Book Reviews

ImmunoparasitologyImmunoparasitology: Principles and Methods in Malaria and Schistosomiasis Research. Ed. by G. T. Strickland and K. W. Hunter. Pp. 294. Illustrated. £29,75. London: Praeger. 1982.Walsh and Hoyt's Clinical Neuro-Ophthalmology, vol. 1. By Neil R. Miller. Pp. xii +381. Illustrated. R66,-. Baltimore: Williams & Wilkins. 1982Urinary tract infectionUrinary Tract Infection (Currenr Topics in Infection, No. 3). By R. Maskell. Pp. viii + 144. Illustrated. R37,-. London: Edward Amold. 1982.Common Health Problems in Medical Practice. By E. Scott Medley. Pp. xvi +343. Illustrated. Baltimore: Williams & Wilkins. 1982.Endocrine pathologyEndocrine Pathology: General and Surgical. 2nd ed. Ed. by J. M. B. Bloodworth jun. Pp. xii + 895. Illustrated. Baltimore: Williams & Wilkins. 1982.Experimental Hematology Today, 1982. Ed. by S. J. Baum, D. D. Ledney and S. Thierfelder. Pp. xx +266. Illusuated. DM 237,-. Basle: S. Karger. 1982.Medical Disorders of Alcoholism: Pathogenesis and Treatment (Major Problems in International Medicine, vol. XXII). By C. S. Lieber. Pp. xvii + 589. Illusuated. ± RI08,-. Philadelphia: W. B. Saunders. 19.82.Breast Cancer (Clinics in Oncology, No. I, vol. 3). Guest ed. M. Baum. Pp. vii +647 + 955. Illustrated. Rll,75. Philadelphia: W. B. Saunders. 1982.Handbook of Medical Parasitology. By Viqar Zaman and Loh Ah Keong. Pp. viii + 218. Illustrated. £17,-. New York: ADIS Health Science Press. 1982

The compatibility of circularity and national dietary recommendations for animal products in five European countries: a modelling analysis on nutritional feasibility, climate impact, and land use

BACKGROUND National food-based dietary guidelines (FBDGs) are generally designed from a human health perspective and often disregard sustainability aspects. Circular food production systems are a promising solution to achieve sustainable healthy diets. In such systems, closing nutrient cycles where possible and minimising external inputs contribute to reducing environmental impacts. This change could be made by limiting livestock feed to available low-opportunity-cost biomass (LOCB). We examined the compatibility of national dietary guidelines for animal products with livestock production on the basis of the feed supplied by available LOCB. METHODS We investigated whether the national dietary recommendations for animal products for Bulgaria, Malta, the Netherlands, Sweden, and Switzerland could be met with domestically available LOCB. We used an optimisation model that allocates feed resources to different species of farm animals. Of the resulting scenarios, we assessed the nutritional feasibility, climate impact, and land use. FINDINGS Our results showed the environmental benefits of reducing the recommended animal products in the FBDGs, and that animal products from LOCB could provide between 22% (Netherlands) and 47% (Switzerland) of total protein contributions of the FBDGs. This range covers a substantial part of the nutritional needs of the studied populations. To fully meet these needs, consumption of plant-based food could be increased. INTERPRETATION Our results contribute to the discussion of what quantities of animal products in dietary guidelines are compatible with circular food systems. Thus, national dietary recommendations for animal products should be revised and recommended quantities lowered. This finding is consistent with recent efforts to include sustainability criteria in dietary guidelines. FUNDING Swiss National Science Foundation and the Dutch Research Council

Patient organisations and the reimbursement process for medicines: an exploratory study in eight European countries

<p>Abstract</p> <p>Background</p> <p>Little is known about the role European patient organisations play in the process of deciding on reimbursement for medicines. Therefore we <it>explore </it>the current role of patient organisations in the process of reimbursement for medicines in Western Europe. We focus in particular on collaboration between patient organisations and the pharmaceutical industry in this respect.</p> <p>Methods</p> <p>Sixty-eight patient organisations representing seven medical conditions, from ten Western European countries, were asked to participate in the study. The participating organisations reported their experiences in a web-based questionnaire.</p> <p>Results</p> <p>Twenty-one patient organisations completed the questionnaire (response rate: 31%), of which ten (47.6%) demanded reimbursement for medicines. Organisations demanding reimbursement were larger than those not demanding reimbursement. The main aim of these organisations was to create better accessibility of medicines for patients. Most organisations limited themselves to single actions. Only two engaged in multiple actions. Almost all organisations had general policies on cooperation with the pharmaceutical industry, with autonomy as the key feature. The patient organisations said they were reasonably successful and almost always satisfied with their own role in the reimbursement process.</p> <p>Conclusion</p> <p>Our study has found that the role of European patient organisations in the reimbursement process still seems limited, especially for small patient organisations.</p

A novel genetic variant of Streptococcus pneumoniae serotype 11A discovered in Fiji.

OBJECTIVES: As part of annual cross-sectional Streptococcus pneumoniae carriage surveys in Fiji (2012-2015), we detected pneumococci in over 100 nasopharyngeal swabs that serotyped as '11F-like' by microarray. We examined the genetic basis of this divergence in the 11F-like capsular polysaccharide (cps) locus compared to the reference 11F cps sequence. The impact of this diversity on capsule phenotype, and serotype results using genetic and serologic methods were determined. METHODS: Genomic DNA from representative 11F-like S. pneumoniae isolates obtained from the nasopharynx of Fijian children was extracted and subject to whole genome sequencing. Genetic and phylogenetic analyses were used to identify genetic changes in the cps locus. Capsular phenotypes were evaluated using the Quellung reaction and latex agglutination. RESULTS: Compared to published 11F sequences, the wcwC and wcrL genes of the 11F-like cps locus are phylogenetically divergent, and the gct gene contains a single nucleotide insertion within a homopolymeric region. These changes within the DNA sequence of the 11F-like cps locus have modified the antigenic properties of the capsule, such that 11F-like isolates serotype as 11A by Quellung reaction and latex agglutination. CONCLUSIONS: This study demonstrates the ability of molecular serotyping by microarray to identify genetic variants of S. pneumoniae and highlights the potential for discrepant results between phenotypic and genotypic serotyping methods. We propose that 11F-like isolates are not a new serotype but rather are a novel genetic variant of serotype 11A. These findings have implications for invasive pneumococcal disease surveillance as well as studies investigating vaccine impact

Intranasal Vaccination With Lipoproteins Confers Protection Against Pneumococcal Colonisation

Streptococcus pneumoniae is endowed with a variety of surface-exposed proteins representing putative vaccine candidates. Lipoproteins are covalently anchored to the cell membrane and highly conserved among pneumococcal serotypes. Here, we evaluated these lipoproteins for their immunogenicity and protective potential against pneumococcal colonisation. A multiplex-based immunoproteomics approach revealed the immunogenicity of selected lipoproteins. High antibody titres were measured in sera from mice immunised with the lipoproteins MetQ, PnrA, PsaA, and DacB. An analysis of convalescent patient sera confirmed the immunogenicity of these lipoproteins. Examining the surface localisation and accessibility of the lipoproteins using flow cytometry indicated that PnrA and DacB were highly abundant on the surface of the bacteria. Mice were immunised intranasally with PnrA, DacB, and MetQ using cholera toxin subunit B (CTB) as an adjuvant, followed by an intranasal challenge with S. pneumoniae D39. PnrA protected the mice from pneumococcal colonisation. For the immunisation with DacB and MetQ, a trend in reducing the bacterial load could be observed, although this effect was not statistically significant. The reduction in bacterial colonisation was correlated with the increased production of antigen-specific IL-17A in the nasal cavity. Immunisation induced high systemic IgG levels with a predominance for the IgG1 isotype, except for DacB, where IgG levels were substantially lower compared to MetQ and PnrA. Our results indicate that lipoproteins are interesting targets for future vaccine strategies as they are highly conserved, abundant, and immunogenic

Development of a multiplexed bead-based immunoassay for the simultaneous detection of antibodies to 17 pneumococcal proteins

Presently, several pneumococcal proteins are being evaluated as potential vaccine candidates. Here, we gather novel insights in the immunogenicity of PLY, PsaA, PspA, PspC, NanA, Hyl, PpmA, SlrA, Eno, IgA1-protease, PdBD, BVH-3, SP1003, SP1633, SP1651, SP0189 and SP0376. We developed a multiplex bead-based immunoassay (xMAP® Technology, Luminex Corporation) to simultaneously quantify antibodies against these 17 pneumococcal proteins in serum. The median fluorescence intensity (MFI) values obtained for human pooled serum with the multiplex assay were between 82% and 111% (median 94%) of those obtained with the singleplex assays. For IgG, the coefficient of variation (CV) in serum ranged from 2% to 9%, for IgA, the CV ranged from 3% to 14% and for IgM, the CV ranged from 11% to 15%. Using this immunoassay, we showed that anti-pneumococcal antibody levels exhibited extensive inter-individual variability in young children suffering from invasive pneumococcal disease. All proteins, including the proteins with, as yet, unknown function, were immunogenic. In conclusion, the multiplex Streptococcus pneumoniae immunoassay based on proteins is reproducible. This assay can be used to monitor anti-S. pneumoniae antibody responses in a material- and time-saving manner