Pre-Clinical Evaluation of a Replication-Competent Recombinant Adenovirus Serotype 4 Vaccine Expressing Influenza H5 Hemagglutinin

Influenza virus remains a significant health and social concern in part because of newly emerging strains, such as avian H5N1 virus. We have developed a prototype H5N1 vaccine using a recombinant, replication-competent Adenovirus serotype 4 (Ad4) vector, derived from the U.S. military Ad4 vaccine strain, to express the hemagglutinin (HA) gene from A/Vietnam/1194/2004 influenza virus (Ad4-H5-Vtn). Our hypothesis is that a mucosally-delivered replicating Ad4-H5-Vtn recombinant vector will be safe and induce protective immunity against H5N1 influenza virus infection and disease pathogenesis.The Ad4-H5-Vtn vaccine was designed with a partial deletion of the E3 region of Ad4 to accommodate the influenza HA gene. Replication and growth kinetics of the vaccine virus in multiple human cell lines indicated that the vaccine virus is attenuated relative to the wild type virus. Expression of the HA transgene in infected cells was documented by flow cytometry, western blot analysis and induction of HA-specific antibody and cellular immune responses in mice. Of particular note, mice immunized intranasally with the Ad4-H5-Vtn vaccine were protected against lethal H5N1 reassortant viral challenge even in the presence of pre-existing immunity to the Ad4 wild type virus.Several non-clinical attributes of this vaccine including safety, induction of HA-specific humoral and cellular immunity, and efficacy were demonstrated using an animal model to support Phase 1 clinical trial evaluation of this new vaccine

Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis

<p>Abstract</p> <p>Background</p> <p>Passive smoke exposure increases the risk of lower respiratory infection (LRI) in infants, but the extensive literature on this association has not been systematically reviewed for nearly ten years. The aim of this paper is to provide an updated systematic review and meta-analysis of studies of the association between passive smoking and LRI, and with diagnostic subcategories including bronchiolitis, in infants aged two years and under.</p> <p>Methods</p> <p>We searched MEDLINE and EMBASE (to November 2010), reference lists from publications and abstracts from major conference proceedings to identify all relevant publications. Random effect pooled odds ratios (OR) with 95% confidence intervals (CI) were estimated.</p> <p>Results</p> <p>We identified 60 studies suitable for inclusion in the meta-analysis. Smoking by either parent or other household members significantly increased the risk of LRI; odds ratios (OR) were 1.22 (95% CI 1.10 to 1.35) for paternal smoking, 1.62 (95% CI 1.38 to 1.89) if both parents smoked, and 1.54 (95% CI 1.40 to 1.69) for any household member smoking. Pre-natal maternal smoking (OR 1.24, 95% CI 1.11 to 1.38) had a weaker effect than post-natal smoking (OR 1.58, 95% CI 1.45 to 1.73). The strongest effect was on bronchiolitis, where the risk of any household smoking was increased by an OR of 2.51 (95% CI 1.96 to 3.21).</p> <p>Conclusions</p> <p>Passive smoking in the family home is a major influence on the risk of LRI in infants, and especially on bronchiolitis. Risk is particularly strong in relation to post-natal maternal smoking. Strategies to prevent passive smoke exposure in young children are an urgent public and child health priority.</p

Situações de desconforto vivenciadas pelo idoso hospitalizado com a invasão do espaço pessoal e territorial Situaciones de incomodidad vividas por el anciano hospitalizado con la invasión del espacio personal y territorial Uncomfortable situation experienced by the elderly hospitalized with the personal and territorial invasion

A comunicação é a essência da vida e inerente ao ser humano, pois ela traz a possibilidade de as pessoas se relacionarem, compartilhando suas idéias, pensamentos, vivências e sentimentos. Por meio dela somos capazes de nos relacionarmos e assim construirmos uma condição de atendimento e interação com o outro. Esse estudo teve como objetivo identificar as situações de desconforto vivenciadas pelo idoso hospitalizado com a invasão do espaço territorial e pessoal. Pesquisa realizada com 30 idosos hospitalizados em hospital público do interior de São Paulo. Verificou-se que as situações de invasão territorial de desagrado dos idosos foram aquelas relacionadas ao barulho provocado pela equipe e à negligência da preservação da privacidade e das limitações do espaço do idoso. Já as de invasão pessoal estão ligadas à manipulação da unidade do cliente sem seu consentimento e ao desrespeito à intimidade com a banalização da exposição do corpo.<br>La comunicación es la esencia de la vida y es inherente al ser humano, pues trajo la posibilidad a la persona de se relacionaren, compartiendo sus ideas, pensamientos, experiencias y sentimientos. A través de la comunicación somos capaces de establecer relaciones con las personas y, así construir condiciones adecuadas de atención y interacción con los demás. El objetivo de este estudio fue identificar las situaciones de incomodidad experimentados por el anciano hospitalizado ante la invasión del espacio territorial y personal. Investigación realizada con 30 ancianos hospitalizados en un hospital público de una ciudad del interior de São Paulo. Se encontró que, a los ancianos les desgustan las invasiones territoriales relacionadas con el ruido causado por el equipo profesional y por la negligencia con la preservación de la intimidad y de las limitaciones del espacio del anciano. Las incomodidades con la invasión personal están relacionados no sólo con el manejo de la cama del cliente sin su consentimiento sino también a la falta de respecto hacia su intimidad y a la sensación de trivialidad con que es tratada la exposición del cuerpo.<br>Communication is essential for life and inherent to man. Communication brings opportunity for individuals to relate to each other, share ideas, thoughts, life experiences and feelings. It also enables us to exchange information and build an environment to better serve and interact with each other. This paper was aimed to identify personal uncomfor table experience among elderly inpatients regarding privacy and territorial invasion in a public hospital in Sao Paulo, Brazil. 30 elderly patients were inter viewed with a standard questionnaire. The most common complaints among hospitalized elder patients were hospital ward noise level; negligence on maintaining privacy and invasion of personal space. Regarding invasion of personal space, many patients complained about being manipulated without previous consent and perceived being treated with disrespect during physical exam with banalization of the human body