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PLoS Pathogens 2012Inactivated poliovirus vaccine (IPV) may be used in mass vaccination campaigns during the final stages of polio eradication. It is also likely to be adopted by many... (Review)
Review
Inactivated poliovirus vaccine (IPV) may be used in mass vaccination campaigns during the final stages of polio eradication. It is also likely to be adopted by many countries following the coordinated global cessation of vaccination with oral poliovirus vaccine (OPV) after eradication. The success of IPV in the control of poliomyelitis outbreaks will depend on the degree of nasopharyngeal and intestinal mucosal immunity induced against poliovirus infection. We performed a systematic review of studies published through May 2011 that recorded the prevalence of poliovirus shedding in stool samples or nasopharyngeal secretions collected 5-30 days after a "challenge" dose of OPV. Studies were combined in a meta-analysis of the odds of shedding among children vaccinated according to IPV, OPV, and combination schedules. We identified 31 studies of shedding in stool and four in nasopharyngeal samples that met the inclusion criteria. Individuals vaccinated with OPV were protected against infection and shedding of poliovirus in stool samples collected after challenge compared with unvaccinated individuals (summary odds ratio [OR] for shedding 0.13 (95% confidence interval [CI] 0.08-0.24)). In contrast, IPV provided no protection against shedding compared with unvaccinated individuals (summary OR 0.81 [95% CI 0.59-1.11]) or when given in addition to OPV, compared with individuals given OPV alone (summary OR 1.14 [95% CI 0.82-1.58]). There were insufficient studies of nasopharyngeal shedding to draw a conclusion. IPV does not induce sufficient intestinal mucosal immunity to reduce the prevalence of fecal poliovirus shedding after challenge, although there was some evidence that it can reduce the quantity of virus shed. The impact of IPV on poliovirus transmission in countries where fecal-oral spread is common is unknown but is likely to be limited compared with OPV.
Topics: Animals; Humans; Immunity, Mucosal; Poliomyelitis; Poliovirus; Poliovirus Vaccine, Inactivated; Poliovirus Vaccine, Oral; Virus Shedding
PubMed: 22532797
DOI: 10.1371/journal.ppat.1002599 -
International Journal of General... Mar 2011The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of...
BACKGROUND
The objectives of this review were to integrate the evidence of curative effects through aquatic exercise and assess the quality of studies based on a review of nonrandomized controlled trials (nRCTs).
METHODS
Study design was a systematic review of nonrandomized controlled trials. Trials were eligible if they were nonrandomized clinical trials. Studies included one treatment group in which aquatic exercise was applied. We searched the following databases from 2000 up to July 20, 2009: MEDLINE via PubMed, CINAHL, and Ichushi-Web.
RESULTS
Twenty-one trials met all inclusion criteria. Languages included were English (N = 9), Japanese (N = 11), and Korean (N = 1). Target diseases were knee and/or hip osteoarthritis, poliomyelitis, chronic kidney disease, discomforts of pregnancy, cardiovascular diseases, and rotator cuff tears. Many studies on nonspecific disease (healthy participants) were included. All studies reported significant effectiveness in at least one or more outcomes. However results of evaluations with the TREND and CLEAR-NPT checklists generally showed a remarkable lack of description in the studies. Furthermore, there was the problem of heterogeneity, and we were therefore not able to perform a meta-analysis.
CONCLUSION
Because there was insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of nRCTs, we were unable to offer any conclusions about the effects of this intervention. However, we were able to identify problems with current nRCTs of aquatic exercise, and propose a strategy of strengthening study quality, stressing the importance of study feasibility as a future research agenda objective.
PubMed: 21556311
DOI: 10.2147/IJGM.S17384 -
Neuroepidemiology 2011Updated, robust estimates of the incidence and prevalence of rare long-term neurological conditions in the UK are not available. Global estimates may be... (Review)
Review
BACKGROUND
Updated, robust estimates of the incidence and prevalence of rare long-term neurological conditions in the UK are not available. Global estimates may be misrepresentative as disease aetiology may vary by location.
OBJECTIVES
To systematically review the incidence and prevalence of long-term neurological conditions in the UK since 1988.
SEARCH STRATEGY
Medline (January 1988 to January 2009), Embase (January 1988 to January 2009), CINAHL (January 1988 to January 2009) and Cochrane CENTRAL databases.
SELECTION CRITERIA
UK population-based incidence/prevalence studies of long-term neurological conditions since 1988. Exclusion criteria included inappropriate diagnoses and incomprehensive case ascertainment.
DATA COLLECTION AND ANALYSIS
Articles were included based on the selection criteria. Data were extracted from articles with ranges of incidence and prevalence reported.
MAIN RESULTS
Eight studies met the criteria (3 on motor neurone disease; 4 on Huntington's disease; 1 on progressive supranuclear palsy). The incidence of motor neurone disease ranged from 1.06 to 2.4/100,000 person-years. The prevalence ranged from 4.02 to 4.91/100,000. The prevalence of Huntington's disease ranged from 4.0 to 9.94/100,000. The prevalence of progressive supranuclear palsy ranged from 3.1 to 6.5/100,000.
CONCLUSIONS
The review updates the incidence/prevalence of long-term neurological conditions. Future epidemiological studies must incorporate comprehensive case ascertainment methods and strict diagnostic criteria.
Topics: Amyotrophic Lateral Sclerosis; Ataxia; Charcot-Marie-Tooth Disease; Humans; Huntington Disease; Incidence; Multiple System Atrophy; Postpoliomyelitis Syndrome; Prevalence; Supranuclear Palsy, Progressive; United Kingdom
PubMed: 21088431
DOI: 10.1159/000321712 -
Revista de Neurologia May 2010Fatigue is the most common symptom and the most disabling in patients with post-polio syndrome. (Review)
Review
INTRODUCTION
Fatigue is the most common symptom and the most disabling in patients with post-polio syndrome.
AIM
To analyze the effectiveness of various treatments used to improve fatigue syndrome patients post-polio.
MATERIALS AND METHODS
Systematic review. Is defined a bibliographic search strategy in Medline (from 1961), EMBASE (from 1980), ISI Web of Knowledge and Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), AMED (January 1985), EMI and Physiotherapy Evidence Database (PEDro) until February 2008, the population defined (post-polio syndrome patients) and intervention (any treatment for fatigue in these patients). Outcome were selected as different scales of fatigue and fatigue or vitality dimension scales quality of life. Clinical trials were selected.
RESULTS
We retrieved 396 articles, of which 23 were analyzed in detail. Finally, 19 were included in the analysis, a total of 705 patients.
CONCLUSIONS
Lamotrigine, bromocriptine, aerobics and flexibility exercises, hydrokinesitherapy and technical aids are treatment techniques that reduce more fatigue in these patients.
Topics: Clinical Trials as Topic; Databases, Factual; Exercise Therapy; Fatigue; Humans; Postpoliomyelitis Syndrome; Quality of Life; Treatment Outcome
PubMed: 20473835
DOI: No ID Found -
The Journal of Bone and Joint Surgery.... Oct 2009Neurological conditions affecting the hip pose a considerable challenge in replacement surgery since poor and imbalanced muscle tone predisposes to dislocation and... (Review)
Review
Neurological conditions affecting the hip pose a considerable challenge in replacement surgery since poor and imbalanced muscle tone predisposes to dislocation and loosening. Consequently, total hip replacement (THR) is rarely performed in such patients. In a systematic review of the literature concerning THR in neurological conditions, we found only 13 studies which described the outcome. We have reviewed the evidence and discussed the technical challenges of this procedure in patients with cerebral palsy, Parkinson's disease, poliomyelitis and following a cerebrovascular accident, spinal injury or development of a Charcot joint. Contrary to traditional perceptions, THR can give a good outcome in these often severely disabled patients.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arthropathy, Neurogenic; Arthroplasty, Replacement, Hip; Central Nervous System Diseases; Cerebral Palsy; Female; Hip Joint; Humans; Male; Middle Aged; Parkinson Disease; Poliomyelitis; Prognosis; Prosthesis Failure; Spinal Injuries; Stroke; Treatment Outcome; Young Adult
PubMed: 19794158
DOI: 10.1302/0301-620X.91B10.22934