Biomedical subjects
A Leentvaar-Kuijpers
Publications and source records attributed to A Leentvaar-Kuijpers.
Simultaneous passive and active immunization against hepatitis A.
The serum antibody response to simultaneous administration of immune globulin (Ig) and an inactivated hepatitis A vaccine was investigated in healthy volunteers who had been tested and found free of hepatitis A virus. One hundred and forty nine subjects were randomly allocated into three groups. Group 1 received three doses of hepatitis A vaccine at 0, 1 and 6 months, group 2 received 5 ml of Ig and group 3 received a combination of Ig and vaccine. In group 3 the seropositivity rate measured by enzyme-linked immunosorbent assay was 100% at day 5, month 1 and 2, 96% at month 6 and again 100% at month 7. In the group that received vaccine alone the seroconversion rates were 0, 96, 100, 98 and 100 respectively. The geometric mean titres in subjects who received passive/active immunization were about twofold lower than in subjects who received vaccine alone, indicating interference of Ig with the immune response. Despite this, the data show that simultaneous administration of hepatitis A vaccine and Ig confers both immediate protection via Ig administration and long-term vaccine-induced protection. As the antibody levels reached are about twofold lower compared to that after administration of hepatitis A vaccine alone, a booster dose may be required sooner, than if the vaccine were administered alone.
Decreasing incidence of PID in Amsterdam.
OBJECTIVE: To study the incidence of pelvic inflammatory disease (PID) in Amsterdam in the period 1983-1990. METHODS: Patients diagnosed with PID based on a clinical definition were reported weekly by 30 general practices who covered 11% of the Amsterdam population. Annual age specific incidences were calculated using the number of women in the participating practices as the denominator. RESULTS: The PID incidence was approximately 50 per 10,000 women through 1986, and then started to decrease in 1987 to reach 24 per 10,000 in 1990. The decreasing trend since 1987 was seen in the age-groups 20-24, 25-34 and 35-44 years, but not among teenagers. The moment of decline coincided with extensive attention given in the Dutch media to the risk of heterosexual transmission of the human immunodeficiency virus (HIV). CONCLUSION: It is plausible that the declining incidence of PID was influenced by a change of heterosexual behaviour under the threat of AIDS.
[Immune response following preventive intracutaneous rabies vaccination].
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Needlestick injuries, surgeons, and HIV risks.
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[The epidemiology of AIDS in Amsterdam, 1982-1988].
The results are reported of AIDS monitoring in Amsterdam in the period 1982-1988. Males with homosexual contacts are the principal risk group followed by the fast-growing group of users of intravenous drugs. Transmission of the human immunodeficiency virus to the heterosexual population will occur mostly via sexual contacts with users of drugs. An investigation of the degree of underreporting in Amsterdam revealed 23 unreported patients (5.7% of the cumulative total). The median duration of survival of AIDS patients increased: 1982-1985, 9 months, 1986, 12 months, 1987, 16 months. Two-year survival of patients in the periods 1986 and 1987 was practically the same, however. It is assumed that at the end of 1991, 1124 AIDS patients domiciled in Amsterdam will have been diagnosed.
[HIV occupational risk of surgical specialists and operating room personnel in the Saint Lucas Hospital in Amsterdam].
All instrument and needle accidents, and mucosal exposure to blood involving surgical specialists and operating room personnel were recorded for a seven-month period in a middle-sized Amsterdam hospital, the St. Lucas. Fifty-four accidents were reported, of which 42 were percutaneous wounds and 12, blood splatters in the eyes. The frequency of percutaneous wounds per operation per person ranged from 0 to 0.013. In the same period 3098 patients who had to be operated on were asked to participate in an anonymous study for HIV antibody. One hundred and twenty patients refused participation (3.9%). Of the 2978 participating patients seven were seropositive for anti-HIV (0.23%). The observed percutaneous accident frequency and HIV prevalence were used in combination with reports from the literature on the risk of infection after a single exposure to HIV infected material, to calculate the HIV professional risk for operating room personnel in this hospital. For general surgeons the risk of infection (based on 500 operations per year) was calculated as 0.0012 for an occupational lifespan of 30 years. For the other specialists and functions the risk was the same or less. Considering the low risk our conclusion is that screening of preoperative patients is not necessary in this hospital. The observance of general protective measures provides sufficient protection for the professional group examined.