Demographic and Clinical Factors Associated with Response to Smallpox Vaccine in Preimmunized Volunteers

CONTEXT: In March 2003, the French Ministry of Health implemented a program on preparedness and response to a biological attack using smallpox as weapon. This program included the establishment of a preoutbreak national team that could be revaccinated against smallpox. OBJECTIVE: To identify demographic and clinical factors associated with vaccination success defined as the presence of a pustule at the inoculation site at day 8 (days 7-9), with an undiluted vaccinia virus derived from a Lister strain among preimmunized volunteers. VOLUNTEERS AND METHODS: From March 2003 to November 2006, we have studied prospectively 226 eligible volunteers. Demographic data were recorded for each volunteer (age, sex, number of previously smallpox vaccinations and date of the last vaccination). Smallpox vaccine adverse reactions were diagnosed on the basis of clinical examination performed at days 0, 7, 14, 21 and 28 after revaccination. RESULTS: A total of 226 volunteers (sex ratio H/F = 2.7) were revaccinated. Median age was 45 years (range: 27-63 yrs). All volunteers completed follow-up. Median number of vaccinations before revaccination was 2 (range: 1-8). The median delay between time of the study and the last vaccination was 29 years (range; 18-60 yrs). Sixty-one volunteers (27%) experienced one (n = 40) or more (n = 21) minor side effects during the 2-14 days after revaccination. Successful vaccination was noted in 216/226 volunteers (95.6%) at day 8 and the median of the pustule diameter was 5 mm (range: 1-20 mm). Size of the pustule at day 8 was correlated with age (p = 0.03) and with the presence of axillary adenopathy after revaccination (p = 0.007). Sex, number of prior vaccinations, delay between the last vaccination and revaccination, and local or systemic side effects with the exception of axillary adenopathy, were not correlated with the size of the pustule at day 8. CONCLUSIONS: Previously vaccinated volunteers can be successfully revaccinated with the Lister strain

JAK inhibition in Aicardi-Goutières syndrome: a monocentric multidisciplinary real-world approach study

International audienceThe paradigm type I interferonopathy Aicardi-Goutières syndrome (AGS) is most typically characterized by severe neurological involvement. AGS is considered an immune-mediated disease, poorly responsive to conventional immunosuppression. Premised on a chronic enhancement of type I interferon signaling, JAK1/2 inhibition has been trialed in AGS, with clear improvements in cutaneous and systemic disease manifestations. Contrastingly, treatment efficacy at the level of the neurological system has been less conclusive. Here, we report our real-word approach study of JAK1/2 inhibition in 11 patients with AGS, providing extensive assessments of clinical and radiological status; interferon signaling, including in cerebrospinal fluid (CSF); and drug concentrations in blood and CSF. Over a median follow-up of 17 months, we observed a clear benefit of JAK1/2 inhibition on certain systemic features of AGS, and reproduced results reported using the AGS neurologic severity scale. In contrast, there was no change in other scales assessing neurological status; using the caregiver scale, only patient comfort, but no other domain of everyday-life care, was improved. Serious bacterial infections occurred in 4 out of the 11 patients. Overall, our data lead us to conclude that other approaches to treatment are urgently required for the neurologic features of AGS. We suggest that earlier diagnosis and adequate central nervous system penetration likely remain the major factors determining the efficacy of therapy in preventing irreversible brain damage, implying the importance of early and rapid genetic testing and the consideration of intrathecal drug delivery

Antiretroviral-naive and -treated HIV-1 patients can harbour more resistant viruses in CSF than in plasma

Objectives The neurological disorders in HIV-1-infected patients remain prevalent. The HIV-1 resistance in plasma and CSF was compared in patients with neurological disorders in a multicentre study. Methods Blood and CSF samples were collected at time of neurological disorders for 244 patients. The viral loads were >50 copies/mL in both compartments and bulk genotypic tests were realized. Results On 244 patients, 89 and 155 were antiretroviral (ARV) naive and ARV treated, respectively. In ARV-naive patients, detection of mutations in CSF and not in plasma were reported for the reverse transcriptase (RT) gene in 2/89 patients (2.2%) and for the protease gene in 1/89 patients (1.1%). In ARV-treated patients, 19/152 (12.5%) patients had HIV-1 mutations only in the CSF for the RT gene and 30/151 (19.8%) for the protease gene. Two mutations appeared statistically more prevalent in the CSF than in plasma: M41L (P = 0.0455) and T215Y (P = 0.0455). Conclusions In most cases, resistance mutations were present and similar in both studied compartments. However, in 3.4% of ARV-naive and 8.8% of ARV-treated patients, the virus was more resistant in CSF than in plasma. These results support the need for genotypic resistance testing when lumbar puncture is performe

Hétérogénéité de l'industrie : secteur organisé et secteur inorganisé dans le textile

Lévy Brigitte. Hétérogénéité de l'industrie : secteur organisé et secteur inorganisé dans le textile. In: Tiers-Monde, tome 30, n°119, 1989. L'Inde : libéralisation et enjeux sociaux, sous la direction de Bernadette Madeuf et Philippe Cadène. pp. 647-672

The Rise of Asian Emerging Countries in the Global Economy: Implications for the Multilateral/Regional Trade Regime

This article first considers the process of competitive liberalization, which has driven the trend toward free trade and which has contributed to further integration of world economies. It illustrates that the trading system is highly competitive, with nations from North America, Europe and Asia seeking to sustain economic growth through greater reliance on export trade and through MNCs’ global value chains of production. The first section emphasizes that regionalism has strengthened worldwide, with the major economic players tending to focus on regional agreements, and more recently, on bilateral agreements. Next, the article discusses regionalization patterns, with an emphasis on the integration taking place in Asia. The major trade bloc in the region, the Association of Southeast Asian Nations (ASEAN), is focusing on increased integration into the global economy. In recent years, it has been promoting trade agreements with Japan, South Korea, and the emerging Asian countries of China and India, among others. Therefore, the article considers whether a new economic pole is emerging in Asia. Last, the difficulties in concluding the Doha Development Round of World Trade Organization (WTO) negotiations and the stalling of those negotiations from July 2006 to February 2007 point to an urgent need for global governance and supportive institutions. This article looks at critical issues in the global system, such as full participation of all players (particularly emerging and developing countries) in the decision-making process of international institutions, and the pursuit of sustainable development. Also, the impact of different cultures of trade will be important factors to consider in order to understand the emerging new world order.Dans un premier temps, cet article retrace le processus de libéralisation concurrentielle qui tendait vers le libre commerce et une intégration accrue de l’économie mondiale. Il met en évidence que le système de commerce est hautement compétitif avec des pays nord-américains, européens et asiatiques essayant d’augmenter leur croissance économique par le biais du commerce international. Il souligne l’essor du régionalisme soutenu par les économies principales avec une tendance récente aux accords bilatéraux. Dans un deuxième temps, l’article analyse plus particulièrement les structures de régionalisation en mettant l’accent sur l’évolution en Asie. L’accord principal dans la région, ASEAN, vise une intégration accrue dans l’économie mondiale, permettant ainsi de poser la question de savoir si nous assistons à l’émergence d’un nouveau (troisième) pôle économique mondial. Enfin, l’article souligne le besoin urgent d’une gouvernance mondiale soutenue par des institutions appropriées, étant donné l’impasse dans laquelle se trouve le cycle de Doha. Il faut s’assurer d’une participation équitable de tous les pays concernés et de leur développement durable. La prise en considération des différences entre les cultures de commerce régionales sera cruciale pour l’accomplissement d’une telle stratégie.Der vorliegende Aufsatz untersucht den Prozess konkurrierender Marktliberalisierung, der in Richtung globalen Freihandels und zunehmender ökonomischer Integration treibt. Dabei wird der hochkompetitive Charakter des Handelssystems deutlich, in dem nordamerikanische, europäische und asiatische Länder ökonomisches Wachstum durch verstärkten Außenhandel und über die Wertschöpfungsketten von multinationalen Konzernen herbeizuführen suchen. Im ersten Abschnitt wird gezeigt, dass sich die regionale Integration weltweit verstärkt, wobei die jeweiligen Hauptakteure auf multilaterale, in jüngster Zeit auch verstärkt bilaterale Abkommen setzen. Im nächsten Abschnitt werden Formen der Regionalisierung untersucht unter besonderer Berücksichtigung Asiens. Das wichtigste Handelsabkommen in der Region, ASEAN, strebt eine verstärkte Weltmarktintegration an. In jüngerer Zeit hat es insbesondere Abkommen mit Japan, Südkorea und den Schwellenländern Indien und China vorangetrieben. Infolgedessen geht der Artikel der Frage nach, inwieweit in Asien ein neues Welthandelszentrum entsteht. Abschließend werden die Schwierigkeiten der Doha-Runde und ihr derzeitiger Stillstand als Ausdruck des dringenden Erfordernisses globaler Governance und diese stützender Institutionen gewertet. Der Beitrag untersucht kritische Punkte des globalen Systems wie etwa die volle und gleichberechtigte Teilnahme aller Handelspartner inclusive der Schwellen- und Entwicklungsländer am Entscheidungsprozess der internationalen Institutionen oder die Verfolgung des Ziels nachhaltiger Entwicklung. Des weiteren darf die Bedeutung der Unterschiede in den verschiedenen Handelskulturen nicht verkannt werden, soll es zu einem besseren Verständnis des internationalen Handels kommen

THE INTERFACE BETWEEN GLOBALIZATION, TRADE AND DEVELOPMENT: THEORETICAL ISSUES FOR INTERNATIONAL BUSINESS STUDIES

Globalization, widely cited as the dominant international economic trend of the post-World War II era, is deeply connected with the opening of the world economy. The relationship between trade and growth has been intensively debated in the economic literature, within the fields of economics, sociology, political sciences, and others. However, in the areas of International Business (IB) and management studies, research about an integrated approach to the issues of globalization deserves further attention. In particular, in the 21 st century, companies are being challenged to think differently about the purpose and societal impact of their activities on the poorest nations. Therefore, this paper addresses economic and social issues of accelerating globalization within a framework of IB and management studies

Emerging Countries, Regionalization, and World Trade

The economic development of emerging countries such as China, India, Brazil, and Russia has serious implications for the multilateral trading system, and for government policies worldwide. This paper explores globalization and regionalization processes in order to assess the effects of trade liberalization on emerging countries. Today, major economic players tend to focus on bilateral and regional agreements. Attention must be paid to how these agreements affect the multilateral trading system and the trilateral world economy. One aspect that stands out from this study is that the role of countries such as China and India, which are reshaping trade patterns, remains to be defined within the Asian regional framework. Equity issues also have an important role to play, both at a regional and at a global level. Consideration of the intersections between the regional and/or bilateral trade agreements of member countries raises interesting questions about the role of trade blocs in the future trajectory of the global economy.