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101.
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Helen E.D. Burchett Sandra Mounier-Jack Sergio Torres-Rueda Ulla K. Griffiths Pierre Ongolo-Zogo Stephen Rulisa Jean-Marie Edengue Enrique Chavez Yayehirad Kitaw Mitike Molla Mamadou Konate Lawrence Gelmon Washington Onyango-Ouma Mylene Lagarde Anne Mills 《Vaccine》2014
Objective
We aimed to explore the impacts of new vaccine introductions on immunization programmes and health systems in low- and middle-income countries.Methods
We conducted case studies of seven vaccine introductions in six countries (Cameroon, PCV; Ethiopia, PCV; Guatemala, rotavirus; Kenya, PCV; Mali, Meningitis A; Mali, PCV; Rwanda, HPV). Interviews were conducted with 261 national, regional and district key informants and questionnaires were completed with staff from 196 health facilities. Routine data from districts and health facilities were gathered on vaccination and antenatal service use. Data collection and analysis were structured around the World Health Organisation health system building blocks.Findings
The new vaccines were viewed positively and seemed to integrate well into existing health systems. The introductions were found to have had no impact on many elements within the building blocks framework. Despite many key informants and facility respondents perceiving that the new vaccine introductions had increased coverage of other vaccines, the routine data showed no change. Positive effects perceived included enhanced credibility of the immunisation programme and strengthened health workers’ skills through training. Negative effects reported included an increase in workload and stock outs of the new vaccine, which created a perception in the community that all vaccines were out of stock in a facility. Most effects were found within the vaccination programmes; very few were reported on the broader health systems. Effects were primarily reported to be temporary, around the time of introduction only.Conclusion
Although the new vaccine introductions were viewed as intrinsically positive, on the whole there was no evidence that they had any major impact, positive or negative, on the broader health systems. 相似文献104.
105.
Magdalena Kraft Macarena Pia Knop Jean-Marie Renaudin Kathrin Scherer Hofmeier Claudia Pföhler Maria Beatrice Bilò Roland Lang Regina Treudler Nicola Wagner Thomas Spindler Jonathan O'B Hourihane Ioana Maris Alice Koehli Andrea Bauer Lars Lange Sabine Müller Nikolaos G. Papadopoulos Bettina Wedi Anne Moeser Luis F. Ensina Montserrat Fernandez-Rivas Ewa Cichocka-Jarosz George Christoff Blanca E. Garcia Iwona Poziomkowska-Gęsicka Victoria Cardona Tihomir B. Mustakov Uta Rabe Vera Mahler Linus Grabenhenrich Sabine Dölle-Bierke Margitta Worm The Network for Online Registration of Anaphylaxis 《Allergy》2020,75(4):901-910
106.
Antoine Néel Benoit Henry Sebastien Barbarot Agathe Masseau François Perrin Claire Bernier Xavier Kyndt Xavier Puechal Pierre-Jean Weiller Olivier Decaux Jacques Ninet Arnaud Hot Achille Aouba Leonardo Astudillo Jean-Marie Berthelot Fabrice Bonnet Jean-Marie Brisseau Bérangère Cador Fabienne Closs-Prophette Thomas Dejoie Jean-Dominique de Korwin Robin Dhote Renato Fior Bernard Grosbois Eric Hachulla Pierre-Yves Hatron Henry Jardel David Launay Adrien Lorleac'h Pierre Pottier Guillaume Moulis Jacques Serratrice Amar Smail Mohamed Hamidou 《Autoimmunity reviews》2014,13(10):1035-1041
The aim of this study is to assess the long-term effectiveness and safety of IL1Ra in Schnitzler syndrome (SchS). Between 2010 and 2012, we performed a nationwide survey among French internal medicine departments to identify SchS patients. We retrospectively analyzed the long-term efficacy and safety of IL1Ra and the outcome of patients that did not receive this treatment. Forty-two patients were included in the study, 29 of whom received IL1Ra. The mean age at disease onset was 59.9 years. Disease manifestations included urticaria (100%), fever (76%), bone/joint pain (86%), bone lesions (76%), anemia (67%), and weight loss (60%). The monoclonal gammopathy was overwhelmingly IgM kappa (83%). The mean follow-up was 9.5 years (range: 1.6-35). Two patients developed Waldenström's macroglobulinemia and one developed AA amyloidosis. All of the 29 patients who received IL1Ra responded dramatically. After a median follow-up of 36 months (range: 2-79), the effectiveness remained unchanged. All patients remained on anti-IL-1 therapy. Twenty-four patients (83%) went into complete remission and five (17%) into partial remission. Three patients experienced grade 3-4 neutropenia. Six patients developed severe infections. No lymphoproliferative diseases occurred while on IL1Ra. When last seen, all patients without anakinra had an active disease with variable impact on their quality of life. Their median corticosteroids dosage was 6 mg/d (range: 5-25). IL1Ra is effective in SchS, with a sharp corticosteroid-sparing effect. Treatment failures should lead to reconsider the diagnosis. Long-term follow-up revealed no loss of effectiveness and a favorable tolerance profile. The long-term effects on the risk of hemopathy remain unknown. 相似文献
107.
Rahul R. Singh Nurdan Ozyilmaz Simon Waller Jean-Marie U-King-Im Ming Lim Ata Siddiqui Manish D. Sinha 《European journal of pediatrics》2014,173(9):1225-1231
Posterior reversible encephalopathy syndrome (PRES) is characterized clinically by headaches, seizures, vomiting, nausea, visual abnormalities, and altered mental function and is often (but not invariably) accompanied by parieto-occipital imaging features. The aim of this study is to describe the clinical and radiological features and outcome following PRES in a paediatric cohort. From a retrospectively identified cohort, case records were studied to confirm a diagnosis of PRES. Neuroimaging was reviewed again to assign to recently described radiological subtypes parieto-occipital pattern, holohemispheric watershed pattern, dominant superior frontal sulcus pattern, and asymmetrical or partial expression of the three primary patterns (A/P). Patient outcome was measured by the modified Rankin scale (mRS) scores. Nine boys and three girls with mean age of 12 were identified. Hypertensive episodes (n?=?11), tacrolimus toxicity (n?=?4), and autoimmunity (n?=?1) were identified as potential risk factors/etiologies. Their median mRS at the peak of illness was 2 (range 2–5); three children required intensive care support. After mean follow-up of 35 months (median 37 months; range 3–60 months), all patients improved significantly with mean mRS of 1 (median 1; range 0–1). Conclusion: PRES is easily recognizable by the clinical and radiological features. Although severe at presentation, the outcome from this condition is favorable. 相似文献
108.
109.
Katarzyna Bryc Adam Auton Matthew R. Nelson Jorge R. Oksenberg Stephen L. Hauser Scott Williams Alain Froment Jean-Marie Bodo Charles Wambebe Sarah A. Tishkoff Carlos D. Bustamante 《Proceedings of the National Academy of Sciences of the United States of America》2010,107(2):786-791
Quantifying patterns of population structure in Africans and African Americans illuminates the history of human populations and is critical for undertaking medical genomic studies on a global scale. To obtain a fine-scale genome-wide perspective of ancestry, we analyze Affymetrix GeneChip 500K genotype data from African Americans (n = 365) and individuals with ancestry from West Africa (n = 203 from 12 populations) and Europe (n = 400 from 42 countries). We find that population structure within the West African sample reflects primarily language and secondarily geographical distance, echoing the Bantu expansion. Among African Americans, analysis of genomic admixture by a principal component-based approach indicates that the median proportion of European ancestry is 18.5% (25th–75th percentiles: 11.6–27.7%), with very large variation among individuals. In the African-American sample as a whole, few autosomal regions showed exceptionally high or low mean African ancestry, but the X chromosome showed elevated levels of African ancestry, consistent with a sex-biased pattern of gene flow with an excess of European male and African female ancestry. We also find that genomic profiles of individual African Americans afford personalized ancestry reconstructions differentiating ancient vs. recent European and African ancestry. Finally, patterns of genetic similarity among inferred African segments of African-American genomes and genomes of contemporary African populations included in this study suggest African ancestry is most similar to non-Bantu Niger-Kordofanian-speaking populations, consistent with historical documents of the African Diaspora and trans-Atlantic slave trade. 相似文献
110.
As transdermal patches become more widely prescribed, it is important that clinicians understand: (a) the common causes of
skin reactions with these medications; (b) how to minimize these reactions; and (c) how to manage the signs and symptoms.
Here we review published data for skin reactions with patch medications approved within the past decade. Overall, the most
common application site signs and symptoms appear to be localized redness (erythema) or itching, sometimes accompanied by
swelling (edema). Typically, these are mild to moderate in severity, transient in nature, and occur in 20% to 50% of patients.
Most are localized to the area of application, and resolve spontaneously within several days following patch removal. Discontinuations
due to these types of event are infrequent, ranging from 1.7% to 6.8% in the 6-month trials reviewed here. Based on expert
opinion, the majority of these skin reactions would be a form of irritant contact dermatitis, with infrequent cases of allergic
contact dermatitis. These types of reactions usually cause minimal pain or discomfort to the patient, and are unlikely to
be of medical concern. Signs and symptoms of irritant contact dermatitis may be minimized by rotation of the application site,
careful removal of the patch, and appropriate use of moisturizers and topical corticosteroids. In conclusion, the potential
advantages of transdermal patches usually outweigh any additional skin issues; however, further research into treatment and
management strategies is required. 相似文献