Internações sensíveis à atenção primária específicas de mulheres / Sensitive female-specific hospitalization in primary care

Objetivou-se analisar as internações por condições sensíveis à atenção primária (ICSAP) específicas em mulheres e os fatores que determinam ou influenciam a ocorrência dessas internações (fatores socioeconômicos, sociodemográficos e controle de saúde) por meio de um inquérito de morbidade hospitalar realizado com amostra de 429 mulheres internadas em hospitais conveniados ao Sistema Único de Saúde. O percentual de ICSAP foi 49,42% (n = 212), com destaque para as internações específicas do sexo feminino 19,35% (n = 83). Associaram ao risco de internar por CSAP: idade superior a 60 anos, baixa escolaridade, internação prévia, realização de controle regular de saúde, falta de vínculo com a Estratégia Saúde da Família (ESF) e ser gestante. As causas evidentes foram as condições relacionadas à gravidez, ao parto e ao puerpério e às inflamações nos órgãos pélvicos femininos. Os resultados sugerem falhas no atendimento ambulatorial que deveria ser oportuno e resolutivo no contexto da saúde da mulher.

The scope of this paper was to analyze female-specific sensitive hospitalization occurring in primary care conditions and factors that determine or affect the occurrence of such hospitalizations (social, economic and demographic factors; health control). Analysis was performed by surveys on hospital morbidity with a sample of 429 females attended in Unified Health System (SUS) contracted hospitals. The sensitive hospitalizations percentage in primary care reached 49.42% (n = 212), highlighting female-specific hospitalization at 19.35% (n = 83). Hospitalization risks comprised elderly people over sixty, low schooling, previous hospitalizations, normal health control, lack of association with the Family Health Strategy and pregnancy. Evident causes were related to conditions of pregnancy, childbirth, post-partum and inflammations of the female pelvic organs. Results suggested flaws in outpatient attendance that should be adequate and provide solutions in women’s health.

Evaluation of immune response against hepatitis A and typhoid vaccines and their combination

The immunogenicity of both Typhoid Vi polysaccharide and inactivated Hepatitis A vaccines were tested and the immunogenic reflection of each vaccine on the other one in combination was detected. Groups of balb/C mice were immunized with different formulations containing different concentrations of typhoid Vi polysaccharide and hepatitis A vaccines, Four experiments were done a fellows:-Exp. I group I [mice was injected with alum 1mg/ ml], group 2, 3, 4 were immunized with three concentration [25, 12.5.6.25 micro g / ml typhoid [Ty] vaccine respectively. Exp. II groups 5, 6, 7 were immunized with hepatitis A [HA] vaccine with three concentration [400, 200, 100 IU/ ml respectively. Exp. III group 3A was immunized with [25 micro g / ml Ty vaccine], groups 33, 3C, 3D were immunized with combination of typhoid and hepatitis A vaccines [25 micro g / ml Ty +400, 200, 100 IU /ml HA respectively]. Exp. IV group 4A was immunized with [400 IU /ml HA vaccine], groups 43, 4C were immunized with combination of hepatitis A and typhoid vaccines. The results revealed that hepatitis A vaccine has a synergistic effect on the immunogenicity of typhoid Vi vaccine. On the other hand, the immune response against hepatitis A was higher when combined with different concentrations of typhoid vaccine

Immunogenicity and safety of a pentavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, haemophilus influenzae type b conjugate combination vaccine (pentaxim™) with hepatitis B vaccine.

Objective: To obtain immunogenicity and safety data for a pentavalent combination vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate). Design: Multicenter, open, Phase III clinical study. A DTaP-IPV//PRP~T vaccine (PentaximTM) was given at 6,10,14 weeks of age; and Hepatitis B vaccine at 0,6,14 or at 6,10,14 weeks of age. Immunogenicity assessed 1 month post-3rd dose; safety assessed for 30 minutes by the investigator, then by parents and investigators to 8 days and 30 days post-vaccination. Setting: Tertiary-care hospitals. Participants/patients: 226 healthy Indian infants (6 weeks of age). Main outcome measures: Immunogenicity and safety. Results: Immunogenicity was high for each vaccine antigen, and similar to a historical control study (France) following a 2,3,4 month of age administration schedule. Post-3rd dose, 98.6% of subjects had anti-PRP ³0.15 mg/mL and 90.0% had titers ³1.0 mg/mL; the anti-PRP GMT was 4.1 µg/mL. Seroprotection rates for diphtheria and tetanus (³0.01 IU/mL) were 99.1% and 100%; and 100%,99.1% and 100%, for polio types 1,2 and 3 (³8 [1/dil]) respectively. Anti-polio GMTs were 440.5,458.9, and 1510.7 (1/dil) for types 1,2 and 3 respectively. The vaccine response rates to pertussis antigens (4-fold increase in antibody concentration) were 93.7% for PT and 85.7% for FHA; the 2-fold increase was 97.1% and 92.4%. Vaccine reactogenicity was low with adverse reaction incidence not increasing with subsequent doses. Conclusion: The DTaP-IPV//PRP~T vaccine, given concomitantly with monovalent hepatitis B vaccine, was highly immunogenic at 6, 10 and 14 weeks of age in infants in India. The vaccine was well tolerated.

Immunogenicity of a combined DTPa-HB vaccine co-administered with Haemophilus influenzae type B conjugate vaccine (PRP-T) for primary and booster vaccinations

OBJECTIVE: To evaluate the immunogenicity of a combined DTPa-HB vaccine co-administered with Haemophilus influenzae type b conjugate vaccine (PRP-T) in Brazilian infants. MATERIAL AND METHODS: A prospective and open clinical study, in which 110 infants were immunized with a three-dose primary vaccination regime at two, four and six months of age and with a single booster vaccination. Blood samples were drawn immediately before the first dose, one month after the third dose, at the time of the booster dose and one month after the booster to assess seropositivity and antibody geometric mean titers (GMTs) of antibodies for diphtheria, tetanus, hepatitis B, Haemophilus influenzae type b and for the three pertussis antigens: Pertussis Toxin (PT), Filamentous Hemagglutinin (FHA) and Pertactin (PRN). RESULTS: Among the original 110 infants, 93 completed the study. Seropositivity was 100 percent for all seven involved antibodies, after the primary vaccination course. At the time of the booster dose, all antibodies (except diphtheria 33.7 percent and anti-PT 59 percent) were seropositive for more than 94 percent of subjects. After the booster, seropositivity increased to 100 percent for all antibodies. The GMT of these antibodies followed a similar pattern, with a strong increase after the primary course, followed by a second increase after the booster dose. At this time, GMT was2- to 7-fold higher than after the primary course, for all vaccine components. CONCLUSIONS: Concomitant administration of DTPa-HB and Hib vaccines elicited strong seroprotection for all the antigenic components. No interference with antibody response was evident. The vaccines provided high immunogenicity, following both the primary vaccinations and the booster dose.

Immune response chicken vaccinated with combined E. coli and multocida vaccine private

Immunogenicity of an experimentally prepared combined oil emulsified Escherichia coli-Pasteurella multocida [E. coli-P. multocida] vaccine was evaluated in susceptible chickens. The immune responses of vaccinated birds against monovalent E. coli, P. multocida and combined E. Coli-P. mutocida vaccines as estimated serologically using indirect haemagglutination test and ELISA test revealed no substantial differences with respect to the protective values between the monovalent and combined vaccines. The results of challerge test showed that vaccinated chickens could be effectively immunized with combined E. coli-P. multocida vaccine against challenge with E. coli and P. multocida virulent strains. In conclusion, this locally prepared vaccine was safe, immunogenic and protect chickens against E. coli and P. multocida infection

Primary and booster vaccination with DTPw-HB/Hib pentavalent vaccine in Costa Rican children who had received a birth dose of hepatitis B vaccine

Objective. The DTPw-HB/Hib pentavalent combination vaccine has been developed following recommendations of the World Health Organization for the introduction of hepatitis B (HB) and Haemophilus influenzae type b (Hib) vaccines into routine childhood vaccination programs. The objectives of this study were to: 1) analyze the immunogenicity and the reactogenicity of the DTPw-HB/Hib pentavalent combination vaccine in comparison to separate injections of DTPw-HB and Hib vaccines as primary vaccination in a group of children who had received a dose of HB vaccine at birth and 2) in the second year of life to assess the antibody persistence as well as the response to a DTPw-HB/Hib or DTPw/Hib booster. Methods. In the first part of the study (primary-vaccination stage), conducted in 1998-1999, we analyzed the immunogenicity and reactogenicity of the DTPw-HB/Hib combination vaccine in comparison to separate injections of DTPw-HB and Hib vaccines as primary vaccination at 2, 4, and 6 months of age in 207 Costa Rican children who had received a dose of HB vaccine at birth. Later, in the booster-vaccination stage of the study, in 1999-2000, in a subset of the children (69 toddlers, now 15-18 months old), antibody persistence was measured, and response to a DTPw-HB/Hib or DTPw/Hib booster was also assessed. Results. In both primary-vaccination groups, at least 97.5 percent of the infants reached protective levels of antibodies (seropositivity) against the antigens employed in the vaccines. The DTPw-HB/Hib pentavalent combination vaccine did not result in more local reactions than did the DTPw-HB vaccine alone, and, in terms of general reactions, there was no clinically significant difference between the combination or separate injections, and with the pentavalent vaccine having the benefit of needing one less injection. Nine months after the third dose of the primary-vaccination course, antibody persistence was similar in both groups, with over 93 percent of children still having protective/seropositive titers for Hib, HB, and tetanus and about 50 percent for diphtheria and Bordetella pertussis. At 15 months of age, virtually all the toddlers responded with a strong boost response to all the vaccine antigens, whether they received the DTPw-HB/Hib pentavalent vaccine or the DTPw/Hib vaccine as a booster. Both booster regimens were equally well tolerated, indicating that up to five...

Effect of tetravalent vaccine as control measure for calf diarrhea through dam vaccination

The present study was conducted on 80 pregnant buffalo dams and their neonates, of which 20 pregnant dam were injected s/c two times, at 8 weeks before the expected time of calving and again 4 weeks later with tetravalent vaccine [Lactovac vet.] to control neonatal calf diarrhea. The rest of dams were used as a control group. Immunoglobulin [IgM and IgA] concentration levels and some biochemical parameters [total protein, albumin and globulin] were measured in serum of buffalo dams prior to vaccination and after calving and compared with those of non vaccinated dams. The means of serum immunoglobulins and [total protein, albumin and globulin] of vaccinated dams after calving were increased when compared to those of control non vaccinated dams after calving. A high significant difference was noticed between serum IgM of vaccinated and non vaccinated dams after calving. High significant differences were observed between 36-48 h old calves of both groups with regard to serum IgG, IgM and IgA. High significant differences were observed between colostral IgG, IgM and IgA of vaccinated and non vaccinated dams. High significant reverse correlations were noticed between serum IgM of vaccinated dams and their calves as well as between colostral IgG of non vaccinated dams and serum of their calves. A significant positive correlation between colostral IgA of vaccinated dams and serum of IgA of their calves was observed. The previous results of immunization of pregnant buffalo dams with [lactovac vet] revealed that there was a striking increase in the level of both serum and colostral immunoglobulins of vaccinated dams in comparison with non vaccinated dams as well as in serum of 36-48 h old calves born to vaccinated darns in comparison to those born to non vaccinated darns. Clinical observations of neonates [test and control groups] clearly demonstrated that [Lactovac vet] induced a pronounced decrease in the incidence of diarrhea, pneumonia and mortality rates. It is highly recommended that a program depending on vaccination of darns during late gestation with [Lactovac-vet.] could successfully be used to protect neonates against the most prevalent diarrhoegenic agents and minimize a great economic loss

An antibody induction method in mice for the potency assays of diphtheria and tetanus components in combined vaccines.

Eleven batches of Adsorbed Diphtheria-Tetanus (DT) vaccines and thirteen batches of Adsorbed Diphtheria-Pertussis-Tetanus (DTP) vaccines were tested for the potency of diphtheria and tetanus components by an Antibody Induction Method (AIM) developed in mice. The potency results obtained were found comparable and did not show any statistically significant difference with those obtained by WHO recommended lethal challenge tests for diphtheria in guinea pigs and for tetanus in mice. AIM in mice is more economical as both diphtheria and tetanus components of combined vaccine can be tested in the same experiment and the procedure also eliminates the use of guinea pigs required in the lethal challenge/conventional tests. The data obtained while testing tetanus component by the conventional antibody induction (IP) method in guinea pigs suggests that minimum requirements laid down in i.p. is too low which may be fixed as at least 3 out of 9 guinea pig sera and should contain > or = 4 units of tetanus antitoxin per ml.

Strategies for production of a potential candidate vaccine for cholera.

First attempt at cholera vaccination was made by Jaime Ferran in 1884. Since then, a variety of strategies and methods have been evolved to create a safe, efficacious vaccine against cholera. For the first few years emphasis was on the development of parenteral vaccines. However, as a result of accumulation of a tremendous amount of knowledge, not only on Vibrio cholerae-the causative agent, but also on its interaction with the host, emphasis has shifted towards the development of oral vaccines. Two such vaccines, one killed, a whole cell/B subunit combination vaccine and the other a live attenuated one, have shown promise. The combination vaccine in its present state of development confers only a transient protection in young children, while the live attenuated one produces adverse reaction. To combat these, various strategies are being evolved. In one attempt, a potential candidate vaccine strain has been constructed from a non-reactogenic clinical isolate of V. cholerae, which is devoid of all known major virulence genes and is also a good colonizer. In animal studies this construct has shown considerable promise. This review discusses the various strategies that have been employed so far in the quest for an ideal cholera vaccine.