No abstract

SUMMARYThis study evaluated whether different bacillus Calmette±Gue Ârin (BCG) strains, routes of administration, vaccination age and percutaneous tools in¯uenced immune responses to BCG vaccination in infants. Proliferative responses, cytokine production and cell-mediated cytotoxicity obtained in post-vaccinated children were compared to baseline cord bloods and unvaccinated 10-week-old infants. BCG vaccination generally induced strong lymphoproliferative and T helper type 1 (Th1)-type cytokine responses. There was a trend for greater responsiveness following the intradermal route of vaccination, with Japanese-172 strain and with delaying vaccination until 10 weeks. Cord mononuclear cells differentially stimulated the Th2-type cytokines interleukin-5 (IL-5) and IL-10 selectively in response to BCG, as compared to H37Rv or puri®ed protein derivative stimulation. We document for the ®rst time the generation of mycobacterium-speci®c cytotoxic T lymphocytes in neonates, following BCG vaccination. Cytotoxic activity correlated with the ratio of interferon-c to IL-5, aside from a single instance where use of the Biovac 1 tool resulted in a striking dissociation selectively against H37Rv targets. These data have implications for correlates of protective immunity in design of vaccine studies.

Introduction High-acuity patients are typically transported directly to the emergency centre via ambulance by trained prehospital care providers. As such, the emergency centre becomes the first of many physical transition points for patients, where a change of care provider (or handover) takes place. The aim of this study was to describe the variables perceived to be important during patient handover by a cohort of South African prehospital care providers. Methods A purpose-designed questionnaire was used to gather data related to prehospital emergency care provider opinions on the importance of certain patient variables. Results We collected 175 completed questionnaires from 75 (43%) BAA, 49 (28%) ANA, 15 (9%) ECT, 16 (9%) ANT and 20 (11%) ECP respondents. Within the ten handover variables perceived to be most important for inclusion in emergency centre handover, five were related to vital signs. Blood pressure was ranked most important, followed by type of major injuries, anatomical location of major injuries, pulse rate, respiration rate and patient history. These were followed by Glasgow Coma Score, injuries sustained, patient priority, oxygen saturations and patient allergies. Conclusion This study has provided some interesting results related to which handover elements prehospital care providers consider as most important to include in handover. More research is required to correlate these findings with the opinions of emergency centre staff.

No abstract