Dressing liposomal particles with chitosan and poly(vinylic alcohol) for oral vaccine delivery

Liposomes have been used as adjuvants since 1974. One major limitation for the use of liposomes in oral vaccines is the lipid structure instability caused by enzyme activities. Our aim was to combine liposomes that could encapsulate antigens (i.e., Dtxd, diphtheria toxoid) with chitosan, which protects the particles and promotes mucoadhesibility. We employed physical techniques to understand the process by which liposomes (SPC: Cho, 3: 1) can be sandwiched with chitosan (Chi) and stabilized by PVA (poly-vinylic alcohol), which are biodegradable, biocompatible polymers. Round, smooth-surfaced particles of REVs-Chi (reversed-phase vesicles sandwiched by Chi) stabilized by PVA were obtained. The REVs encapsulation efficiencies (Dtxd was used as the antigen) were directly dependent on the Chi and PVA present in the formulation. Chi adsorption on the REVs surface was accompanied by an increase of zeta-potential. In contrast, PVA adsorption on the REVs-Chi surface was accompanied by a decrease of zeta-potential. The presence of Dtxd increased the Chi surface-adsorption efficiency. The PVA affinity by mucine was 2,000 times higher than that observed with Chi alone and did not depend on the molecule being in solution or adsorbed on the liposomal surface. The liberation of encapsulated Dtxd was retarded by encapsulation within REVs-Chi-PVA. These results lead us to conclude that these new, stabilized particles were able to be adsorbed by intestinal surfaces, resisted degradation, and controlled antigen release. Therefore, REVs-Chi-PVA particles can be used as an oral delivery adjuvant.

Effects of testosterone and corticosterone on immunocompetence in the zebra finch

The original immunocompetence handicap hypothesis (ICHH) suggested that testosterone has a handicapping effect in males by both promoting the development of sexual signals and suppressing immune function. A modified version, the stress-linked ICHH, has recently proposed that testosterone is immunosuppressive indirectly by increasing production of corticosterone. To test both the original and stress-mediated versions of the ICHH, we implanted male zebra finches taken from lines selected for divergent maximum stress-induced levels of corticosterone (high, low and control) with either empty or testosterone-filled implants. Their humoral and cell-mediated immune responses were then assessed by challenge with diphtheria:tetanus vaccine and phytohemagglutinin respectively. We found no effect of the hormone manipulations on either PHA or tetanus antibody responses, but found a significant interaction between titers of both testosterone and corticosterone on diphtheria secondary antibody response; antibody response was greatest in individuals with high levels of both hormones. There was also a significant interactive effect between testosterone treatment group and corticosterone titer on body mass; the body mass of males in the elevated testosterone treatment group decreased with increasing corticosterone titer. These results suggest that, contrary to the assumption of the stress-mediated version of the ICHH, high plasma levels of corticosterone are not immunosuppressive, but are in fact immuno-enhancing in the presence of high levels of plasma testosterone. Equally, the central assumption of the ICHH that testosterone is obligately immunosuppressive is also not supported. The same individuals with the highest levels of both hormones and consequently the most robust antibody response also possessed the lowest body mass.

Assessment of delay in age-appropriate vaccination using survival analysis

 Assessment of delay in age-appropriate vaccination provides more information about timeliness of vaccination than up-to-date vaccination coverage. The authors applied survival analysis methods to data from a vaccination coverage survey among children aged 13–59 months conducted in Argentina in 2002. By age 19 months, 43% of children (95% confidence interval (CI): 40, 46) were vaccinated with the fourth dose of diphtheria, tetanus, and pertussis (DTP4). By age 13 months, 55% of children (95% CI: 52, 57) were vaccinated with measles-containing vaccine. By age 7 months, 33% of children (95% CI: 27, 40) were vaccinated with the third dose of hepatitis B. Compared with firstborn children, third children were more likely to be delayed for DTP4 (relative risk (RR) = 1.41, 95% CI: 1.22, 1.62), measles-containing vaccine (RR = 1.54, 95% CI: 1.32, 1.78), and the third dose of hepatitis B (RR = 1.31, 95% CI: 1.03, 1.67). Children whose caregivers had completed secondary school were less likely to be delayed for DTP4 (RR = 0.68, 95% CI: 0.52, 0.90) compared with those whose caregivers had not completed primary school. Survival analysis methods were helpful in measuring vaccine uptake and should be considered in future surveys when assessing delay in age-appropriate vaccination. Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved.

Vacinação e biossegurança: o olhar dos profissionais de enfermagem

The present study analyzes the conceptions and the nursing workers' practices about the relationship between vaccination and biosecurity in a public hospital of reference in communicable diseases in Natal/RN. It is treated, therefore, of a exploratory/descriptive study with qualitative and quantitative approach. They were constituted as collaborators of the research twenty-two nursing professionals, being five nurses, three auxiliary and fourteen technicians in nursing. The information were obtained through the interview technique with semi-structured route. In the quantitative approach, the information were analyzed by statistics and presented in form of tables and graphs to characterize the workers and the aspects related to the vaccination situation of the same ones; and in the qualitative approach, we used the method of content analysis. The analysis was accomplished starting from the categories empiric coming from the process of analysis of the field material, measure through inferences and interpretations based on the authors studied in the theoretical referential of the research. Starting from the analysis of the results, we verified that the nursing interviewees' workers establish in a clear way and it aims at, in your speeches, a direct relationship between vaccination and biosecurity besides attributing a meaning of great importance with relationship to the use of the vaccines in your professional lives in what refers to the control and decrease of the risks, above all the biological ones, to the which are exposed in the daily exercise of your functions. However, when analyzing those workers' vaccination situation, we verified that the vaccination covering still meets on this side of the expected for the vaccines of occupational interest, with prominence just for the vaccines against diphtheria and tetanus and to against hepatitis B, that presented coverings considered very good and above the national average. Considering that the institution, although has a service of health occupational active and offer some vaccines of occupational interest, it still presents a work of little mobilization in what refers to the consciousness and the workers' permanent education with relationship to the need and importance of the occupational vaccination, not only for your workers' protection, as well as measure in the infection control and, therefore, as safety for your patients/clients. We understood that that work type didn't still become politics guided by ministries of Health or of the Labor, however, it falls to the institutions that work for the interest of the workers' health to struggle for all and any action and mobilization that have as objective protects the workers of the risks in your work atmosphere

Stretch Injuries of Skeletal Muscles: Experimental Study in Rats' Soleus Muscle

The study aimed to verify the physiological injury behavior by stretching the soleus muscle of rats, using a noninvasive experimental model. Twenty-four rats were used and divided into three groups of eight animals: control group (A), group that performed tetanus followed by electrical stimulation and a sudden dorsiflexion of the left paw performed by a device equipped with a mechanism of muscle soleus rapid stretching (B); and a group that only received the tetanus (C). Three days later, the animals were killed, and the soleus muscle was resected and divided into three segments. Morphological changes indicative of muscle damage appeared in all three segments of group B. In a lesser degree, similar changes were also detected in muscles subjected to only tetanus. This model was effective; reproducing an injury similar to what occurs in human sports injuries.

Cinética dos anticorpos de origem colostral contra a toxina épsilon de Clostridium perfringens tipo D em cordeiros

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Tétano em pequenos ruminantes: estudo retrospectivo dos principais achados clínico-epidemiológicos em 11 casos

A retrospective study of major clinical and epidemiological findings was performed in 11 cases of tetanus observed in eight sheep and three goats from 1998 to 2008. The cases occurred predominantly in animals aging from five days to two years, in winter season, with history of recent wounds or surgical procedures. Muscle rigidity and muscular tremors (72.0%), tachycardia/dyspnea (54.5%), change of placement of ears (45.4%), protusion of the third eyelid (27.2%), hypersensitivity to external stimulus (18.1%), and elevation of ears (18.1%) were the most common clinical signs.

Tétano em um gato

Relata-se neste artigo o caso de tétano em um gato macho de 3 anos 8 dias após a realização de orquiectomia bilateral, onde o histórico do animal associado aos achados clínicos e laboratoriais propiciaram a definição do diagnóstico. Mesmo após tratamento, o quadro evoluiu para tetania generalizada e óbito. Neste caso, a ação da neurotoxina na musculatura estriada esquelética do esfíncter uretral foi um fator agravante para a doença, levando à retenção vesical e azotemia pós-renal.

Experiência clínica com o uso de sedativos em terapia intensiva: estudo retrospectivo

JUSTIFICATIVA E OBJETIVOS: Dentre as indicações mais freqüentes de sedação em pacientes internados em Unidades de Terapia Intensiva (UTI) estão a instituição e a manutenção de ventilação artificial, a ansiedade e procedimentos desconfortáveis ou dolorosos. O objetivo deste estudo retrospectivo foi verificar as indicações e as técnicas mais comuns de sedação em pacientes graves internados na Unidade de Terapia Intensiva Cirúrgica da Escola Paulista de Medicina (EPM/UNIFESP) durante um período de 11 meses. MÉTODO: Após terem sido excluídos os pacientes que permaneceram na UTI menos de 24 horas ou estavam sem exames indispensáveis para o cálculo do índice de gravidade (APACHE II), a amostra ficou reduzida a 307 pacientes. Foram analisadas as técnicas mais utilizadas, as indicações de sedação e a associação de bloqueadores neuromusculares. RESULTADOS: A sedação foi administrada em 37,4% dos pacientes. Entre as indicações de sedação estão os distúrbios de natureza psiquiátrica, como delírio, agitação, medo e ansiedade. Estas corresponderam a 25,77% de todas as indicações. A maioria dos pacientes ventilados artificialmente também necessita de sedativos. Instalação e manutenção de ventilação mecânica corresponderam à maioria das indicações, em torno de 57,73% dentre os pacientes sedados. Procedimentos como intubação traqueal e broncoscopia tiveram 11,34% das indicações e controle do metabolismo (coma barbitúrico e tétano), 5,15%. As técnicas mais comumente utilizadas incluíram opióides isolados ou associados a benzodiazepínicos. Neste estudo, o fentanil foi utilizado em 58% das técnicas, isoladamente, e em 21,64% associado ao midazolam. Haloperidol, diazepam, propofol e tiopental somaram 19,5%. Bloqueadores neuromusculares foram utilizados em 22,7% dos casos em pacientes ventilados artificialmente. CONCLUSÕES: A sedação é recurso terapêutico freqüente em Terapia Intensiva, comumente utilizada para facilitar a ventilação artificial e tratar os problemas de natureza psiquiátrica. Fentanil, isoladamente ou em associação com midazolam, foi o agente mais utilizado.

Situação vacinal infantil e características individuais e familiares do interior de São Paulo

The aim of this study was to describe and analyze individual and family characteristics of children and those of health services, as well as their relationship with the immunization status for different kinds of vaccines and doses. Three sources of information were used: records from the Municipal Health Information System, immunization charts, and interviews using closed-ended questions. The families interviewed still had one or two growing children; caretakers were usually young unemployed mothers with easy access to health services. Around 30% of them were not instructed on the vaccine being given, its reactions or when to return for the next shot. The greatest levels of tardiness occurred with the vaccines against measles (6.3%) and Haemophilus influenzae B (4.2%). It was possible to observe that tardiness or absence of vaccinations seem to have a stronger relationship with service characteristics than with population characteristics.

Avaliação da assistência pré-natal e puerperal desenvolvidas em região do interior do Estado de São Paulo em 2005

Objectives: to evaluate the structure and process of the prenatal and puerperal care given by Direção Regional de Saúde (DIR) XI, at the city of Botucatu, State of São Paulo, Brazil. Methods: an evaluation of resources and activities developed during prenatal and puerperal care in twenty municipalities comprising DIR XI which had adhered the Prenatal and Birth Humanization Program until 2003. Interviews with city managers and analysis of 385 sampled patient charts taking into account recommendations by the Health Department. Results: structure analysis showed that caregiving was centered on medical work; basic equipment and instruments were available; 85.2% of patients began prenatal care with up to 120 days of pregnancy, and 75.9% had at least six prenatal consultations. The active search for absentees and strategies for early prenatal care initiation were observed in 30% and 50% of the municipalities, respectively. Process indicators showed that 3.6% of women had six prenatal consultations, one puerperal consultation, all basic exams and tetanus immunization. Recording of gestational age, arterial blood pressure and weight was of approximately 90%; 58.7% of the women underwent childbirth review and 31.5% were vaccinated. Conclusions: the performance of the set of activities is a challenge to prenatal care at DIR XI.

Kinetics of epsilon antitoxin antibodies in different strategies for active immunization of lambs against enterotoxaemia

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação do efeito da toxina épsilon do clostridium perfringens em monocamadas de células MDCK (Madin-Darby canine kidney cell)

Pós-graduação em Ciência Animal - FMVA

Surto de tétano em búfalos (Buballus bubalis) no estado do Pará

Descreve-se um surto de tétano em búfalos da raça Murrah em uma propriedade situada no município de São Caetano de Odivelas, localizado na região metropolitana de Belém, estado do Pará. Do rebanho de 250 bubalinos, 80 animais foram vacinados contra raiva por via intramuscular na região da garupa. Em um período de 15 a 19 dias após a vacinação quatro animais adoeceram, um morreu com dois dias de evolução, um foi eutanasiado in extremis no sétimo dia após o início dos sinais clínicos e os demais se recuperaram após tratamento. Nos bubalinos, o primeiro sinal clínico observado foi o prolapso da terceira pálpebra, em especial quando o animal era estimulado, seguido por andar rígido, manifestado por dificuldade de flexão dos membros e permanência em decúbito lateral com os membros estendidos, pálpebras muito abertas, sialorréia, hiperexcitabilidade, orelhas eretas, leve trismo e acúmulo de alimento na cavidade oral. À necropsia foi evidenciada uma área de coloração amarelada com presença de exsudação purulenta na musculatura da região da garupa, local de aplicação da vacina. Ao exame histopatológico não foram evidenciadas alterações significativas. Em dois animais foi realizado tratamento com penicilina por via intramuscular e soro antitetânico por via intramuscular e sub-aracnóide; após duas semanas esses animais se recuperaram. Diante do quadro clínico, dos dados epidemiológicos e da ausência de lesões histológicas foi feito o diagnóstico de tétano. Concluiu-se que o tétano é uma doença a ser considerada na bubalinocultura no Brasil. A infecção, provavelmente ocorreu durante o procedimento de vacinação, através injeções intramusculares utilizando agulhas contaminadas.