How valid are IMS DA summary statistics of children's vaccination status?

Purpose: Accurate recording of immunisation status is essential for the evaluation of any immunization program. In September 2006, 7 Valent Pneumococcal Conjugate Vaccination (PCV7) was introduced into the UK’s routine childhood immunisation programme. This study validated the PCV7 immunization status of children aged 2 years recorded in the IMS Disease Analyses database. / Methods: The PCV7 vaccination uptake rate for children born in 2008 in the IMS DA database was calculated. A sample of 173 of the 2497 children not recorded as vaccinated was identified and a questionnaire was sent to each of their General Practitioners to ascertain the child’s true PCV7 vaccination status. / Results: In the IMS DA data of 15,237 children born in 2008, 12,740 (83.6%) had a vaccination record of PCV7. One hundred and eleven of the 167 questionnaires sent to the child’s general practitioners were returned, giving an adjusted response rate of 111/167 (66.5%). Based on the general practitioners’ responses, 71 (64%) of these children were fully vaccinated according to their General Practitioner’s records making the revised estimated vaccination rate for this cohort 94.1%. / Conclusion: This validation study has shown that caution is needed if using historical IMS patient-level data to analyse the effectiveness of PCV7 as there is a potential under-recording of immunization leading to underrepresentation of vaccination rates by approximately ten per cent. Coverage of other vaccines may also be underestimated in the IMS database

Role of 18F-FDG PET Scans in Patients with Helicobacter pylori-Infected Gastric Low-Grade MALT Lymphoma

BACKGROUND/AIMS: Endoscopic ultrasound (EUS) plays a crucial role in the assessment and treatment of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma; however, interobserver variation, inadequate accuracy in judging the depth of tumor invasion, and histological heterogeneity of the tumor can limit its role. Thus, we have assessed the role of (18)F-FDG PET scans in the management of Helicobacter pylori-infected gastric MALT lymphoma. METHODS: Eighteen patients with H. pylori-infected low-grade gastric MALT lymphoma underwent an (18)F-FDG PET scan prior to receiving H. pylori eradication therapy. We analyzed these patients' clinicopathologic data and measured the baseline and change in the metabolic activity of the tumor using standardized uptake values (SUVs). RESULTS: Two patients failed to achieve complete remission of the low-grade gastric MALT lymphoma after successful H. pylori eradication. The baseline SUVs were significantly higher in these patients compared to successfully treated patients, 13.35±0.07 vs 2.98±0.93, respectively (n=2 vs n=16, p<0.001). The reduction in the SUV was significantly greater in the complete remission patients compared to treatment failure patients (p=0.018). CONCLUSIONS: A high SUV at baseline (18)F-FDG PET and a lower reduction in the SUV within 3 months after eradication therapy are associated with treatment failure in H. pylori-positive low-grade gastric MALT lymphoma patients undergoing eradication treatment.ope

Impact of Pneumococcal Conjugate Vaccines (PCV) on the incidence of community acquired pneumonia (CAP) in the UK

Oral Presentation - Respiratory MattersConference Theme: Applying pharmacoepidemiology to improve health care in AsiaAims/Objectives: Heptavalent PCV (PCV7) was introduced into the UK vaccination schedule in September 2006 followed by 13-valent PCV (PCV13) in April 2010. In the US and Europe PCV7 reduced the incidence of invasive pneumococcal disease in children aged <5 years. Hospital pneumonia admission rates in England declined by 19% in the 2 years post-introduction (Koshy et al., 2010). We assessed the impact of PCVs on primary care diagnoses of CAP and associated antibiotic prescribing in children. Methods: A descriptive cohort study was conducted using The Health Improvement Network database of anonymised patient health records for 5% of the UK population. The study population comprised children aged <16 years with ≥6 months’ data and ≥1 pneumonia diagnosis recorded between 1 January 2002 and 31 December 2010. The duration of an episode of CAP was defi ned as 30 days. Annual incidences of CAP and antibiotic prescribing were calculated. Results: CAP incidence declined by 13.3% for children aged <16 years between January 2006 and December 2010 from 1.07 episodes/1000 person-years (PY) to 0.92/1000 PY; the largest reductions were in younger age bands (28.3% in <2 years; 20.3% in 2-5 years; 27.8% in 6-10 years). Antibiotic prescribing decreased by 10.3% overall; however the steepest decline (44.2%) was seen in children aged <2 years from 0.74 treated-episodes/1000 PY in 2006 to 0.41/1000 PY in 2010. Conclusion: PCVs have reduced the incidence of CAP diagnoses and antibiotic prescribing for CAP since their introduction; this is most evident in the main target group of young children <2 years

PVA/Inulin-Based Sustainable Films Reinforced with Pickering Emulsion of Niaouli Essential Oil for Potential Wound Healing Applications

In this study, sustainable water-based films were produced via the solvent-casting method. Petroleum-free-based polyvinyl alcohol (PVA) and carbohydrate-based inulin (INL) were used as matrices. Vegetable-waste pumpkin powder was used in the study because of its sustainability and antibacterial properties. Pickering emulsions were prepared using β-cyclodextrin. The influence of the different ratios of the β-cyclodextrin/niaouli essential oil (β-CD/NEO) inclusion complex (such as 1:1, 1:3, and 1:5) on the morphological (SEM), thermal (TGA), physical (FT-IR), wettability (contact angle), and mechanical (tensile test) characteristics of PVA/inulin films were investigated. Moreover, the antibacterial activities against the Gram (−) (Escherichia coli and Pseudomonas aeruginosa) and Gram (+) (Staphylococcus aureus) bacteria of the obtained films were studied. From the morphological analysis, good emulsion stability and porosity were obtained in the Pickering films with the highest oil content, while instability was observed in the Pickering films with the lowest concentration of oil content. Thermal and spectroscopic analysis indicated there was no significant difference between the Pickering emulsion films and neat films. With the addition of Pickering emulsions, the tensile stress values decreased from 7.3 ± 1.9 MPa to 3.3 ± 0.2. According to the antibacterial efficiency results, films containing pumpkin powder and Pickering emulsion films containing both pumpkin powder and a ratio of 1:1 (β-CD/NEO) did not have an antibacterial effect, while Pickering emulsion films with a ratio of (β-CD/NEO) 1:3 and 1:5 showed an antibacterial effect against Escherichia coli, with a zone diameter of 12 cm and 17 cm, respectively. Among the samples, the films with ratio of (β-CD/NEO) 1:5 had the highest antioxidant capacity, as assessed by DPPH radical scavenging at 12 h intervals. Further, none of the samples showed any cytotoxic effects the according to LDH and WST-1 cytotoxicity analysis for the NIH3T3 cell line. Ultimately, it is expected that these films are completely bio-based and may be potential candidates for use in wound healing applications

Impact of pneumococcal conjugate vaccines on childhood otitis media in the United Kingdom.

BACKGROUND: Studies have demonstrated a reduction for otitis media (OM) following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7), but this has not been evaluated in the United Kingdom (UK). Moreover, there are limited data on any additional impact of PCV13 introduction in 2010. METHODS: We conducted an observational cohort study to investigate the trends in OM incidence and associated antibiotic prescriptions in children aged <10 year-olds during 2002-2012 using a national primary care database. Three time-periods were defined to estimate monthly incidence: pre-PCV7 (January 2002-August 2006), post-PCV7 (September 2007-March 2010), and post-PCV13 (April 2011-December 2012). RESULTS: Overall annual OM incidence declined by 51.3% from 135.8 episodes/1000 person-years in 2002 to 66.1 episodes/1000 person-years in 2012; antibiotic prescription rates for OM declined by 72.9% from 57.9 prescriptions/1000 person-years to 15.7 prescriptions/1000 person-years, respectively. PCV7 introduction was associated with significant decline in OM rates across all age-groups (21.8%; 95% CI, 20.2-23.4), including <2 year-olds (19.8%; 95% CI, 16.0-23.5%); 2-4 year-olds (23.0%; 95% CI, 20.4-25.4%) and 5-9 year-olds (20.2%; 95% CI, 17.6-22.7%). There was an additional significant reduction in OM (18.5%; 95% CI, 16.7-20.2%) and associated antibiotic prescribing (12.2%; 95% CI, 8.6-15.6%) after the introduction of PCV13 across all age-groups. CONCLUSION: The introduction of PCV7 was associated with a 22% significant reductions in OM in children aged <10 year-olds with an additional 19% reductions after PCV13 introduction. These declines are equivalent to 592,000 and 15,700 fewer consultations and OM-related hospitalizations, respectively, in England and Wales every year. Although the continuing decline in OM rates in our study suggests that further reduction may continue to occur, it is important to monitor long-term trends in all pneumococcal diseases, including OM and pneumonia, because of increasing replacement of non-vaccine pneumococcal serotypes in carriage and disease

Response of nine triticale genotypes to different salt concentrations at the germination and early seedling stages

Salinity stress poses a major challenge to agricultural productivity worldwide, and understanding their responses at the early growth stage is vital for devising strategies to cope with this stress. Therefore, to improve triticale productivity, this study investigated the salinity stress tolerance of different salt-tolerant triticale genotypes aiming to cultivate them on saline soils. To this end, salinity stress impacts on nine triticale genotypes, i.e., Zhongsi 1084, Gannong No. 2, Gannong No. 4, Shida No. 1, C6, C16, C23, C25 and C36 at germination and early seedling stages was evaluated. Each genotype was subjected to six treatments inducing control, 40, 80, 120, 160, and 200 mM NaCl treatments to study their effect on seedling and termination traits of the nine genotypes. Compared to the overall mean seedling vigor index, the seedling vigor index was higher in the genotypes Zhongsi 1084 and C6 (39% and 18.1%, respectively) and lower in Gannong No.2 (41%). Increasing NaCl concentrations negatively affected germination and seedling traits. Compared to other genotypes, Zhongsi 1084 had the highest mean germination rate, germination vigor index, germination percentage, mean daily germination and germination energy. It also showed the lowest relative salt injury. The relative salt injury was higher in the genotype Shida No. 1 than those in Gannong No. 2, Gannong No. 4, Shida No. 1, C16, and C36 genotypes. All genotypes exhibited desirable mean germination time except for line C6. High significant positive correlations were observed among germination rate, germination vigor index, germination percentage, mean daily germination, seedling vigor index, and root length. Principal component analysis (PCA) grouped the most desirable genotypes into two clusters. Our study determined salt stress tolerance of nine triticale genotypes at germination and early seedling stages. to select salt-tolerant genotypes that can be cultivated on saline soil or after salt irrigation

Correlation and prognostic significance of p53, p21(WAF1/CIP1) and Ki-67 expression in patients with superficial bladder tumors treated with bacillus Calmette-Guerin intravesical therapy

Purpose: We determine if, before intravesical bacillus-Calmette Guerin (BCG) therapy, p53, p21(WAF-1-CIP1) (a critical downstream effector of p53 pathway of cell growth control, inhibiting cyclin dependent kinases) and the cell proliferation marker Ki-67 (MIB-1) could be used as prognostic markers of response to BCG in patients with superficial bladder tumors. Materials and Methods: The study included 47 patients with superficial bladder tumors at high risk for recurrence or progression treated with 6 weekly intravesical BCG instillations. We analyzed p53, p21 and Ki-67 on paraffin embedded samples by immunohistochemistry and the percentage of positive cells was determined in a blinded fashion. Quantitative immunostaining was analyzed in relation to time to recurrence and progression using univariate or multivariate analysis and the Kaplan-Meier method. Results: During a mean followup of 24.6 months 23 of the 47 patients (48.9%) presented with tumor recurrence and 10 (21.2%) had later progression to invasive disease. A p21 over expression (greater than 10%) was observed in 23 tumors (48.9%) and positively correlated with p53 (p = 0.0097) but not with Ki-67 (p = 0.327). Of the tumors 18 (38.2%) were p53 and p21 negative. Among p21 positive tumors 15 (65.2%) were p53 and p21 positive, suggesting that p21 may also be regulated by p53 independent pathways. However, p53 did not act as a predictor of recurrence or progression. In contrast, using Kaplan-Meier curves p21 over expression (greater than 10%) and Ki-67 at a 25% cutoff were associated with shorter recurrences-free survival (both p = 0.02 log rank test) but they did not predict additional information about risk of progression. However, multivariate analysis failed to demonstrate any independent prognostic value for p21 or Ki-67 in contrast to tumor stage. Conclusions: Our results indicate that p21(WAF-1-CIP1) seems to be regulated by p53 independent pathways in superficial bladder cancer. The present study did not indicate an independent prognostic significance in patients treated with BCG for p53, p21(WAF-1-CIP1) or Ki-67 markers. Larger prospective studies are needed to evaluate further the independent value of these biological markers in superficial bladder cancer management.SCOPUS: ar.jinfo:eu-repo/semantics/publishe