Transcatheter and surgical intervention for secondary mitral regurgitation

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effects in secondary mitral regurgitation of:. Surgical mitral valve intervention and coronary artery bypass graft versus coronary artery bypass graft alone; and Transcatheter mitral valve intervention and medical therapy versus medical therapy alone

Immunogenicity and efficacy of oral vaccines in developing countries: lessons from a live cholera vaccine

Oral vaccines, whether living or non-living, viral or bacterial, elicit diminished immune responses or have lower efficacy in developing countries than in developed countries. Here I describe studies with a live oral cholera vaccine that include older children no longer deriving immune support from breast milk or maternal antibodies and that identify some of the factors accounting for the lower immunogenicity, as well as suggesting counter-measures that may enhance the effectiveness of oral immunization in developing countries. The fundamental breakthrough is likely to require reversing effects of the 'environmental enteropathy' that is often present in children living in fecally contaminated, impoverished environments