Articles: disease.
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Randomized Controlled Trial Clinical Trial
Safety and immunogenicity of single-dose live oral cholera vaccine CVD 103-HgR in 5-9-year-old Indonesian children.
Oral vaccines offer great promise as public-health measures to prevent disease in less-developed countries. CVD 103-HgR, a genetically engineered, attenuated, Vibrio cholerae O1 strain has proved effective in industrialised countries. We have assessed the safety, immunogenicity, and excretion of this live cholera vaccine in children in north Jakarta, Indonesia. 412 children aged 5-9 years received single doses of 5 x 10(6), 5 x 10(7), 5 x 10(8), 5 x 10(9), or 1 x 10(10) colony forming units (CFU) of CVD 103-HgR or placebo (5 x 10(8) inactivated Escherichia coli K-12) with buffer. ⋯ By contrast, a single 5 x 10(9) CFU dose of vaccine resulted in high rates (75% and 87%) of seroconversion with two different batches of vaccine. A batch prepared with a centrifugation step gave significantly higher geometric mean titres (16-fold increase over baseline) than did a batch in which there was a filtration step between fermentation and lyophilisation (10-fold increase over baseline). At a 5 x 10(9) CFU dose, CVD 103-HgR is well tolerated and highly immunogenic in Indonesian children and should therefore be further investigated for use as a one-dose live oral cholera vaccine in developing countries.
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To correlate deep bacterial infections with HIV infection and evaluate the influence of HIV on clinical picture and outcome in patients with meningitis, pneumonia or pyomyositis. ⋯ These results show a strong association between pyomyositis, pneumonia and HIV infection. They also indicate an increased mortality associated with HIV infection in patients with pyogenic meningitis, especially pneumococcal meningitis. Pyomyositis should be considered an indicator of stage III HIV disease in the proposed WHO clinical staging system.
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The Journal of urology · Sep 1992
Review Case ReportsFemale fertility following extracorporeal shock wave lithotripsy of distal ureteral calculi.
This study was prompted by a spontaneous abortion in a 21-year-old woman following extracorporeal shock wave lithotripsy (ESWL ) of a distal ureteral calculus. To our knowledge, it is the first clinical retrospective study on the possible adverse effects of ESWL to the female reproductive tract. We analyzed treatment data and radiation exposure of 84 women in the reproductive period, and surveyed the patients by questionnaire, to which 67 (79.8%) responded. ⋯ Overall 7 children with no malformations or chromosomal anomalies were born to 6 patients. Miscarriages were noted in 3 patients (4.5%) but they occurred at least 1 year after ESWL. Our data suggest that ESWL of lower ureteral calculi is a safe and effective procedure, and does not affect female fertility or lead to increased teratogenic risk.
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Br J Obstet Gynaecol · Sep 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy.
To compare the antihypertensive effects of epoprostenol sodium (prostacyclin) with that of dihydralazine in acute hypertensive crises of pregnancy. ⋯ The place of epoprostenol in pregnancy might be in patients with severe hypertension and tachycardia and in those requiring acute control of severe hypertension on the operating table before general anaesthesia.