Oct 18, 2012

Intravenous immunoglobulin treatment of the post-polio syndrome



Intravenous immunoglobulin treatment of the post-polio syndrome: Henrik Gonzalez1, Mohsen Khademi2, Kristian Borg1* and Tomas Olsson2

Abstract
Background
Expression of inflammatory cytokines in cerebrospinal fluid (CSF) has led to the hypothesis of intrathecal chronic inflammation to explain the denervation observed in post-polio syndrome (PPS). It has been shown that therapy with intravenous immunoglobulin (IVIG) improves physical performance and dampens down the inflammatory process at 6 months in PPS patients. We here examined the effects of IVIG on cytokine expression and clinical outcome one year after IVIG treatment.
Methods
From a previous study with 135 PPS patients included, 41 patients were further evaluated before un-blinding for one year (21 placebo and 20 treated with IVIG, Xepol® 50 mg/ml), and were assessed for clinical variables by performing the Short Form-36 survey (SF-36) questionnaire assessment, the 6 minute walk distance test (6MWT) and registering pain level by Visual Analogue Scale (VAS) after IVIG treatment. A separate cohort of 37 PPS patients went through lumbar puncture (LP) at baseline and 20 patients, treated with IVIG, repeated the LP one year later. Thirty patients affected with other neurological diseases (OND) were used as control group. Inflammatory cytokines TNF, TGFβ, IFNγ, IL-23, IL-13 and IL-10 were measured in blood cells and CSF cells with RT-PCR.
Results
Scores of the physical components of SF-36 were significantly higher at the one year follow up time-point in the IVIG-treated patients when compared to baseline as well as to the control subjects. Pain VAS score and 6MWT improved significantly in the IVIG-treated patients when compared with baseline Relative expression of TNF and IFN-γ in both PBMCs and CSF from PPS patients were increased compared to OND subjects at baseline (p < 0.05). One year after IVIG-treatment a decreased expression of IFN-γ and IL23 was found in CSF of PPS patients, while anti-inflammatory IL-13 was increased (p < 0.05).
Conclusions
IVIG has effects on relevant QoL variables and inflammatory cytokines up to one year in patients with PPS. This gives a basis for scheduling IVIG in upcoming trials with this therapy.
Keywords: Post-polio syndrome (PPS); Intravenous immunoglobulin (IVIG); Cerebrospinal fluid (CSF); Inflammatory cytokines

Oct 17, 2012

New Vaccine Joins Campaign to End Polio














New Vaccine Joins Campaign to End Polio
New Vaccine Joins Campaign to End Polio
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  • Duration: 4:02
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  • Published: 10 Feb 2010
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  • Updated: 29 Aug 2012
This is the VOA Special English Development Report, from voaspecialenglish.com The World Health Organization has begun to use a new vaccine against polio. Officials say it will become a major tool in the campaign to end a disease that mainly affects children under age five. The new formulation is known as BOPV, or bivalent oral polio vaccine. It was used for the first time in December in a polio immunization campaign in Afghanistan. Carol Pandak is with the PolioPlus program of the service organization Rotary International. She explains that health workers have been using what are called trivalent vaccines in some places. These are areas like Afghanistan where more than one kind of polio virus exists. There are three types of polio virus. The trivalent vaccine is least effective against type three, more effective against type one and highly effective against type two. As a result, few new cases of type two have been reported since nineteen ninety-nine. This has led to greater use of monovalent vaccines to protect against either type one or type three polio. But Carol Pandak says the monovalent vaccine is not enough in areas with both kinds of polio. Rod Curtis at the World Health Organization in Geneva says the new bivalent vaccine solves this problem. Carol Pandak says tests found the new vaccine to be thirty percent more effective than the trivalent vaccine. More than thirty new cases of polio were reported in Afghanistan last year. About half were type one and the ...
Gov't Issues Polio Alert
Gov't Issues Polio Alert
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  • Duration: 3:28
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  • Published: 06 Sep 2011
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  • Updated: 05 Jul 2012
Author: kenyacitizentv
The government has declared a public health alert after a three - year - old boy tested positive for a polio - type virus in Rongo district of Nyanza province. Public health and sanitation Beth Mugo said ministry officials have since been dispatched to the area in an effort to contain the outbreak as well as administer polio vaccines to children under the age of five. The ministry will undertake house to house vaccinations in five regions which have been declared highly volatile. Judy Kosgey has that report.

Oct 16, 2012

Franklin Delano Roosevelt was truly disabled,


By ANN WHITCHER-GENTZKE
Published: July 19, 2012
Even as he grappled with the effects of polio from age 39 to the end of his life, it’s an open question whether Franklin Delano Roosevelt was truly disabled, historian and disability studies scholar Michael Rembis told an attentive audience in Davis Hall yesterday. More than 80 people gathered for the sixth installment in the UBThisSummer lecture series entitled “Exploring UB’s Engagement in Health and Wellness.”
Rembis, associate director of UB’s Center for Disability Studies and an adjunct professor in the Department of History, used the example of FDR’s health to explore larger questions of how disabilities are perceived in our society. He also described how the disability rights movement has grown from a concentration on improved living environments to one that empowers disabled individuals to live their lives fully.
He also outlined the development of disability scholarship, a relatively new academic endeavor that calls into question commonly accepted notions of what it is to be disabled and what wellness might mean for the individual whose health is viewed negatively.
Rembis traced FDR’s strenuous campaigning for New York governor in 1928 and in the first of his presidential elections in 1932. Following his diagnosis of polio in 1921, he spent seven years undergoing a range of treatments. His mother, Sara Roosevelt, hoped he would remain at the family’s home in Hyde Park, N.Y., where he could live comfortably as a country squire. But others, including his wife Eleanor, urged him on to a vigorous political life.
When Al Smith, the unsuccessful Democratic candidate for president in 1928, voiced his support for Roosevelt’s gubernatorial cause, “the Republican press had a field day” criticizing efforts to push FDR into political life in defiance of his doctor’s orders and perhaps threatening his life, Rembis said. But Smith famously retorted that notwithstanding FDR’s polio, a governor need not be “an acrobat. We do not elect him for his ability to do a double-back flip or a handspring. The work of the governorship is brainwork.”
Rembis said FDR’s health and stamina were never issues in his campaigning and subsequent presidency. Rather, what made life challenging for him were the logistics of his getting from place to place. He could not stand without assistance and he was obliged to wear heavy leg braces.
“Everything was new or an experiment,” Rembis said. For instance, a special steel bar was installed on his campaign train and he had to be carried when on stairs or navigating tight spaces. After FDR was elected New York governor in 1928 by a razor-thin margin, he was greeted by a horde of reporters who surrounded his car. No doubt flashing his famous grin, FDR requested “no movies of me getting out of the machine, boys.” The press of that day dutifully cooperated with “this splendid deception,” Rembis recounted.
While a distinctive disability rights movement has been active in the U.S. for more than 100 years, scholars generally agree that a broader movement emerged in the 1960s and 1970s coincident with the U.S. civil rights movement. Enactment of the Americans with Disabilities Act (ADA) in 1990 was a key step forward, Rembis said. But over the years it was weakened by court decisions that gradually narrowed the definition of who might be considered disabled, thus making it almost impossible to file successful discrimination lawsuits. To counter these effects, Congress enacted the ADA Amendments Act of 2008, Rembis pointed out.
“There has been a fundamental rearticulation of what it means to be disabled,” along with an expansion of the “socio-political model” to include a broad range of impairments, including mental illness, learning and developmental disabilities and chronic illness, Rembis said. Ideas about disabled people often are tied to historic, cultural, political and socio-economic considerations, and “they change over time,” he noted.
By questioning attitudes that see disabled persons as “tragic” or “victims,” or solely as “patients” or “clients” within the helping professions, one might now respond differently to FDR’s physical limitations, Rembis said. Instead of viewing people like FDR as “heroes” for surmounting their physical circumstances, far better to see them as “living their lives—and lives worth living.”
During a question-and-answer session, Rembis said the disability rights movement now is concentrating more on inclusiveness rather than mere “tolerance” for those with a disability. And it’s focusing on housing that is accessible for all, rather than simply “accommodating” the needs of disabled individuals.
Finally, answering his own rhetorical question about FDR that framed the lecture, Rembis said the nation’s 32nd president was “impaired but he was not disabled.”

Oct 15, 2012

Wiping Out Polio: How The U.S. Snuffed Out A Killer


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Sixty years ago, polio was one of the most feared diseases in the U.S.
As the weather warmed up each year, panic over polio intensified. Late summer was dubbed "polio season." Public swimming pools were shut down. Movie theaters urged patrons not to sit too close together to avoid spreading the disease. Insurance companies started selling polio insurance for newborns.
The fear was well grounded. By the 1950s, polio had become one of the most serious communicable diseases among children in the United States.
In 1952 alone, nearly 60,000 children were infected with the virus; thousands were paralyzed, and more than 3,000 died. Hospitals set up special units with iron lung machines to keep polio victims alive. Rich kids as well as poor were left paralyzed.
Then in 1955, the U.S. began widespread vaccinations. By 1979, the virus had been completely eliminated across the country.
Now polio is on the verge of being eliminated from the world. The virus remains endemic in only two parts of the globe: northern Nigeria and the border between Afghanistan and Pakistan.
Throughout this week, we'll be reporting on the fight to eradicate the last few pockets of polio. We kick off with a look back at how the U.S. and the rest of the world wiped out the virus for good.
During the peak of the polio epidemic in the U.S., some hospital wards even had large, room-like iron lungs where multiple children lived.
EnlargeCourtesy of the University of Pennsylvania
During the peak of the polio epidemic in the U.S., some hospital wards even had large, room-like iron lungs where multiple children lived.

The first major polio epidemic in the United States hit Vermont in 1894 with 132 cases. A larger outbreak struck New York City in 1916, with more than 27,000 cases and 6,000 deaths. As the number of polio cases grew, the paralytic disease changed the way Americans looked at public health and disability.
Franklin D. Roosevelt contracted polio 12 years before he became president. Roosevelt concealed the extent to which he suffered from polio, but he acknowledged having it. His presidency put polio front and center on the national stage. In 1938, Roosevelt founded the National Foundation for Infantile Paralysis and spearheaded the March of Dimes for polio research. In 1946, President Harry Truman declared polio a threat to the United States and called on Americans to do everything possible to combat it.
"The fight against infantile paralysis cannot be a local war," Truman declared in a speech broadcast from the White House. "It must be nationwide. It must be total war in every city, town and village throughout the land. For only with a united front can we ever hope to win any war."
"Polio was a fear of parents throughout this country," says Dr. John L. Sever, recalling his childhood in Chicago. He later helped launch the Rotary International's global drive against polio.

Newsreel: 'Junior' Gets Vaccinated

A 1950s newsreel shows widespread vaccinations under way with the Salk vaccine.
Early attempts to develop a vaccine ran into numerous hurdles. A vaccine tested on 10,000 children by two researchers at New York University provided no immunity and left nine children dead. Other vaccine trials used "volunteers" at mental institutions.
At the University of Pittsburgh, Jonas Salk launched what was then the largest human trial in history, injecting nearly 2 million American kids with a potential vaccine. When it was announced that his vaccine worked, Salk was hailed as a humanitarian hero.
Famed CBS newsman Edward R. Murrow asked Salk who owned the patent to his vaccine. The scientist replied: "There is no patent. Could you patent the sun?"
The battle of science against disease, however, wasn't as smooth and simple as movie house newsreels from the time depicted it. At one point, a botched batch of vaccine paralyzed and even killed some of the recipients.
Salk's main rival in the vaccine race, Albert Sabin at Cincinnati Children's Hospital, couldn't gain political support in the U.S. for what he viewed as his superior vaccine. So at the height of the Cold War, he tested it in the Soviet Union instead.
Both Salk's and Sabin's vaccines are still used today. But Sabin's version, which requires just two drops in a child's mouth, proved much easier to use in mass immunization campaigns.
Sever says this oral vaccine was key to wiping out polio in the developing world: "After all, if you could count to two, you could be an immunizer."
The U.S. recorded its last case of polio in 1979, among isolated Amish communities in several states. Then the effort to eradicate polio globally began in earnest. The Western Hemisphere reported its last case, in Peru, in 1991.

Stamping Out The Last Pockets Of Polio

The world is getting tantalizingly close to eradicating the polio virus. Although 11 countries reported cases of polio in 2011, the virus has turned up in only four countries so far this year.
http://npr.org/news/graphics/2012/10/gr-polio-624.gif
In 1988, the World Health Organization set a new goal: eliminate polio. Since then, international institutions have poured billions of dollars into the eradication effort. They're getting very close to their target: So far this year, there have been fewer than 200 polio cases globally.
But the intensive immunization efforts against polio right now can't let up at all, warnsJoel Breman at the National Institutes of Health.
"We've seen what can happen when there's any break in the chain," Breman says. "In 2003 and 2004, northern Nigeria stopped vaccinating, even though they had endemic transmission. And boom! Twenty-one other countries that claimed and had proven to have eliminated polio became reinfected all over."

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