Immunogenicity and safety of an inactivated hepatitis A vaccine in Taiwanese adults and children.

The safety and immunogenicity of an inactivated hepatitis A vaccine (AVAXIM, 160 antigen units) was evaluated in 190 subjects: 50 children aged from 2 to 5 years, 70 children aged from 6 to 17 years and 70 adults aged from 18 to 30 years in a monocentric, open, non-controlled, phase III trial conducted in Taipei, Taiwan from December 1996 to October 1997. The vaccine was administered intramuscularly, with a two-dose schedule 6 months apart. Clinical adverse events were monitored during the seven days following each injection. Hepatitis A virus (HAV) antibody titers were measured by modified radioimmunoassay on the day of inclusion and four weeks after both the first dose and booster injection. Among the 190 subjects who received the first dose, 174 (91.6%) were initially HAV seronegative and 16 (8.4%) were HAV seropositive at inclusion. One hundred and seventy-four subjects (91.6%) received the booster dose and completed the study. One month after the first dose, all the subjects, whatever the age, presented HAV antibody titers over 20 mIU/ml. In children (2 to 17 years), the GMT was 136 mIU/ml at week 4 and 7,906 mIU/ml four weeks after the booster dose. In adults (> or = 18 years), GMT values were 93 mIU/ml at week 4 and 3,655 mIU/ml four weeks after the booster. These results show a strong anamnestic response to the second dose of vaccine and are compatible with long-term antibody persistence in each age group. The vaccine was safe and well tolerated. No vaccine-related serious adverse event occurred. No immediate reaction occurred. The majority of the reactions were reported by adults after the primary injection. Local reactions (pain and redness) were reported by 9.0% and 4.0% of the subjects after the primary and the booster doses, respectively. Systemic reactions (mainly myalgia/arthralgia or asthenia) affected less than 10% of the subjects after the first dose and less than 3% after the booster. Results from this study in a Taiwanese population are consistent with those obtained with the same vaccine in previous European studies in children and adults, and suggest that AVAXIM (160 AU) is suitable for use in all subjects aged over 2 years.

Comparison of Plasmodium falciparum infectivity to Anopheles dirus D using direct and indirect blood feeding methods

Membrane feeding method (indirect blood feeding) using defibrinated blood has been established and was found to be as good as the direct feeding method with no singificant differences in the production of oocysts and sporozoites in Anopheles dirus D (p > 0.05). However, lsuccessful feeding was greater in the direct feeding method (69.4 per cent) when compared to the membrane feeding method (46.7 per cent) (p <0.0001). Based on 19 malaria patients who had > 400 gametocytes per ul of blood, the effect of antimalarial drugs on oocyst and sporozoite rates was also studied and it was found that mefloquine treated patients produced reduced infection and infectivity in an. dirus D than those who received antimalarial drugs other than mefloquine. Patients who had gametocytes and have been treated for causes other than malaria and who did not receive any antimalarial drugs were found to produce the highest infection and infectivity rates in An. dirus D (p < 0.0001).

Rapid and efficient removal of immature Aedes aegypti in metal drums by sweep net and modified sweeping method.

A modified sweeping method was developed using a cotton sweep net for control of Ae. aegypti immatures in 200 liter (44 gallon) metal drums which are major sources of breeding in Yangon. Laboratory experiments revealed that with only 4 sweeps (approximately 10 minutes duration), the mean % removal (+/- SD) of Ae. aegypti fourth stage larvae was 88.5% +/- 1.47. This was followed by a field study undertaken in Sanchaung township, Yangon. Twenty-eight drums with moderate (< 500 immatures) to high (> or = 500 immatures) Ae. aegypti density were tested in the field. It was found that with only 4 sweeps per drum, a total of 24,886 immatures were removed out of 29,155 immatures in these 28 drums, giving a mean % removal per drum of 85.36% +/- 10.74 (range = 55.54-98.62%). This sweeping method is simple, cost-effective, and readily accepted by the community. It could be an appropriate technology for control of the dengue hemorrhagic fever (DHF) vector Ae. aegypti.

Malaria Situation in a Forested Foot-hill Area of Myanmar

Entomological survey was carried out during July 1987 in a forestedfoot hill teak plantation area Tha-bye-wa village, Oktwin Township, Pegu Division. At the same time, thick and thin blood films were taken and spleen rate determined in children. The parasite rate for children under 10 years of age was 66.7

(16/24) and the infant parasite rate was 50

(2/4). The spleen rate for children 2-9 years age group was found to be 88.2

(15/17). The anopheline fauna collected was mostly made up of An. dirus, An.minimus, An. tessalatus, An. minimus was found to have occysts and one An. vagus collected biting man had sporozoites in the salivary glands. Two species of mosquitoes were also recorded for the first time in Burma. The epidemiological pattern of malaria transmission in the area and possible methodologies for control in such areas are discussed.

Anophiline mosquitoes of Myanmar. 2: Anopheles (Cellia) minimus Theobald, 1901

Anopheles minimus together with Anopheles dirus consitute the primary vectors of malaria in Myanmar. The former has a wider distribution and occurs in higher densities with longer seasonal prevalence and is therefore considered to be the most important malaria vector in the country. Previous studies showed that An.minimus breeds in grassy edges of perennial hill streams, in slow running irrigation channels and terraced rice field while DMR teams, in addition, found it breeding in small puddles in stream beds together with An. maculatus. At Phado, An. minimus was found to constitute 26.2 per cent, 50.5 per cent and 44.1 per cent in monsoon, cool/dry hot/dry seasons respectively.Prevalence of An.minimus in relation to distance from forest was presented. Biting, resting behaviour and host preference studies were carried out and results presented. Man-biting rate and vectorial capicities in relation to rainfall for each month over a year are also presented.

Anopheline mosquitoes of Myanmar. 1: Anopheles (Cellia) dirus Peyton and Harrison, 1979

Results of the study involving distribution, breeding habits, biology under laboratory cinditions, adult bionomics and its relationship to malaria transmission under different ecological condition have been studied and presented. Cytogenetics and iso-enzyme studies to differentiate its sibling species were also presented. Of the sibling species of An.dirus, species D was found to predominate in Myanmar, whereas species A was recorded from Central Burma. Susceptibility of An.dirus to DDT and Bacillus sphaericus was also reported.

Is direct cardiotoxicity the primary cause of death following i. v. injection of the basic phospholipase A2 from Naja Nigricollis venom?

Con objeto de elucidar la función del Ca intracelular en la transmisión neuromuscular investigamos en preparaciones de músculo de rana los efectos del ácido1,2-bis(o-aminofenoxi)etano-N,N,N',N'-tetraacético (BAPTA) sobre el aumento-potenciación por frecuencia (anteriormente llamado facilitación por frecuencia) el que ha sido de utilidad para identificar los sitios de acción de varios agentes colinérgicos. La disminución de los iones Ca del espacio intracelular por BAPTA sólo suprimió el componente dependiente de Ca del fenómeno (ma) sin modificar el factor de estimulación dependiente de frecuencia (K). La depresión causada por BAPTA en la facilitación de corto plazo del potencial de placa (EPP) fue la misma tanto en reposo como en la estimulación. El efecto del BAPTA fue parcialmente antagonizado, por el ionóforo de Ca A23187. Esto sugiere que la capacidad de "buffer" de Ca del BAPTA se mantiene durante la estimulación repetitiva de baja frecuencia. BAPTA no modificó la potenciación post-tetánica de los EPP miniatura en medio libre de Ca. Estos resultados indican que los iones Ca son esenciales para la liberación de transmisor y para la facilitación de corto plazo, pero no son responsables de todos los cambios en la liberación de transmisor

Rehabilitation after dialysis and kidney transplantation

La rehabilitación después del transplante en pacientes con enfermedad renal terminal es estudiada en 106 sujetos que recibieron 117 transplantes. Cincuenta y tres porciento de nuestros pacientes estaban empleados antes del transplante. Después del transplante, no existió ningún aumento en el empleo de los pacientes. En general, los pacientes que recibieron transplantes, se sintieron mejor y estuvieron físicamente más activos que los pacientes en diálisis. Unicamente 19% de los pacientes en diálisis se sintieron que llevaban una vida normal, cuando 40% tuvieron la misma sensación después del transplante. A pesar de la mejoría obtenida después del transplante, todavía 31% los pacientes no fueron sexualmente funcionales