Protective Efficacy against Respiratory Syncytial Virus following Murine Neonatal Immunization with BBG2Na Vaccine: Influence of Adjuvants and Maternal Antibodies

Alum-adsorbed BBG2Na, a recombinant vaccine derived in part from the respiratory syncytial virus (RSV) subgroup A G protein, induced moderate antibody titers after 1 immunization in 1-week-old mice but conferred complete lung protection upon RSV challenge. The anti-BBG2Na IgG1-IgG2a neonatal isotype profile was suggestive of dominant Th2 responses compared with those in adults. Formulation of BBG2Na with a Th1-driving adjuvant efficiently shifted neonatal responses toward a more balanced and adultlike IgG1-IgG2a profile without compromising its protective efficacy. BBG2Na-induced protective immunity was maintained even after early life immunization in the presence of high titers of maternal antibodies. Under these conditions, the protective efficacy (86%-100%) reflected the high capacity of the nonglycosylated G2Na immunogen to escape inhibition by RSV-A—induced maternal antibodies. Thus, immunization with BBG2Na protected against viral challenge despite neonatal immunologic immaturity and the presence of maternal antibodies, two major obstacles to neonatal RSV vaccine developmen

Psychothérapie et mécanismes de défense = Psychotherapy and defense mechanisms

Dans cet article, les auteurs mettent en dialogue deux facettes des mécanismes de défense en situation psychothérapeutique : la psychopathologie et le changement. Pour commencer, les instruments de mesure les plus utilisés sont présentés, avec un accent sur les échelles d'évaluation par un juge externe. Les conceptions de Vaillant et de Perry sont présentées et discutées. L'article se continue avec une synthèse des travaux empiriques de recherche en psychothérapie se focalisant sur les changements des mécanismes de défense au cours des psychothérapies, principalement d'orientation psychanalytique. Une réflexion autour du lien avec le concept d'alliance thérapeutique, ainsi qu'avec celui du coping complète cette synthèse. Des travaux récents concernant des psychothérapies de courte et de longue durée sont ensuite abordés. Les défenses sont également discutées du point de vue de la psychopathologie, à travers deux exemples d'études empiriques mettant en évidence des spécificités dans des troubles psychiatriques. Les retombées de ces résultats de recherche pour la pratique psychanalytique sont mentionnées tout au long de cet article de synthèse. With the present article, we aim to develop a dialogue between two aspects of defense mechanisms in psychotherapy : psychopathology and change. First, the most frequently used instruments will be presented, with a particular focus on observer-rated scales, and Vaillant's and Perry's models are sketched and discussed. Then, we review empirical research on changes in defense mechanisms over the course of psychotherapy, mainly psychoanalytic. An elaboration on the links with the concept of therapeutic alliance and the concept of coping completes this overview. Recent studies on change in short- and long-term psychotherapy are then discussed. Defense mechanisms are then examined from a psychopathology point of view, using two examples of empirical studies pointing to distinctive characteristics of mental disorders. Clinical implications for psychoanalytic practice are discussed throughout the article

La dyspnée de l'adulte

La dyspnée est le sentiment d'une respiration inconfortable et difficile. Elle n'est pas synonyme de tachypnée (fréquence respiratoire augmentée) ou d'hyperventilation (ventilation minute augmentée). On peut en effet rencontrer des patients hyperventilant lors d'acidose métabolique (par exemple lors d'acidocétose diabétique) ou d'état de choc, sans qu'ils ne ressentent de dyspnée

Certificats médicaux pour les séjours en haute montagne et la plongée sous-marine

People are more and more looking for adventures and discovery of unusual locations. Journeys to high altitude and scuba diving are part of these activities and their access has become easier for a lot of people not necessarily experienced with their dangers. The general practitioner will have to be able to deliver some advices and recommendations to his patients about the risks related to these activities and their ability to practice them. He will also have to deliver some certificates of medical fitness to dive. This paper proposes a brief review of the most important medical aspects to know about high altitude and scuba diving

Renal transplantation in the elderly: a long‐term, single‐centre experience

Background. End‐stage renal failure increases with advancing age and renal transplantation should be considered in end‐stage renal failure patients older than 60 years. However, there is a paucity of data on long‐term patient and graft survival in this population. Methods. From October 1983 to March 1999, 310 renal transplantations were performed at Geneva University Hospital in 283 patients, of which 49 were done in 48 patients older than 60 years (mean age 65.6±4.1 years). The following data were analysed at 1, 5, and 10 years, and compared between the patients >60 years and 60 years. Graft survival at 10 years was 59% for patients 60 years. Graft survival at 10 years censored for death with functioning graft was 65% for patients 60 years. Main causes of mortality in the older patients were related to cardiovascular events (47%), neoplasia (41%), and sepsis (18%). Overall, recipient and donor age were not predictive factors for graft survival, as shown by multiple logistic regression. Conclusions. Renal transplantation should be considered in patients older than 60 years, since graft survival is excellent in this population. Although these patients have a shorter life expectancy, they benefit from renal transplantation similarly to younger kidney transplant recipient

Renal transplantation in the elderly: a long-term, single-centre experience

End-stage renal failure increases with advancing age and renal transplantation should be considered in end-stage renal failure patients older than 60 years. However, there is a paucity of data on long-term patient and graft survival in this population