Evaluation of the compliance with recommended procedures in newborns exposed to HBsAg-positive mothers: a multicenter collaborative study.

BACKGROUND: Maternal-infant transmission of hepatitis B virus (HBV) during birth carries a high risk for chronic HBV infection in infants with frequent subsequent development of chronic disease. This can be efficiently prevented by early immunization of exposed newborns. The purpose of this study was to determine the compliance with official recommendations for prevention of perinatal HBV transmission in hepatitis B surface antigen (HBsAg) exposed infants. METHODS: Records of pregnant women at 4 sites in Switzerland, admitted for delivery in 2005 and 2006, were screened for maternal HBsAg testing. In HBsAg-exposed infants, recommended procedures (postnatal active and passive immunization, completion of immunization series, and serological success control) were checked. RESULTS: Of 27,131 women tested for HBsAg, 194 (0.73%) were positive with 196 exposed neonates. Of these neonates, 143 (73%) were enrolled and 141 (99%) received simultaneous active and passive HBV immunization within 24 hours of birth. After discharge, the HBV immunization series was completed in 83%. Only 38% of children were tested for anti-HBs afterwards and protective antibody values (>100 U/L) were documented in 27% of the study cohort. No chronically infected child was identified. Analysis of hospital discharge letters revealed significant quality problems. CONCLUSIONS: Intensified efforts are needed to improve the currently suboptimal medical care in HBsAg-exposed infants. We propose standardized discharge letters, as well as reminders to primary care physicians with precise instructions on the need to complete the immunization series in HBsAg-exposed infants and to evaluate success by determination of anti-HBs antibodies after the last dose.

Genital Chlamydia trachomatis: understanding the roles of innate and adaptive immunity in vaccine research.

Chlamydia trachomatis is the leading cause of bacterial sexually transmitted disease worldwide, and despite significant advances in chlamydial research, a prophylactic vaccine has yet to be developed. This Gram-negative obligate intracellular bacterium, which often causes asymptomatic infection, may cause pelvic inflammatory disease (PID), ectopic pregnancies, scarring of the fallopian tubes, miscarriage, and infertility when left untreated. In the genital tract, Chlamydia trachomatis infects primarily epithelial cells and requires Th1 immunity for optimal clearance. This review first focuses on the immune cells important in a chlamydial infection. Second, we summarize the research and challenges associated with developing a chlamydial vaccine that elicits a protective Th1-mediated immune response without inducing adverse immunopathologies.

Agreed-upon procedures report on the City of Prairie City, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Prairie City, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Granger, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of New Vienna, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of New Vienna, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Sidney, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Sidney, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Lambs Grove, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Lambs Grove, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Dallas Center, Iowa for the period July 1, 2013 through June 30, 2014

Agreed-upon procedures report on the City of Dallas Center, Iowa for the period July 1, 2013 through June 30, 2014

Activation of the NLRP3 inflammasome in dendritic cells induces IL-1beta-dependent adaptive immunity against tumors.

The therapeutic efficacy of anticancer chemotherapies may depend on dendritic cells (DCs), which present antigens from dying cancer cells to prime tumor-specific interferon-gamma (IFN-gamma)-producing T lymphocytes. Here we show that dying tumor cells release ATP, which then acts on P2X(7) purinergic receptors from DCs and triggers the NOD-like receptor family, pyrin domain containing-3 protein (NLRP3)-dependent caspase-1 activation complex ('inflammasome'), allowing for the secretion of interleukin-1beta (IL-1beta). The priming of IFN-gamma-producing CD8+ T cells by dying tumor cells fails in the absence of a functional IL-1 receptor 1 and in Nlpr3-deficient (Nlrp3(-/-)) or caspase-1-deficient (Casp-1(-/-)) mice unless exogenous IL-1beta is provided. Accordingly, anticancer chemotherapy turned out to be inefficient against tumors established in purinergic receptor P2rx7(-/-) or Nlrp3(-/-) or Casp1(-/-) hosts. Anthracycline-treated individuals with breast cancer carrying a loss-of-function allele of P2RX7 developed metastatic disease more rapidly than individuals bearing the normal allele. These results indicate that the NLRP3 inflammasome links the innate and adaptive immune responses against dying tumor cells.

Agreed-upon procedures report on the City of Derby, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Derby, Iowa for the period August 1, 2013 through July 31, 2014

Agreed-upon procedures report on the City of Stanwood, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Stanwood, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Harper, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Harper, Iowa for the period November 1, 2013 through October 31, 2014

Agreed-upon procedures report on the City of Brayton, Iowa for the period September 1, 2013 through August 31, 2014

Agreed-upon procedures report on the City of Brayton, Iowa for the period September 1, 2013 through August 31, 2014