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At least 19 recordsLinked to original sources
PubMed1988

Immunization of healthy adults with live attenuated varicella vaccine.

Live attenuated varicella vaccine was administered to healthy varicella-susceptible adults. Of 187 adults immunized with the Oka strain of vaccine, seroconversion to varicella-zoster virus (VZV) occurred in 82% after one dose and in 94% after two doses. Adverse effects were unusual. After immunization, one subject developed mild zoster caused by wild-type virus. Twelve adults developed a mild breakthrough case of chickenpox after exposure to VZV. Protection after household exposure was observed in nine (56%) of 16; however, the illness in all seven patients with breakthrough illness was modified, with an average of only 24 vesicles. Subjects seropositive at household exposure were unlikely to develop a breakthrough illness. Approximately 25% of vaccinees who seroconverted lost detectable antibodies to VZV after vaccination, but even those who became seronegative were partially protected. Varicella vaccine offered significant protection against severe chickenpox in healthy adults.

Adolescent↗
PubMed1984

Symposium on infectious complications of neoplastic disease (Part II). Immunoprophylaxis of varicella-zoster infections.

Because it is possible to identify groups of persons with a high risk of varicella development and also because it is possible to anticipate when an attack may occur, immunoprophylaxis for varicella has met with great success. In contrast, the nature of zoster--its unpredictability and low attack rate--makes immunoprophylaxis much more difficult to implement. Varicella may be modified by administration of varicella-zoster immune globulin within three days of a known exposure to the virus. Although interferon has not yet been used in an attempt to prevent or modify varicella in humans, it has been used successfully to abort an outbreak of simian varicella in a monkey colony. Thus it might be clinically useful, particularly for those who cannot be given varicella-zoster immune globulin within three days of exposure. Transfer factor has also been shown to induce at least partial immunity to varicella in children with leukemia. The duration of this protection is unknown, and further study of the efficacy of transfer factor against both varicella and possibly even against zoster seems warranted. Live attenuated varicella vaccine, although still experimental, seems now to be the most practical way to prevent severe varicella in high-risk persons. The vaccine is safe and immunogenic, even in children with underlying leukemia who are still receiving chemotherapy. Studies in Japan, Europe, and the United States have shown that most vaccinated leukemic children who are exposed are protected against severe disease, although mild breakthrough cases have been reported. Varicella vaccine's potential to cause zoster remains under study.

Animals↗
PubMed1984

Nursery-associated hepatitis A traced to a male nurse.

A small epidemic of nursery-associated hepatitis A (HA), in which silently infected children played a cryptic role in transmitting the illness to adult contacts, was investigated. It was found that a male nurse had transmitted HA to four children before he fell ill. He was not heard from for about two months as he was a part-time worker and was admitted to a local hospital in another prefecture. Two of the four silently infected children transmitted HA to their parents who then revealed the presence of nursery-associated HA. The epidemic was terminated by injection of human gamma globulin to nursery children and to antibody-negative parents, nursery staff and other contacts except for two breakthrough cases.

Adolescent↗
PubMedDate not supplied

Human immune responses to live attenuated varicella vaccine.

Experiences with the use of the live attenuated varicella vaccine for the immunization of varicella-susceptible adults and healthy and leukemic children are described. Healthy children, for whom a greater than 90% rate of seroconversion and protective efficacy was noted, showed the best response. Leukemic children experienced a 40%-50% rate of vaccine-associated rash; protective efficacy approached 90%. For adults, a 10% rate of vaccine-associated rash and a protective efficacy of 70% were noted. Breakthrough cases of vaccine were mild, indicating modification of the course of the illness by the vaccine.

Adult↗
PubMed1991

Lack of transmission of the live attenuated varicella vaccine virus to immunocompromised children after immunization of their siblings.

The safety of administering the live attenuated Oka/Merck varicella vaccine to the well siblings of children with malignancy was evaluated as a strategy for reducing the risk of household exposure to varicella among immunocompromised children. Susceptible well children were eligible for vaccination if the child with malignancy had leukemia, lymphoma, or solid tumor in remission for 3 months or longer. No evidence of vaccine virus transmission was found among 30 children with malignancy whose 37 healthy susceptible siblings were immunized with varicella vaccine. Varicella-zoster virus was not isolated from the oropharyngeal secretions taken from 17 vaccinees or their 14 immunocompromised siblings. None of the 30 immunocompromised children had vaccine-related rashes or showed immunologic evidence of subclinical varicella-zoster virus infection based on testing for varicella-zoster virus IgG antibodies and T-lymphocyte proliferation to varicella-zoster virus. Four healthy vaccinees eventually had mild breakthrough cases of varicella, with transmission to the high-risk sibling in 3 cases. However, even in these families, the immunocompromised children had been protected from household exposure varicella for at least 20 months early in the course of their immunosuppressive treatment.

Adolescent↗
PubMed1985

A multicentre trial of live attenuated varicella vaccine in children with leukaemia in remission.

Two hundred forty children with acute leukaemia in remission for at least 1 year were immunized with live attenuated varicella vaccine. All were susceptible to varicella before immunization. There was a seroconversion to varicella-zoster virus in approximately 85% after 1 dose, and in 97% after 2 doses. The major side effect was mild to moderate rash, seen mainly in children with maintenance chemotherapy suspended for 1 week before and 1 week after vaccination. Vaccinees with rash were at some risk (10%) to transmit vaccine virus to varicella susceptibles with whom they had close contact. Twenty-nine vaccinees were subsequently exposed to varicella in their households. The attack rate of clinical varicella in these vaccinees was 21%, which is significantly lower than the 80%-90% attack rate occurring in varicella susceptibles after household exposure. All these breakthrough cases of varicella were mild, even in leukaemics receiving chemotherapy. Varicella vaccine was approximately 80% effective in preventing clinical varicella in children with leukaemia and completely effective in preventing severe varicella in this high-risk group.

Acute Disease↗
PubMed1987

Unilateral normal perfusion pressure breakthrough after carotid endarterectomy: case report.

The authors report a case of unilateral malignant cerebral edema that occurred after the removal of a high grade atheromatous lesion of the ipsilateral internal carotid artery. A form of unilateral normal perfusion pressure breakthrough caused by postischemic impairment of cerebrovascular autoregulation and exacerbated by systemic hypertension is thought to have contributed to this complication. Control of the hypertension and treatment of the cerebral edema with mannitol and dexamethasone led to a complete neurological recovery.

Aged↗
PubMed1988

Using immersion test data to screen chemical protective clothing.

A test to screen chemical protective materials in order to select potential candidates for further testing has been examined. The method involved determining the weight and volume changes in materials caused by immersion in the challenge chemical. Simple regression analysis showed that relatively short breakthrough times based on weight change and final thickness could be predicted with 90% confidence. Better results were obtained when discriminant analysis was used to classify breakthrough times greater than either 4 or 8 hr as a function of the weight change and final thickness. In 6% or less of the cases, actual breakthrough times were less than 4 or 8 hr when the predicted times were greater than these values. Discriminant analysis also was used to classify permeation rates as less than either 90 or 400 mg/m2-min based on weight change and initial thickness. In this case, actual permeation rates less than these were predicted to be greater in 4% and 7% of the cases, respectively.

Immersion↗
PubMed2023

Exploiting Real-Time Genomic Surveillance Data To Assess 4CMenB Meningococcal Vaccine Performance in Scotland, 2015 to 2022.

The United Kingdom implemented the first national infant immunization schedule for the meningococcal vaccine 4CMenB (Bexsero) in September 2015, targeting serogroup B invasive meningococcal disease (IMD). Bexsero contains four variable subcapsular proteins, and postimplementation IMD surveillance was necessary, as nonhomologous protein variants can evade Bexsero-elicited protection. We investigated postimplementation IMD cases reported in Scotland from 1 September 2015 to 30 June 2022. Patient demographics and vaccination status were combined with genotypic data from the causative meningococci, which were used to assess vaccine coverage with the meningococcal deduced vaccine antigen reactivity (MenDeVAR) index. Eighty-two serogroup B IMD cases occurred in children >5 years of age, 48 (58.5%) of which were in unvaccinated children and 34 (41%) of which were in children who had received ≥1 Bexsero dose. Fifteen of the 34 vaccinated children had received one dose, 17 had received two doses, and two had received three doses. For 39 cases, meningococcal sequence data were available, enabling MenDeVAR index deductions of vaccine-preventable (M-VP) and non-vaccine-preventable (M-NVP) meningococci. Notably, none of the 19 of the children immunized ≥2 times had IMD caused by M-VP meningococci, with 2 cases of NVP meningococci, and no deduction possible for 17. Among the 15 children partially vaccinated according to schedule (1 dose), 7 were infected by M-VP meningococci and 2 with M-NVP meningococci, with 6 for which deductions were not possible. Of the unvaccinated children with IMD, 40/48 were ineligible for vaccination and 20/48 had IMD caused by M-VP meningococci, with deductions not being possible for 14 meningococci. IMPORTANCE This study demonstrates the value of postimplementation genomic surveillance of vaccine-preventable pathogens in providing information on real-world vaccine performance. The data are consistent with 2 and 3 doses of Bexsero, delivered according to schedule, providing good protection against invasive disease caused by meningococci deduced from genomic data to be vaccine preventable. Single doses provide poorer protection to infants. In practical terms, these data can provide public health reassurance when vaccinated individuals develop IMD with non-vaccine-preventable variants. They further indicate that additional testing is needed on variants for which no immunological data exist to improve estimates of protection, although these data suggest that the uncharacterized variants are unlikely to be covered by Bexsero. Finally, the confirmation that incomplete or absent doses in infancy lead to reduced protection supports public health and general practitioners in promoting vaccination according to schedule.

Infant↗
PubMed1974

Three flies and three islands: parallel evolution in Drosophila.

Most organisms are evolutionary conservatives; they may subdivide their niches but tend to remain within them. Yet the fossil record shows many cases of breakthrough to a new mode of life. How may such evolutionary innovation be recognized at this time level? Three species of Drosophila have accomplished an innovation in that they breed as obligate commensals on tropical land crabs. This could be dismissed as a curious aberration were it not for the fact that the three flies concerned represent three different phyletic lines of the family. Although Drosophila is abundant on the continents, these three parallel innovative evolutions have occurred on islands. The proposal is made that the genetic systems of many conservative groups of organisms carry variability that would permit them to evolve in a novel direction. The realization of this capacity, however, is possible only under special environmental conditions.

Adaptation, Biological↗
PubMed1986

Live attenuated varicella vaccine use in immunocompromised children and adults.

Live attenuated varicella vaccine has been administered to 307 children with leukemia in remission and to 86 healthy adults. The vaccine was well tolerated and immunogenic. The major side effect in leukemic children receiving maintenance chemotherapy was development of a vaccine-associated rash. Vaccinees in whom a rash developed were potentially somewhat infectious to others about 1 month after immunization. Vaccination was not associated with an increase in the incidence of herpes zoster or in relapse of leukemia. Vaccination provided excellent protection against severe varicella. It was associated with a significant decrease in the attack rate of chickenpox following an intimate exposure to varicella-zoster virus, conferring about 80% protection in leukemic children. The cases of breakthrough varicella that occurred were mild. Thus, the vaccine may either prevent or modify varicella in high-risk individuals. It may also have use for prevention of nosocomial varicella.

Adult↗
PubMed1992

Six-year follow-up study on the efficacy and safety of vigabatrin in patients with epilepsy.

Twenty-five patients with epilepsy (mostly with partial seizures) who had responded favourably to a short-term trial of add-on vigabatrin entered maintenance treatment. After 52 to 78 months, 15 patients continue to take the drug with good therapeutic response. Median monthly seizure frequency during the last 2 months on vigabatrin in all patients, including drop-outs, was 3.5 (range 0-74) as compared with 10 (range 3-98) during an initial placebo period (p < 0.01). Drop-outs were caused by adverse events in 2 cases (ataxia and psychotic symptoms respectively), seizure breakthrough in 4 cases and reasons unrelated to treatment in 4 patients. In most patients, side effects were absent or mild, the most frequent complaint being weight gain. It is concluded that the antiepileptic efficacy and good clinical tolerability of vigabatrin are generally maintained during long-term treatment for up to 6 years.

Adolescent↗
PubMed1985

Chromosomal abnormalities in the Kaiser-Permanente Birth Defects Study, with special reference to contraceptive use around the time of conception.

Chromosomal abnormalities were studied in 33,551 abortions and births to women whose contraceptive histories had been recorded at their first antenatal visit in 1975-1977. Chromosome examinations were performed exclusively on clinical grounds. There were 45 de novo abnormalities detected (1.34/1,000); three of them were detected at amniocentesis. Trisomy 21 was observed in 27 cases (0.80/1,000), trisomy 18 in nine (0.27), other trisomies in three (0.09), and translocations or deletions in five (0.15). One case of triploidy and six cases of inherited abnormalities were detected. There were no significant racial variations. No increase in risk for chromosomal abnormalities was found among women who had used oral contraceptives prior to becoming pregnant or among women who experienced oral contraceptive breakthrough pregnancies. Two cases of trisomy 18 were observed among the 814 deliveries following oral contraceptive breakthrough conceptions (2.46/1,000), two cases of trisomy 21 occurred in 338 births following failures of rhythm contraception (5.92/1,000), and no cases of trisomy 21 or 18 among the 1,569 women using spermicides at the time of conception.

Abnormalities, Drug-Induced↗
PubMed1990

Contaminant breakthrough: a theoretical study of charcoal sampling tubes.

A previously developed theoretical model was applied to investigate contaminant breakthrough on charcoal sampling tubes. Associated with the model are two important theoretical parameters. These parameters are k' (a rate constant) and tau (the time required for 50% contaminant breakthrough). In this study, values of K' and tau were determined for n-heptane at five different concentration levels in air: 98, 117, 234, 330, and 988 ppm. These values were used along with pertinent theoretical considerations to calculate the entire (0-100%) breakthrough curve (plot of percent breakthrough versus time) regarding the adsorbance of n-heptane on charcoal sampling tubes. In addition, available experimental data for perchloroethylene, isobutyl acetate, ethyl acetate, and dichloromethane were used in conjunction with the theory to generate theoretical breakthrough curves over the entire range of 0 to 100%. In each case, calculated theoretical breakthrough curves are in remarkable agreement with corresponding experimental data. With the use of an additional theoretical parameter, a, the theory was extended to calculate the weight of contaminant collected on a single element (section) of a charcoal sampling tube at 10% breakthrough and at each of several different contaminant assault concentrations.

Acetates↗
PubMed1985

The need to trace our roots in difficult times. The 1985 AANS presidential address.

Several important events that have played a major role in shaping the destiny of neurological surgery are recounted: the birth of neurosurgery; the founding of scientific surgery; the origin and evolution of microvascular technique in cerebrovascular surgery. In each case, the clinical breakthroughs stemmed from an apparently irrelevant basic laboratory investigation. Also, in each case, the transfer of the laboratory results to the bedside required clinicians who were prepared by training and knowledge to recognize the clinical significance of the fundamental observations. History tells us that if we are to sustain neurological surgery as a vibrant surgical specialty, we must continue to give top priority to the preparation of young minds through education and research. It is more important to understand this now than ever before, because never before have we been so preoccupied with social and economic issues: a preoccupation that is threatening to divert our attention from the main determinants of our specialty's future viability--the acquisition and application of new knowledge.

History, 19th Century↗
PubMed1983

'Breakthrough' enterococcal septicemia in surgical patients. 19 cases and a review of the literature.

We studied 19 surgical patients with 24 postoperative episodes of enterococcal septicemia not arising from the biliary or urinary tracts or from infected heart valves. Fifteen episodes occurred despite the administration of broad-spectrum antibiotics; in only one patient were these drugs effective against enterococcus. There were 14 episodes of enterococcemia in 11 patients following which the patient survived for at least one week. Thirteen (93%) of those episodes were treated with either ampicillin or drainage, or both. Five of the six long-term survivors received ampicillin therapy. Overall mortality was 68%. The data suggest that the enterococcus may emerge as a blood-borne pathogen in immunodepressed, postoperative patients receiving antibiotics for other infections of enteric origin. Antibiotic therapy specifically directed against this organism (and surgical drainage, if necessary) may be indicated during polymicrobial sepsis of enteric or mixed origin. If the spectrum of antibiotics does not include enterococcus, this organism can cause "breakthrough" sepsis, as can many other opportunistic organisms.

Adolescent↗