placental transmitted antibodies which usually does not affect OPV. In this study, the level of poliovirus neutralizing antibody titre among neonates at birth was evaluated. METHODS A cross-sectional study of mother-baby pair. The serum level of the neutralizing Poliovirus antibody IgG titre was done by the Enzyme Linked Immunosorbent Assay (ELISA) technique. RESULTS There was 100% transfer of maternal passive antibodies to their babies. The mean poliovirus antibody titre among neonates was 21.8 IU/L which was above the neutralizing titre level. Most (85.7%) babies antibody level correlate positively with that of their mothers. CONCLUSION The transferred maternal antibodies to the babies are still very high at birth, and capable of dampening the immunity of IPV if introduced early. Programme managers should evaluate the impact and benefit of given booster dose of IPV to pregnant mothers to increase the titre level in their babies. This will be very necessary when the OPV is withdrawn from the immunization schedule.
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Affiliation(s)
- Maduka D Ughasoro
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Ifeyinwa Nnakenyi
- Department of Chemical Pathology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Nneamaka Echendu
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - James O Akpeh
- Department of Otolaryngology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
| | - Stella Oji-Onuoha
- Department of Paediatrics, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Uchenna Anyaoha
- Department of Paediatrics, Federal Medical Centre, Umuahia, Abia State, Nigeria
| | - Ngozi Mbanefo
- Department of Paediatrics, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
| | - Kingsley Ofodile
- Department of Paediatrics, Federal Medical Centre, Umuahia, Abia State, Nigeria
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Tuells J, Aparicio Azcárraga P. [Avatares de la polio en España: 60ª aniversario de las primeras campañas de vacunación.]. Rev Esp Salud Publica 2023; 97:e1-e4. [PMID: 37921382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 11/04/2023] Open
Affiliation(s)
- José Tuells
- Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia; Universidad de Alicante. Alicante. España
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Rodríguez-Zamorano P, Otero Otero J, Pérez González A, Moro Rodríguez LE, Marco F. Primary total hip arthroplasty in patients with sequelae of poliomyelitis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:401-410. [PMID: 37011859 DOI: 10.1016/j.recot.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/12/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12months. RESULTS Sixteen patients underwent surgery, with 13THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1points, the visual analog scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimized with dual mobility cups.
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Affiliation(s)
- P Rodríguez-Zamorano
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España.
| | - J Otero Otero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - A Pérez González
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - L E Moro Rodríguez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España
| | - F Marco
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, España; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, España
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Rodríguez-Zamorano P, Otero Otero J, Pérez González A, Moro Rodríguez LE, Marco F. [Translated article] Primary total hip arthroplasty in patients with sequelae of poliomyelitis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T401-T410. [PMID: 37328055 DOI: 10.1016/j.recot.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 03/23/2023] [Indexed: 06/18/2023] Open
Abstract
INTRODUCTION Total hip arthroplasty (THA) in patients with residual poliomyelitis (RP) is a surgical challenge. Dysplastic morphology, osteoporosis and gluteal weakness hinder orientation, increase fracture risk and reduce implant stability. The aim of this study is to describe a series of patients with RP treated by THA. MATERIAL AND METHODS Retrospective descriptive study of patients with RP treated with THA between 1999 and 2021 in a tertiary hospital, with clinical and radiological follow-up and functional and complication evaluation until present or death, with a minimum of 12 months. RESULTS Sixteen patients underwent surgery, with 13 THA implanted in the paretic limb, 6 for fracture and 7 for osteoarthritis, while the remaining 3 were implanted in the contralateral limb. Four dual mobility cups were implanted as an antiluxation measure. At 1 year postoperatively, 11 had complete range of motion with no increase in Trendelenburg cases. The Harris hip score (HHS) improved 32.1 points, the visual analogue scale (VAS) 5.25 points, and the Merlé-d'Augbiné-Poste scale 6 points. The length discrepancy correction was 13.77mm. Median follow-up was 3.5 years (1-24). Two cases were revised for polyethylene wear and two for instability, with no infections, periprosthetic fractures, or cup or stem loosening. CONCLUSIONS THA in patients with RP allows improvement of the clinico-functional situation with an acceptable complication rate. The risk of dislocation could be minimised with dual mobility cups.
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Affiliation(s)
- P Rodríguez-Zamorano
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain.
| | - J Otero Otero
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain
| | - A Pérez González
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain
| | - L E Moro Rodríguez
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain
| | - F Marco
- Departamento de Cirugía Ortopédica y Traumatología, Hospital Clínico San Carlos, Madrid, Spain; Departamento de Cirugía, Universidad Complutense de Madrid, Madrid, Spain
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Martini M, Orsini D. The ghost of polio haunts us once again. The appeal of the scientific community is clear: "Vaccinate your kids today!". Vaccine 2023; 41:5338-5341. [PMID: 37495489 DOI: 10.1016/j.vaccine.2023.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION In the summer of 2022, a vaccination campaign for the prevention of poliomyelitis was launched and "The CDC recommend that all children be vaccinated against polio, or poliomyelitis". The scientific community is on the alert for new cases of polio, which is spreading. Although polio seemed to have been almost completely eradicated throughout the world, the disease has surprisingly reappeared in some Western countries. The risk of international spread of poliovirus remains a Public Health Emergency of International Concern (PHEIC). METHOD The authors reviewed recent polio cases in some western countries which have caused significant public health concern and they underline the meaning and weight of this issue emphasizing the importance of vaccination. DISCUSSION In June 2022, the British authorities announced that they had detected traces of a form of polio derived from a vaccine strain in the wastewater of some London boroughs. Although no cases of disease were identified, the British government immediately announced that it was proceeding to reinstate polio vaccination for all children. A few weeks later, on July 18, 2022, the New Jersey Department of Health notified the CDCP of the detection of type-2 poliovirus in an unvaccinated young man in the New York metropolitan area. This case immediately triggered an appeal from the CDCP to get vaccinated and, above all, to vaccinate children. Low vaccination coverage means that the population is constantly at risk of further cases of paralytic poliomyelitis. CONCLUSION The appeal to vaccinate children against polio is crucial, as prevention through vaccination is the only defense against the disease. We think that an efficient vaccination campaign can positively influence the process of eliminating the virus. At the same time, however, it demonstrates that simply lowering one's guard can quickly lead to a resurgence of polio cases. Hence, until polio is eradicated, we can be sure that contagion by the wild virus and the risk of vaccine-derived poliovirus will remain possible.
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Affiliation(s)
- Mariano Martini
- Departmentof Health Sciences, University of Genoa, Genoa, Italy; ScientificAdvisor of UNESCO CHAIR "Anthropology of Health - Biosphere and Healing System", Italy.
| | - Davide Orsini
- University Museum System of Siena (Simus), History of Medicine, University of Siena, Siena, Italy
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SCHLUMBERGER M. [Increasing the efficiency of a mobile EPI strategy using injectable polio vaccine in Africa]. Med Trop Sante Int 2023; 3:mtsi.v3i2.2023.344. [PMID: 37525682 PMCID: PMC10387316 DOI: 10.48327/mtsi.v3i2.2023.344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/20/2022] [Indexed: 08/02/2023]
Abstract
Introduction In 1980, partners initiated a mobile simplified EPI (Expanded programme on immunization) strategy for immunizing, with mobile teams, rural and urban populations in Western Africa. This strategy delivered EPI vaccines in two sessions: 1) 3-8 month-old children: BCG-Diphteria Tetanus Pertussis + reinforced killed Polio vaccine; 2) 9-15 month-old children: Diphteria Tetanus Pertussis + reinforced killed Polio vaccine, Measles-Yellow Fever. This strategy was compared to WHO-UNICEF extended EPI strategy, but results were never published in the context of a planned rapid polio eradication with oral polio vaccine. Methods For comparison with standard WHO-UNICEF extended EPI strategy, using oral polio vaccine in four sessions, all the costs generated by these two strategies in 1988 have been collected in two adjacent zones in Burkina Faso, Western Africa: 203,642 inhabitants for WHO-UNICEF extended EPI strategy (Yako); 109,483 inhabitants for mobile simplified EPI strategy (Gourci). An EPI coverage survey at the end of this year has been done in these two adjacent zones with efficiency (costs per fully immunized child) computed. Results In Africa, the simplified mobile EPI strategy using reinforced killed polio vaccine was found two times more efficient (12.71 US$ per fully immunized child) than WHO-UNICEF extended EPI strategy using oral polio vaccine (29.67 US$ per fully immunized child), even if DTP-reinforced killed polio vaccine (0.52 US$ per dose) was more expensive than DTP and oral polio vaccine (0.14 US$ for the combined dose). The missed opportunities uncaught up would have doubled coverage in the WHO-UNICEF extended EPI strategy, versus only a 10% increase with the mobile simplified EPI strategy. The main reason for uncaught up missed opportunities in WHO extended EPI strategy was the absence of requested vaccine delivered by a health agent when attending population at meeting point, due to insufficient cold box volume carried on his moped for transport of vaccine. Discussion After 30 years, since 1990, of poliomyelitis eradication in Africa using oral polio vaccine and with non-added costs in this study of polio mass campaigns, these results should be published to review EPI strategy.
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SALIOU P. [Position of killed polio vaccine in the Expanded Program on Immunization]. Med Trop Sante Int 2023; 3:mtsi.v3i2.2023.380. [PMID: 37525674 PMCID: PMC10387321 DOI: 10.48327/mtsi.v3i2.2023.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 08/02/2023]
Abstract
It may seem surprising that the Editorial Board of Médecine Tropicale et Santé Internationale (MTSI) would agree to publish the article "Increasing the efficiency of a mobile EPI strategy using injectable polio vaccine in Africa" 35 years after the work was completed in 1988. I briefly outline the rationale for this decision here.
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Uysal A, Güntel M, Dede HÖ. The relationship between cartilage thickness and muscle thickness or leg length discrepancy in poliomyelitis sequelae. J Musculoskelet Neuronal Interact 2023; 23:228-235. [PMID: 37259663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To evaluate the relationship between cartilage loss and differences in muscle thickness and/or leg length in poliomyelitis sequelae (PMS). Our study is the first to evaluate the relationship between cartilage loss and both muscle atrophy and leg length discrepancy in the same population. METHODS 37 patients with PMS and 38 healthy controls were included. Talar and distal femoral cartilage thicknesses and gastrocnemius medialis and quadriceps femoris muscle thicknesses were measured via ultrasound. Leg length differences and manual muscle strength were also evaluated. RESULTS The mean muscle thicknesses and cartilage thicknesses were thinner in the more affected legs than in the less affected legs in the patient group. All of the ultrasonographic measurements were thinner in the less affected legs of the patient group than in the right legs of the control group, except for the knee cartilage thicknesses. While there was a correlation between the cartilage thickness difference and the muscle thickness difference between the less and more affected legs in the patient group, there was no correlation between the cartilage thickness difference and leg length differences. CONCLUSIONS Patients with PMS are predisposed to osteoarthritis. Talar and knee cartilage thicknesses may be more associated with the muscle thickness than the leg length discrepancy in PMS.
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Affiliation(s)
- Alper Uysal
- Physical Medicine and Rehabilitation Clinic, Hatay Education and Research Hospital, Hatay, Turkey
| | - Murat Güntel
- Neurology Department, Medicine Faculty, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Hava Özlem Dede
- Clinical Neurophysiology, Neurology Clinic, Hatay Education and Research Hospital, Hatay, Turkey
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Vu DM, Adaramola OS, Freyre K, Mathews SG, Beltran J, Opsha O. Primary intramuscular and intermuscular Echinococcal disease of the iliopsoas and sartorius muscles: A case report. Radiol Case Rep 2023; 18:1743-1747. [PMID: 36915610 PMCID: PMC10006300 DOI: 10.1016/j.radcr.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 03/02/2023] Open
Abstract
Hydatid disease is a parasitic infection caused by the Echinococcus tapeworm. Classically, Echinococcal lesions are slowly growing cystic masses with daughter cysts. The most common sites of disease are the liver in 75% of cases and lungs in 15% of cases. This report covers a case of a patient from Southeast Europe with primary extrahepatic hydatid disease in and along the left iliopsoas and sartorius muscles. Retroperitoneal and soft tissue Echinococcus infection without liver involvement is extremely rare and creates a diagnostic challenge for clinicians and radiologists, especially in nonendemic areas.
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Kim J, Bae KN, Son JH, Shin K, Kim HS, Ko HC, Kim MB, Kim B. Unilateral Psoriasis on the Left Leg and Poliomyelitis of the Right Leg: A Case Report and Review of the Etiology. Ann Dermatol 2023; 35:S93-S96. [PMID: 37853875 PMCID: PMC10608392 DOI: 10.5021/ad.21.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/07/2021] [Accepted: 11/26/2021] [Indexed: 10/20/2023] Open
Abstract
Psoriasis is a common immune-mediated, inflammatory skin disease. However, unilateral psoriasis is rare and few cases have been reported. A 59-year-old male with a polio-affected right leg presented with exfoliative skin on the left leg for three months. He had been treated under the diagnosis of contact dermatitis with secondary infection. After the exfoliative skin lesions improved, psoriatic papules were noted, which was ultimately diagnosed as psoriasis and successfully treated with topical steroid and vitamin D agents. We propose that the Koebner phenomenon has acted as the triggering and aggravating factor of unilateral psoriasis in this patient.
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Affiliation(s)
- Jongwook Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kyung-Nam Bae
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jin-Hwa Son
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Byungsoo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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Morais A, Morais J, Felix M, Neto Z, Madaleno V, Umar AS, Panda N, Lemma F, Chivale JAL, Cavalcante DG, Davlantes E, Ghiselli M, Espinosa C, Whiteman A, Iber J, Henderson E, Bullard K, Jorba J, Burns CC, Diop O, Gumede N, Seakamela L, Howard W, Frawley A. Genetic and epidemiological description of an outbreak of circulating vaccine-derived polio-virus type 2 (cVDPV2) in Angola, 2019-2020. Vaccine 2023; 41 Suppl 1:A48-A57. [PMID: 36803869 PMCID: PMC10823914 DOI: 10.1016/j.vaccine.2023.02.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/06/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023]
Abstract
After six years without any detection of poliomyelitis cases, Angola reported a case of circulating vaccine-derived poliovirus type 2 (cVDPV2) with paralysis onset date of 27 March 2019. Ultimately, 141 cVDPV2 polio cases were reported in all 18 provinces in 2019-2020, with particularly large hotspots in the south-central provinces of Luanda, Cuanza Sul, and Huambo. Most cases were reported from August to December 2019, with a peak of 15 cases in October 2019. These cases were classified into five distinct genetic emergences (emergence groups) and have ties with cases identified in 2017-2018 in the Democratic Republic of Congo. From June 2019 to July 2020, the Angola Ministry of Health and partners conducted 30 supplementary immunization activity (SIA) rounds as part of 10 campaign groups, using monovalent OPV type 2 (mOPV2). There were Sabin 2 vaccine strain detections in the environmental (sewage) samples taken after mOPV2 SIAs in each province. Following the initial response, additional cVDPV2 polio cases occurred in other provinces. However, the national surveillance system did not detect any new cVDPV2 polio cases after 9 February 2020. While reporting subpar indicator performance in epidemiological surveillance, the laboratory and environmental data as of May 2021 strongly suggest that Angola successfully interrupted transmission of cVDPV2 early in 2020. Additionally, the COVID-19 pandemic did not allow a formal Outbreak Response Assessment (OBRA). Improving the sensitivity of the surveillance system and the completeness of AFP case investigations will be vital to promptly detect and interrupt viral transmission if a new case or sewage isolate are identified in Angola or central Africa.
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Affiliation(s)
- Alda Morais
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Joana Morais
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Miguel Felix
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | - Zoraima Neto
- Angola Ministry of Health. R. 17 de Setembro, Luanda, Angola
| | | | - Abubakar Sadiq Umar
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Nirakar Panda
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Fekadu Lemma
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - José Alexandre Lifande Chivale
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Danielle Graça Cavalcante
- World Health Organization, Angola Country Office. Condomínio Rosalinda, Edifício da ONU, Estrada Direita da Samba, Futungo de Belas, Luanda, Angola
| | - Elizabeth Davlantes
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA.
| | - Margherita Ghiselli
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Catherine Espinosa
- Global Immunization Division, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Ari Whiteman
- Geospatial Research, Analysis, and Services Program, US Agency for Toxic Substances and Disease Registry. 4770, Buford Hwy Northeast, Atlanta, GA, USA
| | - Jane Iber
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Elizabeth Henderson
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Kelley Bullard
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Jaume Jorba
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Cara C Burns
- Division of Viral Diseases, US Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, USA
| | - Ousmane Diop
- Polio Eradication Department, World Health Organization, Avenue Appia, 20, 1211, Geneva 27, Switzerland
| | - Nicksy Gumede
- World Health Organization Regional Office for Africa. Cité du Djoué, P.O. Box 06, Brazzaville, Republic of Congo
| | - Lerato Seakamela
- National Institute for Communicable Diseases, 1, Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Wayne Howard
- National Institute for Communicable Diseases, 1, Modderfontein Road, Sandringham, Johannesburg 2192, South Africa
| | - Alean Frawley
- US Centers for Disease Control and Prevention, Angola Country Office, R. Houari Boumediene 32, Luanda, Angola
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Genêt F, Salga M, De Brier G, Jouvion AX, Genêt G, Lofaso F, Prigent H, Obrecht M, Dziri S, Théfenne L. Accuracy of Resting Energy Expenditure Estimation Equations in Polio Survivors. Arch Phys Med Rehabil 2023; 104:418-424. [PMID: 36270514 DOI: 10.1016/j.apmr.2022.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 09/15/2022] [Accepted: 09/25/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To evaluate the accuracy of 4 equations validated for the general population to determine resting energy expenditure (REE) in polio survivors. DESIGN A descriptive, ambispective, single-center observational cohort study of minimal risk care. SETTING Tertiary university care hospital. PARTICIPANTS DATAPOL database of polio survivors followed up in a specialist department (N=298). INTERVENTIONS None. MAIN OUTCOMES MEASURES REE measurement by indirect calorimetry and estimated REE using 4 equations and comparing the values with indirect calorimetry. Analysis of correlations between measured REE and weight, height, and body mass index (BMI) and indicators of severity of polio sequelae. RESULTS Of the 298 polio cases in the database between January 2014 and May 2017, 41 were included (19 men and 22 women). Mean±SD BMI was 26.0±5.6 kg/m2 (56.1% below 25). Measured REE correlated significantly and positively with weight and weaker with BMI. Correlations between measured and estimated REE were strong (between 0.49 and 0.59); correlations were strongest for the simplified World Health Organization and the Harris and Benedict equations. However, the equations systematically overestimated REE by more than 20%, especially in men. We calculated a correction factor for the World Health Organization scale: -340.3 kcal/d for women and -618.8 kcal/d for men. CONCLUSION Analysis of REE is important for polio survivors; The use of estimation equations could lead to the prescription of a nonadapted diet. We determined a correction factor that should be validated in prospective studies.
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Affiliation(s)
- François Genêt
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France.
| | - Marjorie Salga
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Gratiane De Brier
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Arnaud-Xavier Jouvion
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Guillaume Genêt
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Département Parasport Santé, Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Frédéric Lofaso
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France; Service d'explorations fonctionnelles, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Hélène Prigent
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Service d'explorations fonctionnelles, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Maxime Obrecht
- Service de médecine physique et de réadaptation, Hôpital d'Instruction des Armées Laveran, Marseille, France
| | - Sophie Dziri
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; UPOH (Unité Péri Opératoire du Handicap, Perioperative Disability Unit), Service de médecine physique et de réadaptation, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris (AP-HP), Garches, France
| | - Laurent Théfenne
- Université Versailles-Saint-Quentin-en-Yvelines, "End:icap" U1179 Inserm, UFR des sciences de la santé-Simone-Veil, Versailles, France; Military Educational Establishment of the Army Health Service, Ecole du Val de Grâce, 1 Pl. Alphonse Laveran, 75005 Paris, France
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23
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Pfausler B, Rass V, Lindner A. [Infections of the spinal cord and adjacent structures]. Nervenarzt 2023; 94:287-295. [PMID: 36820856 PMCID: PMC9948794 DOI: 10.1007/s00115-023-01439-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/24/2023]
Abstract
Inflammation of the spinal cord and the adjacent structures can be caused by viruses, bacteria, fungi and parasites. Viruses predominantly infect the spinal cord and the nerve roots directly or trigger a secondary immune response, whereas bacteria, fungi and parasites tend to form abscesses, granulomas and cysts and can lead to a secondary compression of the spinal cord, similar to a destructive osteomyelitis. The etiological clarification of an acute or subacute spinal process is carried out based on the clinical presentation, the time course of the development of symptoms, the immune status, neuroimaging and microbial and/or molecular biological examinations of cerebrospinal fluid and serum. The tropism of individual pathogens to certain fiber structures and cellular clusters in the spinal cord in synopsis with the clinical presentation, neuroimaging and a history of exposure, can often quickly lead to a focused clarification and diagnosis. This article deals with important pathogens of spinal and paraspinal infections, the geographical distribution, the clinical and neuroimaging presentation with special consideration of the anatomical and topographical localization and recent epidemiological developments. Particular attention is paid to the outbreak of poliomyelitis due to circulating vaccine-derived poliovirus (cVDPV).
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Affiliation(s)
- Bettina Pfausler
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
| | - Verena Rass
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - Anna Lindner
- Universitätsklinik für Neurologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
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24
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Li S, Chen X, Li S, Weng X, Lin J, Jin J, Qian W. Total Hip Arthroplasty in the Nonparalytic Limb of Residual Poliomyelitis Patients: A Propensity Score Matched Study. Orthop Surg 2023; 15:1037-1044. [PMID: 36810876 PMCID: PMC10102314 DOI: 10.1111/os.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE Poliomyelitis is a rare neuromuscular disease that can cause hip osteoarthritis on the contralateral side due to an abnormal mechanical weight-bearing state, making some residual poliomyelitis patients candidates for total hip arthroplasty (THA). The aim of this study was to investigate the clinical outcome of THA in the nonparalytic limbs of these patients compared with those of non-poliomyelitis patients. METHODS Patients treated between January 2007 and May 2021 were retrospectively identified in a single center arthroplasty database. Eight residual poliomyelitis cases that met the inclusion criteria were matched to non-poliomyelitis cases in a ratio of 1:2 based on age, sex, body mass index (BMI), age-adjusted Charlson comorbidity index (aCCI), surgeon, and operation date. The hip function, health-related quality of life, radiographic outcomes, and complications were analyzed with unpaired Student's t test, Mann-Whitney test, Fisher's exact test or analysis of covariance (ANCOVA). Survivorship analysis was determined using the Kaplan-Meier estimator analysis and Gehan-Breslow-Wilcoxon test. RESULTS After a mean follow-up of about 5 years, patients with residual poliomyelitis had worse postoperative mobility outcomes(P < 0.05), but there was no difference in total modified Harris hip score (mHHS) or European quality of life-visual analogue scale (EQ-VAS) between the two groups (P > 0.05). There was no difference in radiographic outcomes or complications between the two groups, and patients had similar postoperative satisfaction (P > 0.05). No readmission or reoperation occurred in the poliomyelitis group (P > 0.05), but the postoperative limb length discrepancy (LLD) in the residual poliomyelitis group was greater than that in the control group (P < 0.05). CONCLUSION Functional outcomes, health-related quality of life improvement were similarly significantly improved in the nonparalytic limb of residual poliomyelitis patients after THA compared with conventional osteoarthritis patients. However, the residual LLD and weak muscle strength of the affected side will still influence mobility, so residual poliomyelitis patients should be fully informed of this outcome before surgery.
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Affiliation(s)
- Songlin Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xi Chen
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shanni Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xisheng Weng
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin Lin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin Jin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenwei Qian
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chineses Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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25
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Al-Tawfiq JA, Kattan RF, Almoallem SAS, Altawfiq KJ, Mohsni E, Memish ZA. Worldwide poliomyelitis outbreaks: should mass gathering organizers be concerned? J Travel Med 2023; 30:6798397. [PMID: 36331257 DOI: 10.1093/jtm/taac128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/14/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
The polio is the longest PHEIC and the continued occurrence of outbreaks of cVDPV would put further risks globally. The binary nature of PHEIC declarations would not support the continued polio PHEIC due to the requirement of tiered or graded strategies to combat such diseases.
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Affiliation(s)
- Jaffar A Al-Tawfiq
- Infectious Disease Unit, Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
- Division of Infectious Diseases, Johns Hopkins University, Baltimore, MD, USA
| | - Rana F Kattan
- Division Head Inpatient General Pediatrics, Pediatric Department, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia
| | | | | | - Ezzeddine Mohsni
- Programme Essaha Aziza, Union Européenne, Pôle Centre, Tunisie, Tunisia
| | - Ziad A Memish
- Al-Faisal University, Riyadh, Saudi Arabia
- King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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26
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Grassly NC, Andrews N, Cooper G, Stephens L, Waight P, Jones CE, Heath PT, Calvert A, Southern J, Martin J, Miller E. Effect of maternal immunisation with multivalent vaccines containing inactivated poliovirus vaccine (IPV) on infant IPV immune response: A phase 4, multi-centre randomised trial. Vaccine 2023; 41:1299-1302. [PMID: 36690561 DOI: 10.1016/j.vaccine.2023.01.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/22/2023]
Abstract
Multivalent diphtheria, tetanus, acellular pertussis and inactivated poliovirus vaccine (DTaP/IPV) has been offered to pregnant women in the United Kingdom since 2012. To assess the impact of maternal DTaP/IPV immunisation on the infant immune response to IPV, we measured poliovirus-specific neutralising antibodies at 2, 5 and 13 months of age in a randomised, phase 4 study of Repevax or Boostrix/IPV in pregnancy and in a non-randomised group born to women not given DTaP/IPV in pregnancy. Infants whose mothers received DTaP/IPV were less likely to seroconvert after three IPV doses than those whose mothers did not receive DTaP/IPV. At 13 months of age, 63/110 (57.2 %), 46/108 (42.6 %) and 40/108 (37.0 %) were seropositive to types 1 to 3, compared with 20/22 (90.9 %), 20/22 (90.9 %) and 14/20 (70.0 %) (p-values 0.003, <0.001 and 0.012). UK infants whose mothers are given DTaP/IPV in pregnancy may be insufficiently protected against poliomyelitis until their pre-school booster.
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Affiliation(s)
- Nicholas C Grassly
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, UK.
| | - Nick Andrews
- Statistics and Modelling Economics Department, United Kingdom Health Security Agency (UKHSA), UK
| | - Gillian Cooper
- National Institute of Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency, UK
| | - Laura Stephens
- National Institute of Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency, UK
| | - Pauline Waight
- Immunisation and Countermeasures, National Infection Service, UKHSA, London, UK
| | - Christine E Jones
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, St George's, University of London, London, UK; Faculty of Medicine and Institute for Life Sciences, University of Southampton and National Institute for Health and Care Research (NIHR) Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Paul T Heath
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, St George's, University of London, London, UK; St George's University Hospitals NHS Foundation Trust, London, UK
| | - Anna Calvert
- Centre for Neonatal and Paediatric Infection & Vaccine Institute, St George's, University of London, London, UK; St George's University Hospitals NHS Foundation Trust, London, UK
| | - Jo Southern
- Vaccines Medical Development, Scientific and Clinical Affairs, Pfizer Inc, Collegeville, PA, USA
| | - Javier Martin
- National Institute of Biological Standards and Control (NIBSC), Medicines and Healthcare products Regulatory Agency, UK
| | - Elizabeth Miller
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London WC1E 7HT, UK
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Truschkat A, Poller M, Berli M, Hasler P. [Think Interdisciplinary to Improve a Complex Multifactorial Gait Disorder of a 28-Year-Old Polio Patient]. Praxis (Bern 1994) 2023; 112:111-116. [PMID: 36722112 DOI: 10.1024/1661-8157/a003986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Think Interdisciplinary to Improve a Complex Multifactorial Gait Disorder of a 28-Year-Old Polio Patient Abstract. Poliomyelitis with the resulting paralytic sequelae is hardly present in Switzerland anymore and if so, only in elderly persons. The last reported case of poliomyelitis in Switzerland was received by the FOPH in 1982. A 28-year-old patient with paralytic poliomyelitis is extremely rare in this country. A combined multifactorial gait disorder with symptomatic hip dysplasia, pronounced leg length shortening and axial malalignment of the leg on the polio-affected side make this case unique and a special interdisciplinary challenge.
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Affiliation(s)
| | | | - Martin Berli
- Technische Orthopädie, Universitätsklinik Balgrist, Zürich, Schweiz
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28
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Niaz F, Tariq S, Rana MS, Nashwan AJ, Fatima I, Afzal Y, Tariq R. The resurgence of polio: The effect of the Covid-19 pandemic on polio eradication. Ethics Med Public Health 2023; 26:100858. [PMID: 36471883 PMCID: PMC9710480 DOI: 10.1016/j.jemep.2022.100858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 11/20/2022] [Indexed: 06/17/2023]
Affiliation(s)
- F Niaz
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - S Tariq
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - M S Rana
- National Institute of Health, Islamabad, Pakistan
| | - A J Nashwan
- Hamad Medical Corporation, P.O. Box 3050, Doha, Qatar
| | - I Fatima
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Y Afzal
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - R Tariq
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
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29
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Batson A, Glassman A, Federgruen A, Diment J, Ganguly NK, Makoni S, Plotkin S. The world needs to prepare now to prevent polio resurgence post eradication. BMJ Glob Health 2022; 7:bmjgh-2022-011485. [PMID: 36581335 PMCID: PMC9806073 DOI: 10.1136/bmjgh-2022-011485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/10/2022] [Indexed: 12/31/2022] Open
Affiliation(s)
- Amie Batson
- Executive Director, WomenLift Health, Seattle, Washington, USA
| | - Amanda Glassman
- Executive Vice President, Center for Global Development, Washington, DC, USA
| | - Awi Federgruen
- Chair of the Decision, Risk, and Operations (DRO) Division, Columbia University, New York, New York, USA
| | - Judith Diment
- Coordinator of Polio Eradication Advocacy Task Force, UK National Advocacy Adviser for Polio, Rotary International, London, UK
| | - Nirmal Kumar Ganguly
- Former Director General, Indian Council of Medical Research (ICMR), Delhi, India
| | - Simba Makoni
- Former Minister, Ministry of Finance and Economic Development, Harare, Zimbabwe
| | - Stanley Plotkin
- Emeritus Professor at the Wistar Institute, Vaccinologist, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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30
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O’Driscoll CS, Hughes AJ, Davey MS, Queally JM, O’Daly BJ. Total Hip Arthroplasty in Patients With Neurological Conditions: A Systematic Review. Arthroplast Today 2022; 19:101068. [PMID: 36568851 PMCID: PMC9768244 DOI: 10.1016/j.artd.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/20/2022] [Accepted: 11/01/2022] [Indexed: 12/14/2022] Open
Abstract
Background As operative techniques and implant design have evolved over time, total hip arthroplasty (THA) is increasingly being carried out for patients with neurological impairment. This patient group places unique surgical challenges to the arthroplasty surgeon, which may include contractures, instability, and altered muscular tone. The purpose of this systematic review is to report the patient outcomes, complications, and implant survival following THA for patients with neurological conditions affecting the hip. Thus, we aim to support orthopaedic surgeon decision-making when considering and planning THA for these patients. Methods A systematic review was performed as per Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using the PubMed/Medline OVID, Cochrane, and Embase databases. All studies reporting the outcomes of THA in the neurological population which met defined inclusion criteria were included. Results From an initial screen of 1820 studies, 45 studies with a total of 36,251 THAs were included in the final selection. All 45 studies reported complication rates, with controls included in 16 for comparison. High complication rates were observed following THA in the neurologically impaired population, most notably dislocation with observed rates up to 10.6%. An improvement was noted in all 36 studies (1811 THAs) which reported upon patient-reported outcomes. Conclusions THA may be beneficial in the selected patients with neurological conditions, to reduce pain and improve function. There is an increased risk of complications which require careful consideration when planning the operation and open discussion with prospective patients and caregivers before proceeding with surgery.
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Affiliation(s)
- Conor S. O’Driscoll
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin, Ireland,Department of Trauma & Orthopaedics, Galway University Hospital, Galway, Ireland,Department of Trauma & Orthopaedics, Royal College of Surgeons Ireland, Dublin, Ireland,Corresponding author. Tallaght University Hospital, Dublin, Ireland. Tel.: +353857884714.
| | - Andrew J. Hughes
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin, Ireland,Department of Trauma & Orthopaedics, Royal College of Surgeons Ireland, Dublin, Ireland,Rothman Orthopedic Institute, Thomas Jefferson University Hospital, PA, USA
| | - Martin S. Davey
- Department of Trauma & Orthopaedics, Galway University Hospital, Galway, Ireland,Department of Trauma & Orthopaedics, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Joseph M. Queally
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin, Ireland,Department of Trauma & Orthopaedics, St James Hospital, Dublin, Ireland,School of Medicine, University College Dublin, Dublin, Ireland
| | - Brendan J. O’Daly
- Department of Trauma & Orthopaedics, Tallaght University Hospital, Dublin, Ireland,Department of Trauma & Orthopaedics, Royal College of Surgeons Ireland, Dublin, Ireland,School of Medicine, University College Dublin, Dublin, Ireland
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31
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Castilletti C, Capobianchi MR. Polio is back? The risk of poliomyelitis recurrence globally, and the legacy of the severe acute respiratory syndrome coronavirus 2 pandemic. Clin Microbiol Infect 2022; 29:414-416. [PMID: 36503117 PMCID: PMC9731642 DOI: 10.1016/j.cmi.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/22/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Concetta Castilletti
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy
| | - Maria Rosaria Capobianchi
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Verona, Italy.
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32
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Claire Endegue M, Sein C, Lopez Cavestany R, Jeyaseelan V, Palmer T, Norbert Soke G, Diaha A, Jafri B, Mainou BA, Verma H, Mach O. Community-based survey to assess seroprevalence of poliovirus antibodies in far-north Cameroon in 2020. Vaccine X 2022; 12:100244. [PMID: 36560978 PMCID: PMC9763508 DOI: 10.1016/j.jvacx.2022.100244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/28/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Background This study assessed seroprevalence of poliovirus antibodies in children from selected poliovirus high-risk areas of the Far North region of Cameroon which serves to monitor polio immunization program. Methods This was a community-based cross-sectional seroprevalence survey involving collection of dried blood specimens (DBS) among children aged 12-59 months (n = 401). Multi-stage cluster sampling using GIS was applied to select the study sample. Collected DBS were analysed with microneutralization assays for poliovirus neutralizing antibody levels. Results The overall seroprevalence of types 1, 2 and 3 neutralizing antibodies were 86.8 % (95 % confidence interval [CI]: 83.1-89.8), 74.6 % (95 % CI: 70.1-78.6) and 79.3 % (95 % CI: 75.1-83.0), respectively. Median titers (log2 scale) for type 1, 2 and 3 were 7.17 (6.5-7.5), 5.17 (4.83-5.5), and 6.17 (5.5-6.5), respectively. There was an increasing trend in median titers and seroprevalence with age, statistically significant between the youngest and oldest age groups (p < 0.001). Conclusion Though there were several opportunities for vaccination through supplementary immunization activities (SIA) and routine immunization (RI), seroprevalence levels were low for all three serotypes, particularly for type 2. This highlights the need to strengthen RI and SIA quality coverage. Low population immunity makes Cameroon vulnerable to new importations and spread of polioviruses.
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Affiliation(s)
| | - Carolyn Sein
- Polio Eradication, World Health Organization HQ, 1211 Geneva, Switzerland
| | | | - Visalakshi Jeyaseelan
- Polio Eradication, World Health Organization HQ, 1211 Geneva, Switzerland,Corresponding author at: Polio Department, World Health Organization, Avenue Appia 20, CH-1211 Genève 27, Switzerland.
| | - Tess Palmer
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Gnakub Norbert Soke
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Aissata Diaha
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Basit Jafri
- Population Immunity Laboratory, Polio and Picornavirus Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Bernardo A. Mainou
- Population Immunity Laboratory, Polio and Picornavirus Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
| | - Harish Verma
- Polio Eradication, World Health Organization HQ, 1211 Geneva, Switzerland
| | - Ondrej Mach
- Polio Eradication, World Health Organization HQ, 1211 Geneva, Switzerland
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Martini M, Orsini D. The fight against poliomyelitis through the history: past, present and hopes for the future. Albert Sabin's missing Nobel and his "gift to all the world's children". Vaccine 2022; 40:6802-6805. [PMID: 36244880 DOI: 10.1016/j.vaccine.2022.09.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/06/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
Polio, or poliomyelitis, is a disabling and life-threatening disease caused by three poliovirus (PV) serotypes. The virus spreads from person to person and can infect a person's spinal cord, causing paralysis. In 1988, when the WHO registered 350,000 cases of poliomyelitis in the world and 70,000 which occurred in Africa alone, global poliomyelitis eradication was proposed by the World Health Organization to its member States. On 25 August 2020, while the world was waging war against the Coronavirus pandemic, a historic milestone was reached: Africa was officially declared polio-free. It is an important result obtained thanks to an intensive large-scale vaccination campaign. The road was far from smooth, nevertheless, according to the WHO, a great effort needs to be made in order to facilitate access to vaccination and to promote its implementation in those countries where coverage is low and vaccine hesitancy is high because the risk of the spread of poliomyelitis is still relevant. Eradication of the virus in Africa provides us with an excellent opportunity to commemorate the many scientists who contributed to achieving this epoch-making goal: first of all, Jonas Salk, who developed a killed-virus vaccine in 1952, and, especially, Albert Sabin, who in 1961 launched programs of mass immunisation with his oral vaccine against poliomyelitis.
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Affiliation(s)
- Mariano Martini
- Departmentof Health Sciences, University of Genoa, Genoa, Italy; UNESCOCHAIR "Anthropology of Health - Biosphere and Healing System" - University of Genoa, Genoa, Italy.
| | - Davide Orsini
- University Museum System of Siena (Simus), History of Medicine, University of Siena, Siena, Italy
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34
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Kohanzadeh A, Somogyi DZ, Kravitz MB. Tonsillectomy and poliomyelitis: Development of causality. Int J Pediatr Otorhinolaryngol 2022; 162:111290. [PMID: 36067711 DOI: 10.1016/j.ijporl.2022.111290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/07/2022] [Accepted: 08/14/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE This paper serves to review the historical progression of clinical, epidemiological and immunological evidence on the relationship between tonsillectomy and poliomyelitis and its influence on clinical medicine. METHODS A literature review was conducted using terms relating to poliomyelitis, tonsillectomy, and immunology. Primary sources published between 1900 and 2000 were reviewed, analyzed and evaluated based on their historical, clinical, epidemiological, scientific and immunological pertinence towards the relationship between tonsillectomy, and poliomyelitis during epidemics. RESULTS The first study proposing a relationship between poliomyelitis and tonsillectomy was a case report published in 1910 by Phillip Sheppard. In response, other physicians began conducting clinical and epidemiological studies investigating the relationship between recent tonsillectomy and poliomyelitis in children. While the results of many of these studies demonstrated an increased morbidity and mortality rate associated with poliomyelitis in children who underwent recent tonsillectomy, other studies claimed there was no connection. Opposing study results and diverging physician views on this relationship left the medical community divided on whether to recommend against elective tonsillectomies during poliomyelitis outbreaks. The relationship between tonsillectomy and poliomyelitis was established after many years of clinical and epidemiological studies. Further scientific and immunological investigations revealed the causal nature of this relationship.
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Affiliation(s)
- Avraham Kohanzadeh
- Albert Einstein College of Medicine, Bronx, New York, USA; Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA.
| | | | - Meryl B Kravitz
- Albert Einstein College of Medicine, Bronx, New York, USA; Department of Otorhinolaryngology - Head and Neck Surgery, Montefiore Medical Center, Bronx, New York, USA
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Quarleri J. Poliomyelitis is a current challenge: long-term sequelae and circulating vaccine-derived poliovirus. GeroScience 2022; 45:707-717. [PMID: 36260265 PMCID: PMC9886775 DOI: 10.1007/s11357-022-00672-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/12/2022] [Indexed: 02/03/2023] Open
Abstract
For more than 20 years, the World Health Organization Western Pacific Region (WPR) has been polio-free. However, two current challenges are still polio-related. First, around half of poliomyelitis elderly survivors suffer late poliomyelitis sequelae with a substantial impact on daily activities and quality of life, experiencing varying degrees of residual weakness as they age. The post-polio syndrome as well as accelerated aging may be involved. Second, after the worldwide Sabin oral poliovirus (OPV) vaccination, the recent reappearance of strains of vaccine-derived poliovirus (VDPV) circulating in the environment is worrisome and able to persistent person-to-person transmission. Such VDPV strains exhibit atypical genetic characteristics and reversed neurovirulence that can cause paralysis similarly to wild poliovirus, posing a significant obstacle to the elimination of polio. Immunization is essential for preventing paralysis in those who are exposed to the poliovirus. Stress the necessity of maintaining high vaccination rates because declining immunity increases the likelihood of reemergence. If mankind wants to eradicate polio in the near future, measures to raise immunization rates and living conditions in poorer nations are needed, along with strict observation. New oral polio vaccine candidates offer a promissory tool for this goal.
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Affiliation(s)
- Jorge Quarleri
- Instituto de Investigaciones Biomédicas en Retrovirus y Sida (INBIRS), Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina. .,Consejo de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina.
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36
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Orsini D, Bianucci R, Galassi FM, Lippi D, Martini M. Vaccine hesitancy, misinformation in the era of Covid-19: Lessons from the past. Ethics Med Public Health 2022; 24:100812. [PMID: 35721377 PMCID: PMC9189098 DOI: 10.1016/j.jemep.2022.100812] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 06/01/2022] [Indexed: 11/20/2022]
Abstract
Background As the world has challenged/argued with the Covid-19 pandemic over the last two years, there has been an increase in vaccine misinformation. Although immunity against Covid-19 infection is limited to 4-6 months and requires at least three doses of vaccine to be maximally effective, the current vaccination campaign in industrialized countries shows that vaccinated citizens experience greater immunological protection against severe forms of the disease than unvaccinated citizens. Methodology A perusal of the literature was performed in order to reconstruct the communication methods applied in the managing of the Covid-19 pandemic; the management of the current pandemic was compared with the management of another scourge of the past: poliomyelitis. Results/Discussion In order to raise public awareness on public health issues, it is essential that governments and institutions communicate scientific data to all sections of the population in an unambiguous way. In this sense, it is essential to apply "prebunking", which is a layered defense system available to society that prevents misinformation before it is spread. This is to avoid the subsequent debunking of false information, which generates insecurity and fuels fears. Belief in medical misinformation represents a meaningful problem for public health efforts to fight Covid-19 through vaccination. Conclusion/Perspectives In this sense an example of proper management of one of the many epidemics of the recent past, poliomyelitis, should make us reflect on the effectiveness of past approaches. This testimony from the past can provide us with food for thought regarding how to face the present Covid-19 pandemic and to prepare for the future. Certainly, it shows us how the awful pandemics/epidemics from the past was handled and finally overcome, despite perceived risk and vaccine hesitancy.
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Affiliation(s)
- D Orsini
- University Museum System of Siena (SIMUS), History of Medicine, University of Siena, Siena, Italy
| | - R Bianucci
- Department of Cultures and Societies, University of Palermo, Palermo, Italy
- The Ronin Institute, Montclair, New Jersey, USA
| | - F M Galassi
- Archaeology, College of Humanities, Arts and Social Sciences, Flinders University, Adelaide, SA, Australia
| | - D Lippi
- Department of Experimental and Clinical Medicine, School of Sciences of Human Health, University of Florence, 50134 Florence, Italy
| | - M Martini
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Digennaro V, Manzetti M, Bulzacki Bogucki BD, Barile F, Panciera A, Viroli G, Ferri R, Cecchin D, Ruffilli A, Faldini C. Total knee replacements using rotating hinge implants in polio patients: clinical and functional outcomes. Musculoskelet Surg 2022:10.1007/s12306-022-00755-w. [PMID: 35947326 DOI: 10.1007/s12306-022-00755-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/19/2022] [Indexed: 10/15/2022]
Abstract
Little evidences are available in the literature concerning the outcomes of total knee replacement (TKR) in poliomyelitis patients with severe knee deformities or degeneration. Encouraging results have been reported concerning the use of constrained implants, i.e., rotating hinge knee prosthesis (RHK), compared to less constrained ones. The purpose of this paper is to report our experience with rotating hinge total knee replacement, using only RHK prosthesis, to determine functional results, complications, and survival of TKR in poliomyelitis patients. We performed a retrospective chart review of 14 patients with a history of knee osteoarthritis following poliomyelitis that underwent primary TKR, for a total of 15 surgical procedure (one bilateral case). Preoperative and postoperative clinical measurements have been conducted for all patients using the Knee Society Score (KSS). Hip-knee angle, recurvatum knee angle, and Insall-Salvati index were evaluated with full weight-bearing panoramic view X-ray preoperatively and postoperatively. The 2-year postoperative clinical KSS significantly improved from the preoperative scores. The average clinical KSS improved from 32,9 (range 3-48) preoperatively to 77,4 (range 60-88) postoperatively (P value < 0.005). The average functional KSS improved from 32,5 (range 10-60) preoperatively to 59,4 (range 30-95) postoperatively (P value < 0.005). TKR is a successful treatment in improving knee function and patient's quality of life. Using constrained implants, especially rotating hinge implants in polio patients with a quadriceps muscle weakness, could be a good alternative to maintain a physiological kinematics and reducing the revision rate due to knee instability.
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Affiliation(s)
- V Digennaro
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - M Manzetti
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
| | - B D Bulzacki Bogucki
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy.
| | - F Barile
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - A Panciera
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - G Viroli
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - R Ferri
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - D Cecchin
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - A Ruffilli
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
| | - C Faldini
- IRCCS Istituto Ortopedico Rizzoli, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy
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Walusinski O. Arnold Netter Netter (1855-1936) and infectious pathology of the nervous system. Rev Neurol (Paris) 2022; 178:872-877. [PMID: 35851484 DOI: 10.1016/j.neurol.2022.02.460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/25/2022] [Indexed: 11/15/2022]
Abstract
Arnold Netter (1855-1936) was a paediatrician who clinically applied the progress that his Pasteurian contemporaries had made possible through their bacteriological discoveries. From a neurological point of view, he brought looking for Kernig's sign into mainstream use to confirm the clinical diagnosis of meningitis and made diagnostic lumbar puncture systematic. He was one of the first to cure meningococcal and pneumococcal meningitis, long before the era of antibiotics, using subtractive lumbar puncture and intraspinal serotherapy. Netter's attentive vigilance enabled him to recognise, from its onset, the first poliomyelitis epidemic of the 20th century which took place in the summer of 1909. He described the clinical and epidemiological characteristics, identifying the viral rather than microbial origin. Netter detected the first cases of encephalitis lethargica in Paris in 1918. The disease had been described by Constantin von Economo (1876-1931) in Vienna the previous year. Netter spent fifteen years studying this new disease, which caused a pandemic a century ago. He filled in the clinical picture and used his understanding of cerebrospinal fluid and pathological anatomy to enhance knowledge and improve treatment of this neurological pathology.
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Affiliation(s)
- O Walusinski
- Private practice, Lauréat de l'Académie de Médecine, 20, rue de Chartres, 28160 Brou, France.
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Sáinz MP, Pelayo R, Laxe S, Castaño B, Capdevilla E, Portell E. Describing post-polio syndrome. Neurologia 2022; 37:346-354. [PMID: 31103313 DOI: 10.1016/j.nrl.2019.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Patients presenting sequelae of poliomyelitis may present new symptoms, known as post-polio syndrome (PPS). OBJECTIVE To identify the clinical and functional profile and epidemiological characteristics of patients presenting PPS. PATIENTS AND METHODS We performed a retrospective study of 400 patients with poliomyelitis attended at the Institut Guttmann outpatient clinic, of whom 310 were diagnosed with PPS. We describe patients' epidemiological, clinical, and electromyographic variables and analyse the relationships between age of poliomyelitis onset and severity of the disease, and between sex, age of PPS onset, and the frequency of symptoms. RESULTS PPS was more frequent in women (57.7%). The mean age at symptom onset was 52.4 years, and was earlier in women. Age at primary infection >2 years was not related to greater poliomyelitis severity. The frequency of symptoms was: pain in 85% of patients, loss of strength in 40%, fatigue in 65.5%, tiredness in 57.8%, cold intolerance in 20.2%, dysphagia in 11.7%, cognitive complaints in 9%, and depressive symptoms in 31.5%. Fatigue, tiredness, depression, and cognitive complaints were significantly more frequent in women. Fifty-nine percent of patients presented electromyographic findings suggestive of PPS. CONCLUSIONS While the symptoms observed in our sample are similar to those reported in the literature, the frequencies observed are not. We believe that patients' clinical profile may be very diverse, giving more weight to such objective parameters as worsening of symptoms or appearance of weakness; analysis of biomarkers may bring us closer to an accurate diagnosis.
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Affiliation(s)
- M P Sáinz
- Brain Injury Unit of Fundación Institut Guttmann, Institut Universitary de Neurorehabilició adscrit a la UAB, Barcelona, España.
| | - R Pelayo
- Brain Injury Unit of Fundación Institut Guttmann, Institut Universitary de Neurorehabilició adscrit a la UAB, Barcelona, España
| | - S Laxe
- Servicio de Rehabilitación, Institut Guttmann, Barcelona, España
| | - B Castaño
- Servicio de Psiquiatría, Institut Guttmann, Barcelona, España
| | - E Capdevilla
- Servicio de Medicina Interna, Institut Guttmann, Barcelona, España
| | - E Portell
- Servicio de Rehabilitación, Institut Guttmann, Barcelona, España
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40
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Perciaccante A, Asensi V, Cucu AI, Charlier P, Donell ST, Nerlich AG, Bianucci R. War, pandemic and vaccination - Upcoming health problems by the refugee wave in Europe? Vaccine 2022; 40:3096-3097. [PMID: 35473662 DOI: 10.1016/j.vaccine.2022.04.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Antonio Perciaccante
- Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medicine, San Giovanni di Dio Hospital, Gorizia, Italy; Laboratoire Anthropologie Archéologie Biologie (LAAB), Université Paris-Saclay, UVSQ UFR des Sciences de la Santé, Montigny-le-Bretonneux, France.
| | - Victor Asensi
- Infectious Diseases-HIV Unit, Hospital Universitario Central de Asturias (HUCA), Oviedo University School of Medicine, Translational Research in Infective Pathology Lab, ISPA-FINBA, Oviedo, Spain
| | - Andrei I Cucu
- Prof. Dr. N. Oblu Clinical Emergency Hospital, Department of Neurosurgery, Iasi, Romania
| | - Philippe Charlier
- Laboratoire Anthropologie Archéologie Biologie (LAAB), Université Paris-Saclay, UVSQ UFR des Sciences de la Santé, Montigny-le-Bretonneux, France
| | - Simon T Donell
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Andreas G Nerlich
- Institute of Pathology, Academic Clinic Munich-Bogenhausen, München Klinik GmbH, Munich, Germany
| | - Raffaella Bianucci
- Department of Cultures and Societies, University of Palermo, Italy; The Ronin Institute, Montclair, NJ, USA
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41
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Wanke AT, Bruns F. [The 1960 poliomyelitis vaccination campaign in the GDR using the example of the city of Halle (Saale): historical experiences and problems]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2022; 65:718-724. [PMID: 35575809 PMCID: PMC9109446 DOI: 10.1007/s00103-022-03538-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
In den 1950er-Jahren stellte das epidemische Auftreten der spinalen Kinderlähmung (Poliomyelitis) die Gesundheitssysteme weltweit vor große Herausforderungen. Da eine kausale Therapie der Viruserkrankung nicht existierte, kam der Expositionsprophylaxe eine besondere Bedeutung zu. Letztlich gelang es erst durch die Entwicklung von Impfstoffen, die spinale Kinderlähmung nachhaltig zurückzudrängen. In der Deutschen Demokratischen Republik (DDR) wurde 1960 erstmals in Deutschland die Schluckimpfung nach Sabin-Tschumakow verabreicht, mit der binnen eines Jahres die nahezu vollständige Eradikation der spinalen Kinderlähmung in der DDR gelang. Der Artikel zeichnet anhand von unveröffentlichtem Archivmaterial die systematisch angelegte Impfaktion am Beispiel der damaligen Bezirkshauptstadt Halle (Saale) nach. Allein dort wurden im Mai 1960 innerhalb von 3 Tagen 63.328 Kinder und Jugendliche immunisiert. Bei 78.085 im Vorfeld erfassten Impflingen entsprach dies einer Quote innerhalb der poliovulnerablen Bevölkerungsgruppe von rund 81 %. Die Quellen zeigen, dass die staatliche Struktur des Gesundheitswesens der DDR und das Prinzip der aufsuchenden Impfung zum Erfolg der Impfaktion beitrugen.
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Affiliation(s)
- Anne Thordis Wanke
- Institut für Geschichte und Ethik der Medizin, Profilzentrum Gesundheitswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Florian Bruns
- Institut für Geschichte und Ethik der Medizin, Profilzentrum Gesundheitswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland. .,Institut für Geschichte der Medizin, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
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Shing SLH, Murad A, Lope J, Hardiman O, Bede P. Cerebellar remodelling decades after spinal cord insult: neuroplasticity in poliomyelitis survivors. J Integr Neurosci 2022; 21:65. [PMID: 35364653 DOI: 10.31083/j.jin2102065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The cerebellum integrates a multitude of motor and cognitive processes through ample spinal and supratentorial projections. Despite emerging evidence of adaptive neuroplasticity, cerebellar reorganisation in response to severe spinal insult early in life is poorly characterised. The objective of this study is the systematic characterisation of cerebellar integrity metrics in a cohort of adult poliomyelitis survivors as a template condition for longstanding lower motor neuron injury. METHODS A total of 143 participants, comprising 43 adult poliomyelitis survivors and 100 age- and sex-matched healthy controls were recruited in a prospective, single-centre neuroimaging study with a uniform structural and diffusion imaging protocol. First, standard voxelwise grey and white matter analyses were performed. Then, the cerebellum was anatomically segmented into lobules, and cortical thickness and grey matter volumes were evaluated in each lobule. The integrity of cerebellar peduncles was also assessed based on their diffusivity profiles. RESULTS Compared to healthy controls, poliomyelitis survivors exhibited greater cortical thickness in lobules I, II, and III in the right hemisphere and in lobules VIIIA and VIIIB bilaterally. A trend of higher cortical thickness was also detected lobules I, II and III in the left hemisphere. Enhanced cerebellar peduncle organisation was detected, particularly within the middle cerebellar peduncles. CONCLUSIONS Increased cerebellar integrity measures in poliomyelitis survivors are primarily identified in lobules associated with sensorimotor functions. The identified pattern of cerebellar reorganisation may represent compensatory changes in response to severe lower motor neuron injury in childhood and ensuing motor disability.
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Affiliation(s)
- Stacey Li Hi Shing
- Computational Neuroimaging Group, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Trinity College Dublin, D02 PN40 Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity College Dublin, D02 PN40 Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, 53400 Paris, France
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Kozakaitė J, Jakulis M, Brindzaitė R, Miliauskienė Ž, Piombino-Mascali D, Jankauskas R. A possible case of paralysis in early modern Vilnius and the implications for social care. Int J Paleopathol 2022; 36:14-23. [PMID: 34839076 DOI: 10.1016/j.ijpp.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/13/2021] [Accepted: 09/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To present a case of possible paralysis from early modern Vilnius and to discuss the potential level of care that was provided in the society of that time. MATERIALS A partially disturbed skeleton of a young female from a 16th-17th century Orthodox Christian cemetery. METHODS Macroscopic, osteometric and X-ray examinations coupled with a literature review aimed at providing a differential diagnosis. RESULTS The skeletal remains showed signs of disuse atrophy most probably due to a neurological disorder acquired in the woman's late teens. Differentials suggest that the observed limb atrophy was most likely a consequence of poliomyelitis. CONCLUSIONS The case of a young female with paralysis presented in this paper could serve as an example of care provided by her household. SIGNIFICANCE This study substantially contributes to further understanding of the nature and quality of care provided to disabled individuals in their households even in the absence of written sources. LIMITATIONS There is a degree of diagnostic ambiguity due to the application of routine clinical criteria to paleopathological cases. SUGGESTIONS FOR FURTHER RESEARCH The article makes several recommendations for future research, e.g., systematic investigation of possible cases of bone atrophy in a broader sociocultural context, as well as searching for evidence of gastrointestinal infections, especially poliomyelitis, supplemented by the application of biomolecular technologies.
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Affiliation(s)
- Justina Kozakaitė
- Department of Anatomy, Histology, and Anthropology, Vilnius University, M.K. Čiurlionio 21, Vilnius, 03101, Lithuania.
| | - Martynas Jakulis
- Department of Ancient and Medieval History, Vilnius University, Universiteto 7, Vilnius, 01122, Lithuania.
| | - Rūta Brindzaitė
- Department of Anatomy, Histology, and Anthropology, Vilnius University, M.K. Čiurlionio 21, Vilnius, 03101, Lithuania.
| | - Žydrūnė Miliauskienė
- Department of Anatomy, Histology, and Anthropology, Vilnius University, M.K. Čiurlionio 21, Vilnius, 03101, Lithuania.
| | - Dario Piombino-Mascali
- Department of Anatomy, Histology, and Anthropology, Vilnius University, M.K. Čiurlionio 21, Vilnius, 03101, Lithuania.
| | - Rimantas Jankauskas
- Department of Anatomy, Histology, and Anthropology, Vilnius University, M.K. Čiurlionio 21, Vilnius, 03101, Lithuania.
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Brüggenjürgen B, Braatz F, Greitemann B, Drewitz H, Ruetz A, Schäfer M, Seifert W, Steinfeldt F, Weichold C, Yao D, Stukenborg-Colsman C. Experts' Perceived Patient Burden and Outcomes of Knee-ankle-foot-orthoses (Kafos) Vs. Microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot Orthoses (Mp-sscos). Can Prosthet Orthot J 2022; 5:37795. [PMID: 37614478 PMCID: PMC10443469 DOI: 10.33137/cpoj.v5i1.37795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/10/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patients with neuromuscular knee-instability assisted with orthotic devices experience problems including pain, falls, mobility issues and limited engagement in daily activities. OBJECTIVES The aim of this study was to analyse current real-life burden, needs and orthotic device outcomes in patients in need for advanced orthotic knee-ankle-foot-orthoses (KAFOs). METHODOLOGY An observer-based semi-structured telephone interview with orthotic care experts in Germany was applied. Interviews were transcribed and content-analysed. Quantitative questions were analysed descriptively. FINDINGS Clinical experts from eight centres which delivered an average of 49.9 KAFOs per year and 13.3 microprocessor-stance-and-swing-phase-controlled-knee-ankle-foot orthoses (MP-SSCOs) since product availability participated. Reported underlying conditions comprised incomplete paraplegia (18%), peripheral nerve lesions (20%), poliomyelitis (41%), post-traumatic lesions (8%) and other disorders (13%). The leading observed patient burdens were "restriction of mobility" (n=6), followed by "emotional strain" (n=5) and "impaired gait pattern" (n=4). Corresponding results for potential patient benefits were seen in "improved quality-of-life" (n=8) as well as "improved gait pattern" (n=8) followed by "high reliability of the orthosis" (n=7). In total, experts reported falls occurring in 71.5% of patients at a combined annual frequency of 7.0 fall events per year when using KAFOs or stance control orthoses (SCOs). In contrast, falls were observed in only 7.2 % of MPSSCO users. CONCLUSION Advanced orthotic technology might contribute to better quality of life of patients, improved gait pattern and perceived reliability of orthosis. In terms of safety a substantial decrease in frequency of falls was observed when comparing KAFO and MP-SSCO users.
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Affiliation(s)
- B. Brüggenjürgen
- Institute for Health Services Research and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
| | - F. Braatz
- Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Germany
| | - B. Greitemann
- RehaKlinikum Bad Rothenfelde, Klinik Münsterland, Bad Rothenfelde, Germany
| | - H. Drewitz
- Abteilung Orthetik, Otto Bock HealthCare Deutschland GmbH, Göttingen, Germany
| | - A. Ruetz
- Klinik für Konservative Orthopädie, Katholisches Klinikum Koblenz, Montabaur, Germany
| | - M. Schäfer
- Orthopädie-Technik, Pohlig GmbH, Traunstein, Germany
| | - W. Seifert
- Technische Orthopädie, Seifert Technische Orthopädie GmbH, Bad Krozingen, Germany
| | - F. Steinfeldt
- Fachklinik und Gesundheitszentrum, Johannesbad Raupennest GmbH & Co. KG, Altenberg, Germany
| | - C. Weichold
- Technische Orthopädie, Stiftung Orthopädische Universitätsklinikum, Heidelberg, Germany
| | - D. Yao
- Foot Department and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
| | - C. Stukenborg-Colsman
- Foot Department and Technical Orthopedics, Orthopedic Department - Medical School Hannover (MHH) at DIAKOVERE Annastift Hospital, Hannover, Germany
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45
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Tempfer C. [Vaccinations for pregnant women and women attempting to become pregnant]. Gynakol Endokrinol 2022;:1-8. [PMID: 35125986 DOI: 10.1007/s10304-022-00439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/18/2022]
Abstract
Infektionen sind eine wichtige potenzielle Gefahrenquelle für Schwangere und ihre ungeborenen Kinder. Schwangere und Frauen mit Kinderwunsch sollten sich daher fachkundig darüber beraten lassen, welche Impfungen vor bzw. während einer Schwangerschaft sinnvoll sind. Zur Impfberatung gehören auch Fragestellungen zu Reiseimpfungen, insbesondere wenn das Reiseziel in einem Endemiegebiet für Erkrankungen wie Malaria, Gelbfieber, Tuberkulose, Hepatitis, Human-immunodeficiency-virus-assoziierte Erkrankungen, Leishmaniose, Toxoplasmose und Japanische Enzephalitis liegt. Grundsätzlich können alle Toxoidimpfstoffe, inaktivierten Impfstoffe und Immunglobuline in der Schwangerschaft verabreicht werden, Lebendimpfstoffe sind kontraindiziert. Empfehlenswerte Impfungen in der Schwangerschaft sind Tetanus, Diphtherie, Pertussis im Falle eines fehlenden Impfschutzes, die saisonale Influenzaimpfung und aktuell die Coronavirus-disease-19(COVID-19)-Impfung ab dem zweiten Trimenon. Zu den empfohlenen Reiseschutzimpfungen zählen alle Standardimpfungen, das heißt die Grundimmunisierung gegen Rotaviren, Tetanus, Diphtherie, Pertussis, Haemophilus influenzae Typ B, Poliomyelitis, Hepatitis B, Pneumokokken, Meningokokken, Masern, Mumps, Röteln, Varizellen, humanes Papillomavirus und Influenza. Darüber hinaus hat in der Reisemedizin der Immunschutz gegen Hepatitis A einen hohen Stellenwert. Nach den internationalen Gesundheitsempfehlungen der World Health Organization ist zur Einreise in bzw. Ausreise aus bestimmten Ländern eine zusätzliche spezifische Impfvorschrift für die Gelbfieber- und Poliomyelitisimpfung vorgesehen. Einzelne Länder haben darüber hinaus zusätzliche Impfvorschriften für die Ein- und Ausreise. „Indikationsimpfungen“ setzen ein entsprechendes lokales Risiko voraus.
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Bessaud M. [New oral polio vaccine: A turning point for the global polio eradication initiative?]. Med Trop Sante Int 2021; 1:mtsi.2021.191. [PMID: 35891919 PMCID: PMC9283809 DOI: 10.48327/mtsi.2021.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/15/2021] [Indexed: 11/27/2022]
Abstract
Launched in 1988, the Global Polio Eradication Initiative (GPEI) aims to eradicate polioviruses, which are the etiologic agents of poliomyelitis. Coordinated by the World Health Organization, this program relies on two pillars: mass vaccination campaigns that target children and active surveillance of the virus circulation. The GPEI has led to the eradication of two out of three serotypes of wild polioviruses and to the containment of the last serotype in two countries.Two polio vaccines exist: the injectable vaccine and the oral one. Both induce an efficient protection against poliomyelitis, but only the oral vaccine is able to stop poliovirus transmission chains. Therefore, the oral vaccine is essential to contain polioviruses and, finally, to eradicate them. In some contexts where the vaccine coverage is not sufficient, the attenuated strains contained in the oral vaccine can circulate for months and recover a pathogenic phenotype through genetic drift. In order to prevent this phenomenon, a new vaccine strain has been developed through genetic engineering: it has been designed to be as immunogenic as the historical vaccine strain, but more genetically stable to prevent the loss of its attenuation determinants. After being evaluated in vitro and through clinical trials, the novel strain has been rolled out in several African countries and in Tajikistan in 2021.
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Affiliation(s)
- Maël Bessaud
- Institut Pasteur, Unité pathogenèse & populations virales, 25-28, rue du Dr Roux, 75015 Paris, France
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47
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Tahedl M, Li Hi Shing S, Finegan E, Chipika RH, Lope J, Murad A, Hardiman O, Bede P. Imaging data reveal divergent longitudinal trajectories in PLS, ALS and poliomyelitis survivors: Group-level and single-subject traits. Data Brief 2021; 39:107484. [PMID: 34901337 PMCID: PMC8640870 DOI: 10.1016/j.dib.2021.107484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 01/02/2023] Open
Abstract
Imaging profiles from a longitudinal single-centre motor neuron disease study are presented. A standardized T1-weighted MRI protocol was implemented to characterise cortical disease burden trajectories across the UMN (upper motor neuron) - LMN (lower motor neuron) spectrum of motor neuron diseases (MNDs) (Tahedl et al., 2021). Patients with amyotrophic lateral sclerosis (ALS n = 61), patients with primary lateral sclerosis (PLS n = 23) and poliomyelitis survivors (PMS n = 45) were included. Up to four longitudinal scans were available for each patient, separated by an inter-scan-interval of four months. Individual and group-level cortical thickness profiles were appraised using a normalisation procedure with reference to subject-specific control groups. A z-scoring approach was utilised, where each patients' cortex was first segmented into 1000 cortical regions, and then rated as 'thin', 'thick', or 'comparable' to the corresponding region of a demographically-matched control cohort. Fractions of significantly 'thin' and 'thick' patches were calculated across the entire cerebral vertex as well as in specific brain regions, such as the motor cortex, parietal, frontal and temporal cortices. This approach allows the characterisation of disease burden in individual subjects as well as at a group-level, both cross-sectionally and longitudinally. The presented framework may aid the interpretation of individual cortical disease burden in other patient cohorts.
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Affiliation(s)
- Marlene Tahedl
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland.,Department of Psychiatry and Psychotherapy and Institute for Psychology, University of Regensburg, Germany
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Eoin Finegan
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Aizuri Murad
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Pearse Street Room 5.43, Dublin, Ireland.,Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France
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48
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Gómez-De Lara JL, Rodríguez-Paz CA. [Historical, clinical and epidemiological aspects of poliomyelitis in Mexico (1946-1960)]. Rev Med Inst Mex Seguro Soc 2021; 59:585-590. [PMID: 34913637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/04/2021] [Indexed: 06/14/2023]
Abstract
Poliomyelitis emerged in Europe as an epidemic disease at the end of the 19th century. During the thirties of the twentieth century it reached great intensity in the United States and Canada, but it was after the Second World War when the disease became a serious world public health problem, which punished several countries of the world, including Mexico. Poliomyelitis is a very contagious viral disease that invades the central nervous system (destroys motor neurons) that frightened the Mexican population in the first half of the twentieth century, not so much by high mortality and morbidity figures but by its paralytic sequels, like the disability, and by the fact that it affected one of the most vulnerable population groups: children. The disease mainly affected children under five years of age, being rare in the first months of life of the newborn due to the protective effect of immunity that the mother transfers to the son through breast milk; After eight months, at the end of the feed, the infant could be infected by poliovirus by invading the spinal cord and producing paralysis, most commonly of the legs or trunk. Likewise, it caused a paralysis in the respiratory muscles (diaphragm) of children, who had to help them to breathe since, if not, they were suffocated, so they were introduced in machines commonly known as steel lungs or lungs of Emerson type (machine that allows a person to breathe when he lost control of his respiratory muscles, such as the diaphragm, invented in 1928 by the American engineer Philip Drinker).
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Affiliation(s)
- José Luis Gómez-De Lara
- Universidad de Guadalajara, Centro Universitario de Ciencias Sociales y Humanidades. Zapopan, Jalisco, México
| | - Carlos Agustín Rodríguez-Paz
- Instituto Mexicano del Seguro Social, Hospital General de Zona 50 del IMSS, Servicio de Cirugía. San Luis Potosí, San Luis Potosí, México
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49
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Lahav Y, Avidor S, Levy D, Ohry A, Zeilig G, Lahav M, Golander H, Chacham-Guber A, Uziel O, Defrin R. Shorter telomeres among individuals with physical disability: The moderating role of perceived stress. J Gerontol B Psychol Sci Soc Sci 2021; 77:1384-1393. [PMID: 34687310 DOI: 10.1093/geronb/gbab200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Evidence suggests that individuals with physical disability may suffer from psychological distress and accelerated cellular aging, manifested by shortened telomere length (TL), compared with healthy individuals. Studies indicate that high levels of perceived stress and depression may increase the physiological susceptibility and thus, may contribute to a short TL. However, the moderating role of perceived stress and depression within the relationship between physical disability and TL remains unknown. METHODS The participants consisted of 119 male subjects (mean age 54.36 years, range 35-70). Of them, 30 were able-bodied and 86 had a physical disability: 34 were due to Poliomyelitis (polio) and 55 were due to spinal cord injury (SCI). Blood samples for TL analysis were collected; the participants completed questionnaires and underwent disability evaluation. RESULTS Participants with disability had a shorter TL as well as elevated levels of perceived stress and depression compared with able-bodied controls. Both the perceived stress and depression were correlated with a shorter TL. Nonetheless, perceived stress, rather than depression, moderated the relationship between disability and TL; among participants with higher perceived stress levels, in particular, individuals with physical disability had a shorter TL than the able-bodied controls. DISCUSSION The present findings suggest that individuals with physical disability and who exhibit high levels of perceived stress may be particularly vulnerable for accelerated cellular aging, suggesting that perceived stress can be used as a valuable target for intervention.
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Affiliation(s)
- Yael Lahav
- Department of Occupational Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | - Sharon Avidor
- Faculty of Social and Community Sciences, Ruppin Academic Center
| | - David Levy
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | - Avi Ohry
- Section of Rehabilitation Medicine, Reuth Medical and Rehabilitation Center, Tel Aviv.,Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Chaim Sheba Medical Center, Tel Hashomer.,Department of Rehabilitation, Sackler Faculty of Medicine, Tel Aviv University
| | - Meir Lahav
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva
| | - Hava Golander
- Department of nursing, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University
| | | | - Orit Uziel
- The Felsenstein Medical Research Center, Rabin Medical Center and Tel Aviv University, Petah-Tikva
| | - Ruth Defrin
- Department of Physical Therapy, School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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50
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Tahedl M, Li Hi Shing S, Finegan E, Chipika RH, Lope J, Hardiman O, Bede P. Propagation patterns in motor neuron diseases: Individual and phenotype-associated disease-burden trajectories across the UMN-LMN spectrum of MNDs. Neurobiol Aging 2021; 109:78-87. [PMID: 34656922 DOI: 10.1016/j.neurobiolaging.2021.04.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/29/2021] [Accepted: 04/13/2021] [Indexed: 01/18/2023]
Abstract
Motor neuron diseases encompass a divergent group of conditions with considerable differences in clinical manifestations, survival, and genetic vulnerability. One of the key aspects of clinical heterogeneity is the preferential involvement of upper (UMN) and lower motor neurons (LMN). While longitudinal imaging patters are relatively well characterized in ALS, progressive cortical changes in UMN,- and LMN-predominant conditions are seldom evaluated. Accordingly, the objective of this study is the juxtaposition of longitudinal trajectories in 3 motor neuron phenotypes; a UMN-predominant syndrome (PLS), a mixed UMN-LMN condition (ALS), and a lower motor neuron condition (poliomyelitis survivors). A standardized imaging protocol was implemented in a prospective, multi-timepoint longitudinal study with a uniform follow-up interval of 4 months. Forty-five poliomyelitis survivors, 61 patients with amyotrophic lateral sclerosis (ALS), and 23 patients with primary lateral sclerosis (PLS) were included. Cortical thickness alterations were evaluated in a dual analysis pipeline, using standard cortical thickness analyses, and a z-score-based individualized approach. Our results indicate that PLS patients exhibit rapidly progressive cortical thinning primarily in motor regions; ALS patients show cortical atrophy in both motor and extra-motor regions, while poliomyelitis survivors exhibit cortical thickness gains in a number of cerebral regions. Our findings suggest that dynamic cortical changes in motor neuron diseases may depend on relative UMN and/or LMN involvement, and increased cortical thickness in LMN-predominant conditions may represent compensatory, adaptive processes.
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Affiliation(s)
- Marlene Tahedl
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland; Department of Psychiatry and Psychotherapy and Institute for Psychology, University of Regensburg, 93053 Regensburg, Germany
| | - Stacey Li Hi Shing
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Eoin Finegan
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Rangariroyashe H Chipika
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Jasmin Lope
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Orla Hardiman
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland
| | - Peter Bede
- Computational Neuroimaging Group, Biomedical Sciences Institute, Trinity College Dublin, Ireland; Pitié-Salpêtrière University Hospital, Sorbonne University, Paris, France.
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