Optimal age for vaccination against measles in the State of São Paulo, Brazil, taking into account the mother's serostatus.

In order to investigate if the changing levels of measles antibody in women resulting from extensive vaccination programs influence the susceptibility of children, we measured the seroprevalence of measles virus antibody of children in the first year of life and of their mothers. We compared maternal antibody decay of two groups of children: those whose mothers were 25 years old or more (mothers born in the pre-vaccination era), and less than 25 years old (mothers born in the vaccination era). Therefore, the 25-year-age cut-off was chosen to distinguish between vaccinated and non-vaccinated mothers. We also compared the immunogenicity of measles vaccine in children from 6 to 12 months of age, in these two groups and also according to their mother's serostatus. The optimal age of vaccination for a routine program was estimated by means of mathematical models. This study was carried out in a sample of 1216 mothers and their respective children. Our results indicate that the optimal age for vaccination of the whole sample was 15 months, 17 months for children born from older mothers, 14 months for children born from younger mothers, 17 months for children born from seropositive mothers and 12 months for children born from seronegative mothers. Therefore, a change to an earlier age of routine vaccination is not justified by our results.

Burow's triangle advancement flaps for excision of two closely approximated skin lesions.

The Burow's triangle advancement flap can be adapted to simultaneously remove two closely approximated cutaneous lesions. Possible technical variants and their limitations are discussed. Four clinical cases are presented. This technique gives good cosmetic results and reduces operating time.

Determinaçäo da pressäo sistólica sangüínea em recém-nascidos utilizando método näo-invasivo / Determination of systolic blood pressure in newborn infants using noninvasive method

Utilizando a técnica de Doppler, apresentam-se os resultados de medidas de pressöes sistólicas sistêmicas obtidas em membros superior e inferior de 54 recém-nascidos nas primeiras setenta e duas horas de vida. Nas medidas MSD e MID foram utilizados manguitos de 4,75 e 6cm respectivamente, sendo considerado o efeito da largura do manguito na precisäo dos resultados. A média das pressöes sistólicas em MSD foi 82,7 ñ 10,4 mmHg e em MID 79,5 ñ 8,2 mmHg. A análise de regressäo dos dados emparelhados de MSD e MID (r = 7; p < 0,1) indica que näo se pode estabelecer uma relaçäo linear entre as medidas destes membros

[Influence of the gastric acidity on the digoxinemia. Comparison between digoxin and beta-methyldigoxin (author's transl)]. / L'influenza dell'acidita' gastrica sulla digossinemia. Confronto fra diagnossina e beta-metildigossina.

In a medium term study, carried out according to a random cross-over schema, the Authors have evaluated the influence of gastric acidity on the digoxinemia, after the administration of digoxin (0.375 mg/day) and beta-methyldigoxin (0.25 mg/day) from the same batches. The results confirmed the effect of the gastric acidity on cardiac glycosides and an higher stability of beta-methyldigoxin than digoxin. These data suggest that digoxin, particularly in patients with gastric hypoacidity, must be used cautiously, because we can reach decidedly dangerous haematic levels, with a mean deviation of the values from the normal subjects of 89%, in comparison with 18% in the beta-methyldigoxin treated patients.