Nat Reviewer For Fourth Year Pdf Download
the world health organization global strategy for elimination of hepatitis b virus (hbv) is to eliminate chronic hbv infection in children and adults through vaccination and treatment. however, there is limited data on the feasibility of this goal and the number of individuals that should be immunized to drive the transmission to zero has remained an unknown quantity 66 . a recent mathematical model analysis 67 compared the projected impact of vaccination programmes in bangladesh, china, india and vietnam in which the adults are immunized at birth and around the age of 15 years. these programmes, which were projected to lead to significant reductions in hbv incidence and mortality, were shown to be highly effective and were able to predict more realistically than previous analyses the impact of different vaccination strategies on the lifetime incidence of infection, and hence the epidemiological impact of vaccination campaigns 67 .
there is increasing recognition of the importance of preclinical studies to investigate novel vaccine candidates. in 2018, a handful of vaccine candidates for tb were successfully tested in non-human primates (nhps) for the first time and also produced promising results in mice and ferrets 94 . importantly, the nhps were humans seronegative for m. tuberculosis infection at the start of vaccination which shows that the vaccine is effective in preventing tb infection regardless of whether the immune system is primed or not.
in early sepsis the incidence of organ dysfunction is similar and the early mortality also has a long-lasting effect on life-expectancy because of the presence of other pathologies. however, this does not apply to dic patients, in which the fatal outcome occurs later. the treatment of sepsis is associated with a decrease in dic-related organ damage, and these data suggest that the dic should be regarded as a consequence rather than a cause of infection-related organ failure 118 .