Impact of pre-existing dengue immunity on human antibody and memory B cell responses to Zika

Little is known about enduring memory B cell (MBC) responses to Zika virus (ZIKV) and their relationship with circulating antibodies. Here we comprehensively assess MBC frequency and specificity alongside serum binding and neutralizing antibody responses to ZIKV ~2 weeks and ~8 months postinfection in 31 pediatric subjects with 0, 1 or >1 prior infections with the related dengue virus (DENV). ZIKV infection elicits a robust type-specific MBC response, and the majority of late convalescent anti-ZIKV serum neutralizing activity is attributable to ZIKV-specific antibodies. The number of prior DENV infections does not influence type-specific or cross-reactive MBC responses, although ZIKV has the highest cross-reactivity with DENV3. DENV cross-reactive MBCs expanded by ZIKV infection decline in number and proportion by late convalescence. Finally, ZIKV induces greater cross-reactivity in the MBC pool than in serum antibodies. Our data suggest immunity to DENV only modestly shapes breadth and magnitude of enduring ZIKV antibody responses

The experience of low back pain in people with incomplete spinal cord injury in the USA, UK and Greece

Engineering and Physical Sciences Research Council's (EPSRC

Neuropathic pain in a rehabilitation setting after spinal cord injury: an interpretative phenomenological analysis of inpatients’ experiences

Study design Qualitative, semi-structured interviews. Objectives Neuropathic pain (NP) can be psychologically and physically debilitating, and is present in approximately half of the spinal cord injured (SCI) population. However, under half of those with NP are adherent to pain medication. Understanding the impact of NP during rehabilitation is required to reduce long-term impact and to promote adherence to medication and psychoeducation recommendations. Setting United Kingdom. Methods Five males and three females with SCI and chronic NP, resident in rehabilitation wards at a specialist SCI center in the United Kingdom, took part. Semi-structured interviews were conducted with participants less than 15 months post-SCI (mean = 8.4 months). Verbatim transcripts were subject to interpretative phenomenological analysis (IPA). Results Three super-ordinate themes were identified, mediating pain and adherence: (1) the dichotomy of safety perceptions; (2) adherence despite adversity; and (3) fighting the future. Analyses suggest that experience of the rehabilitation setting and responsiveness of care shapes early distress. Attitudes to medication and psychosocial adjustment are relevant to developing expectations about pain management. Conclusions Enhancing self-efficacy, feelings of safety in hospital, and encouraging the adoption of adaptive coping strategies may enhance psychosocial and pain-related outcomes, and improve adherence to medication. Encouraging adaptive responses to, and interpretation of, pain, through the use of interventions such as coping effectiveness training, targeted cognitive behavioral pain management, and acceptance-based interventions such as mindfulness, is recommended in order to reduce long-term reliance on medication

Study of the Effects of Hydro-methanol Extracts of Lavandula vera DC. and Cuscuta epithymum Murr. on the Seizure Induced by Pentylentetranzol in Mice

Abstract: Introduction: Epilepsy is the second most common nervous disorder after brain strok. In spite of present anticonvulsant drugs, researchers need to search for drugs with better efficacy and less side effects. Medicinal plants with various natural components so that different properties are suitable field for investigation. In this study, anticonvulsant effect of Lavandula vera DC. and Cuscuta epithymum Murr. were investigated. Methods: After collection and identification, percolation extract of the plants were prepared by methanol 80% and different doses of extracts were injected intraperitoneally in to mice. Pentylen tetrazole (PTZ) with dose of 90 mg/kg was used for induction of seizure. Changes in the onset time of seizure, duration of seizure, percent of mortality and the percent of seizure protection were determined in different groups. Results: Different doses of extracts of Lavandula vera and Cuscuta epithymum delayed the onset of seizure (P<0.01), but the duration of seizure did not change significantly. Pretreatment of animals with different doses of extracts decreased the mortality rate significantly (P<0.01), the percent of seizure protection was also greater than control group significantly (P<0.05) The most effective dose of Cuscuta epithymum and Lavandula vera were 100 mg/kg and 50 mg/kg respectively. Conclusion: It seems that Cuscuta epithymum and Lavandula vera have effective anticonvulsant component, however more investigations are needed in this field. Keywords: Lavandula vera, Cuscuta epithymum, Seizure, Pentylen tetrazol

Intravenous Paracetamol vs Intranasal Desmopressin for Renal Colic in the Emergency Department: A Randomized Clinical Trial

OBJECTIVE: To evaluate the analgesic efficacy of intranasal desmopressin alone vs intravenous paracetamol in patients referred to the emergency department with renal colic. DESIGN: Randomized clinical trial. SETTING: This study was conducted in the emergency unit of a university hospital. SUBJECTS: Patients referred to the emergency room with renal colic. PRIMARY OUTCOME: Effect of intranasal desmopressin in pain relief in comparison with intravenous paracetamol. METHODS: In this trial, 240 patients diagnosed with renal colic were randomly divided into two groups to compare the analgesic effect of intravenous paracetamol (15â��mg/kg) and intranasal desmopressin spray (40â��μg). Pain scores were measured by a numeric rating scale at baseline and after 15, 30, and 60â��minutes. Adverse effects and need for rescue analgesic (0.05â��mg/kg max 3â��mg morphine sulphate) were also recorded at the end of the study. RESULTS: Three hundred patients were eligible for the study; however, 240 were included in the final analysis. The patients in the two groups were similar in their baseline characteristics and baseline pain scores. The mean pain score after 15â��minutes was more reduced and was clinically significant (>3) in the desmopressin group (Pâ��6). CONCLUSIONS: Our study showed that intranasal desmopressin is as effective as intravenous paracetamol for renal colic pain management; however, significant clinical reduction in pain score occurred faster with intranasal desmopressin. © The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: [email protected]

Epidemiological study of child casualties of landmines and unexploded ordnances: A national study from Iran

Background Despite landmine-risk education programs and extensive demining activities on the Western border of Iran, landmines and unexploded ordnance (UXOs) still cause civilian and child casualties three decades after the Iraq-Iran war (1980-1988). The objective of this study was to understand the epidemiological patterns and risk factors of injury in child casualties of landmines and UXOs in Western and Southwestern Iran. Methods Children who were 18 years old or younger at the time of study and who sustained injuries from landmines and UXOs were identified through a search at the Iranian National Veterans Registry. These children participated in a 5-day gathering. The information on socioeconomic status, health-related issues, quality of life, health care utilization, and clinical profiles concerning the landmine and UXO injuries were collected. The method of data collection consisted of three component surveys: health interview, social survey, and medical examinations. Social surveys and health interviews were conducted in a face-to-face method by utilizing a questionnaire consisting of 39 questions addressing household and individual components, including information on time and type of injuries, physical activity, mental health, and quality of life. A comprehensive team of physicians in different subspecialties evaluated and examined children to assess the current medical and psychiatric conditions and physical activity, and recommended and arranged further medical, rehabilitation, or surgical planning. Results Seventy-eight child casualties were identified and participated in the study. The mean age of the participants at the time of study was 16.11 years old (SD=2 years). The mean age of victims at the time of injury was 8.2 years (SD=3.12 years; ranged from 2 to 15 years old). Sixty-seven (85.9) of the children were male. Provinces of Kurdistan and Kermanshah had the highest number of casualties, with a total number of 54 children (68.3). Eighty percent of the injuries were caused by landmines, and UXO explosions were reported in 20 of the cases. Overall, 24 children (30) had received some landmine-risk education before or after the events. Sixty percent of the explosions had happened in the morning between 9:00 am and 12:00 pm. Playing and grazing livestock were the most prevalent activities/reasons at the time of injury, which were reported in 77 of the subjects. Sixty-three percent of incidents had multiple casualties and in only 13 explosions were the children the only victims of the explosion. The most prevalent injuries were amputations in 41 subjects (52.56), followed by hearing loss in 23 subjects (29.5). Amputations were more common in upper extremities (62) than in lower extremities (38). Conclusion Landmines and UXOs comprise a significant safety hazard to the children living in the Western border of Iran decades after the Iraq-Iran War. The large number of injuries and lack of risk training among victims suggest that landmine cleanings and landmine-risk education should be age-specifically targeted and expanded substantially. © World Association for Disaster and Emergency Medicine 2015