A systematic literature review of human papillomavirus vaccination strategies in delivery systems within national and regional immunization programs

The uptake of human papillomavirus (HPV) vaccine remains suboptimal despite being a part of routine vaccination within national immunization program(s). This indicates probable challenges with the implementation of HPV immunization program(s) in various countries. The objective of this systematic literature review (SLR) was to identify implementation strategies for HPV vaccination within national and regional immunization programs worldwide with an aim to provide guidance for countries targeting to increase their HPV vaccine coverage rate (VCR). A comprehensive literature search was conducted across Medline and Embase and included articles published between January 2012 and January 2022. Of the 2,549 articles retrieved, 168 met inclusion criteria and were included in the review. Strategies shown to improve HPV vaccination uptake in the reviewed literature include campaigns to increase community awareness and knowledge of HPV, health care provider trainings, integrating HPV vaccination within school settings, coordinated efforts via multi-sectoral partnerships, and vaccination reminder and recall systems. Findings may help national authorities understand key considerations for HPV vaccination when designing and implementing programs aiming to increase HPV VCR in adolescents.

Effects of pea extrusion and enzyme and probiotic supplementation on performance, microbiota activity and biofilm formation in the broiler gastrointestinal tract

1. The effects of supplementation of broiler chicken diets with pea meal, carbohydrase enzymes and a probiotic were investigated for potential performance improvement. 2. Raw or extruded pea meal (cv Model, grown in Poland) was included in a wheat-soybean meal-based diet at 250 g/kg. The diets were unsupplemented (control) or supplemented with either carbohydrase enzymes (200 U/kg xylanase and 10 U/kg β-glucanase in feed) or a probiotic (Bacillus subtilis), or both. The diets were fed to Ross 308 broilers aged 9-28 days. 3. After two additional days, chick gastrointestinal tracts were excised and analysed for the presence of Bacillus subtilis biofilm; and the ileal and caecal digesta were analysed for bacterial enzyme activities and to determine the concentration of short-chain fatty acids (SCFAs). 4. Feeding the pea-based diet supplemented with the probiotic compromised feed utilisation, due to higher feed intake. The addition of enzymes to the raw, but not the extruded, pea containing diet partially ameliorated this effect (pea form × additives; P < 0.002). 5. In the ileal digesta, interactions between the dietary treatments were observed for the activities of all bacterial glycolytic enzymes and for SCFA concentrations. β-glucosidase, α-galactosidase and β-glucuronidase were highest in birds fed the diet containing extruded pea supplemented with the probiotic and enzymes (pea form x additives; P = 0.018 to P < 0.006). In the caecal digesta, interactions were observed for bacterial enzyme activities, but not for total SCFA concentration. Biofilm formation in the caecum indicated that the probiotic strain was metabolically active in the broiler gut. 6. In conclusion, supplementation of diets containing raw or extruded pea meal with enzymes and a Bacillus subtilis spore-based probiotic modulated microbiota activity but had no clear effects on broiler performance. Probiotic administration did not cause excessive fermentation in the ileum and caecum but enhanced Bacillus subtilis spp. biofilm formation in the caecum, which may be indicative of a beneficial effect on gut health.

Risk of malignant neoplasms in acromegaly: a case-control study

PURPOSE

Acromegaly is a chronic disease resulting from pathological oversecretion of growth hormone and subsequently insulin growth factor-1. Several complications of the disease have been reported, including cardiovascular diseases, respiratory disorders but also increased risk of benign and malignant neoplasms. The aim of the study was to evaluate the risk of malignant neoplasms in the patients with acromegaly in comparison with the control group.

PATIENTS AND METHODS

Medical documentation of acromegalic patients treated in one medical center between 2005 and 2016 has been analyzed. Results were compared with sex- and age-matched group of subjects with prolactinomas and hormonally inactive pituitary lesions hospitalized in the same department.

RESULTS

Two hundred patients with acromegaly were included. Control group was composed of 145 patients. Any malignant neoplasm in anamnesis was present in 27 (13.5 %) patients with acromegaly and six (4.1 %) subjects from control group (p = 0.003). Thyroid cancer was present in 14 (7.0 %) patients with acromegaly and two (1.4 %) in control group (p = 0.02). Breast cancer was present in seven women (5.4 % of women) in acromegaly group but none of subjects in control group (p = 0.02). Colon cancer-4 (2.0 %) patients in acromegaly group and 0 in control group (p = 0.14).

CONCLUSIONS

Malignant neoplasms are significantly more common in patients with acromegaly. Particularly, risk of thyroid cancer was increased over fivefold. Systematic screening for neoplastic diseases should be important part of follow-up in these patients. Further case-control studies are strongly indicated to evaluate which neoplasms are more common in acromegalic patients and what is the exact risk of malignancy.

[Clinical and laboratory diagnosis of Listeria monocytogenes on the basis of own investigations]

The authors have described the issues surrounding Listeria monocytogenes infection with reference to cases diagnosed and managed during the 5-year period (1995-2000) in the Clinical Department of Neonatal Pathology and Intensive Care of the National Institute of Mother and Child in Warsaw. Four cases of congenital listeriosis have been diagnosed. Some mothers presented with "flu-like" symptoms. All mothers delivered prematurely (29 hbd - 32 hbd). Among the 4 infants the most common clinical features were: perinatal asphyxia, respiratory distress, pathological icterus, haematologic abnormalities. Septicemia occurred in 50% of cases; pneumonia in 100%. Three of them presented skin manifestations; one of the neonates had mucosal abnormalities of the laryngopharynx. Cerebral sonography showed intracranial hemorrhage. One of the infants died within 7 days of birth. The other two neonates developed posthemorrhagic hydrocephalus. Only one infant has normal development. Although listeriosis appears to be not a frequent cause of perinatal infection, clinicians must be aware of Listeria, particularly in gravid patients who present with fever and "flu-like" illness and go into premature labour. Initial therapy implemented in our Department, with ampicillin and aminoglycosides seem to be the most appropriate.

[RSV infections in children including managed cases in premature babies]

The authors assessed RSV infection issues within the Department of Neonatology during the year 2000/2001. The epidemiology, pathology, pathogenesis and the clinical course were discussed. The treatment and prevention patterns have been also presented. There were 5 cases of RSV infection of premature neonates within the Department of Neonatology. One of the mothers was probably the source of infection. The course of infection was described as severe in two infants (diagnosed respiratory insufficiency) and moderate in two other cases (respiratory disorders improved with n-CPAP). The symptoms of disease have been mild only in one case. Prematurity, age between 2-6 months, lung, and heart pathology and immunodeficiency must be considered as negative prognostic factors. Development of vaccination against RSV infection seems to be crucial solution for preterm neonates.

[Patients with multiple sclerosis among the Lódź population. II. Clinical course of the disease and patient fitness]

The motor fitness was assessed in multiple sclerosis patients remaining in their homes in the City of Lódź. The age of the patients was up to 46 years; 5-6 years earlier they had been registered within one year in neurological health service institutions after variously long periods of the disease. The proportion of those with severe motor impairment was 14%, and it was highest (17%) in the groups with disease duration 10-14 years. Nearly half of the group, independently of the age, sex and disease duration, were patients who could move about and perform household works. The proportion of fully fit and nearly fully fit was highest (83%) among those whose disease began under the age of 20 years, and it was lowest (42%) in those with disease onset at the age of 20-29 years. A tendency was observed for a different development of motor function impairment in both sexes depending on the age, age at disease onset and disease duration. In the light of the obtained results it is estimated that in the population of cities in Poland in the whole group of multiple sclerosis patients or subjects with suspected multiple sclerosis registered within one year after variously long disease duration about 40-50% remain after 5-6 years still completely or nearly completely fit.

[Patients with multiple sclerosis among the Lódź population. I. Verification of the diagnosis and clinical characteristics]

Home-treated patients with multiple sclerosis who 5-6 years earlier had sought medical advice in neurological health service institutions were examined. Their age was to 46 years; they came from the population of the City Lódź. Slightly over half of them (53%) were patients whose disease had begun at the age of 20-29 years. In 18% of cases the duration of the disease exceeded 14 years. In 60% of cases the disease had a remitting course, in 83% of them multifocal involvement of the nervous system was present. In nearly all cases (97%) pyramidal tract involvement was present, and in 59% the optic nerves were involved. Females prevailed in this group (75%); the proportion of patients aged 40-46 years was higher among the females. In males the onset of the disease before the age of 30 years was significantly more frequent, while in females the proportion of cases beginning at the age of 30-39 years was significantly greater. Among patients aged up to 40 years registered within one year by the neurologists as certain or suspected cases of multiple sclerosis (independently of the duration of the disease) about 7% patients died in a period of 5.7 years on average (10.5% males and 5.3% females). These observations suggest a different onset or course of the disease in both sexes in this population.

Chronic lymphocytic leukemia: study of cell subsets in cerebrospinal fluid and peripheral blood

Lymphocytic cells in a case of leptomeningeal involvement were studied by immunological methods during chronic lymphocytic leukemia. Conspicuous differences were found between blood and cerebrospinal fluid.

Measles virus infection and multiple sclerosis: serological studies

In 159 patients out of 161 with multiple sclerosis (MS), a significant rise in the level of measles hemagglutination inhibition (HI) antibody was found in the serum and in 92 MS patients the occurrence of measles HI antibody in the CSF was significantly more frequent. MS patients showed CSF humoral response against measles virus by neutralizing test (NV) (76%) more often than by hemagglutination test (37%). CSF FA antibody was found in 60%. In the serum of MS patients the presence of NV, HAd, FA, and GP-RNP was observed. 87% of MS patients showed lowered serum: CSF NV or HI antibody ratios and 78% had a diminished FA antibody ratio. Longitudinal study of serum HI measles virus antibody showed no substantial changes over longer period of the disease. Higher CSF measles antibody titer was found in more disabled patients with a malignant course of the disease (P less than 0.001). It is concluded that either persistent infection with proviruses or nonspecific stimulation of certain clones in individuals with genetic susceptibility provides for an excessive synthesis of humoral viral antibodies in MS.

[The use of cartilage and tissue adhesives for the treatment of surgical-stomatological diseases in old age]

The authors used lyophilized cartilage in plate, bar, chip or powder form in elderly patients. The transplant was also utilized in managing defects resulting from the removal of jaw cysts, bone tumours, etc. Furthermore, the authors treated bone defects of the anterior wall of the maxillary sinus and of the hard palate as well as oro-antral perforations, infected wounds of the soft tissues and inflammatory bone processes. The patients in question had been treated in the surgical service during the years 1959--1975. The authors observed in elderly patients pathological alterations of the capillaries, haemorrhagic tendency and impairment of the blood-clotting mechanism. Furthermore, they found that the granulation tissue was of poor quality. In these cases they used cartilaginous tissue in powder form which promotes the formation of granulation tissue well supplied with blood. In the patients mentioned, the authors also utilized surgical adhesive, namely after tooth extractions and in managing their complications.

[Sural nerve phospholipids in some genetically determined nervous system diseases]

Phospholipid fraction pattern was determined in sural nerve in cases of suspected storage diseases. The material was obtained by means fo biopsy from 22 patients. In some patients features of polyneuropathy were found. Normal values of phospholipids were determined in 22 dying patients who had to neurological diseases. The most frequently observed change concerning the biochemical composition of the sural nerve in this material was a fall in the total amount of phosphatidyl ethanolamine (cephalin) and appearance of lysolecithins which are normally absent. In attempted correlation of histological and biochemical findings in the sural nerve with clinical signs of polyneuropathy it was observed that biochemical changes were present in cases without clinical evidence of polyneuropathy. Biochemical as well as histological investigations of sural nerve may help in intravital diagnosis of diseases belonging to the group of thesauroses.