Feb 16, 2007 (CIDRAP News) – The live-virus, intranasal influenza vaccine FluMist strongly outperformed conventional killed-virus vaccines in a study involving close to 8,000 children younger than 5 years, a finding that may help pave the way for US approval of the vaccine for that age-group.In the international trial conducted in the 2004-05 flu season, there were almost 55% fewer cases of flu in children who received FluMist than in those who received the conventional injectable vaccine, according to a report published in the Feb 15 New England Journal of Medicine (NEJM). The live vaccine worked better than the conventional ones regardless of how well the vaccines matched the circulating viruses.”It’s a pretty convincing result,” commented vaccine expert John Treanor, MD, of the University of Rochester (New York), who was not involved in the research.On the downside, 6- to 11-month-old children in the FluMist group had significantly more hospitalizations for any reason after vaccination and also had a few more episodes of wheezing than their counterparts in the other group.FluMist is currently licensed for use in healthy people between the ages of 5 and 49. On the basis of their findings, the authors, led by Robert B. Belshe, MD, of St. Louis University, conclude that the vaccine is effective and safe for children from 12 to 59 months old with no history of asthma or wheezing.The Centers for Disease Control and Prevention (CDC) currently recommends annual flu vaccination for children from 6 through 59 months old, among other groups considered to have an increased risk of serious complications from flu. Only inactivated, injectable vaccines are licensed for that age-group.FluMist, made by MedImmune Inc., based in Gaithersburg, Md., has been on the market since 2003, but demand for it has been hampered by a higher cost than conventional vaccine and by the requirement to keep it frozen during storage. Last month the Food and Drug Administration (FDA) approved a new formulation that requires refrigeration but not freezing. The refrigerator-stable formulation was used in the new study.MedImmune, which sponsored the study, submitted preliminary results to the FDA in July 2006 with a request to permit use of the vaccine in children aged 1 through 4 years with no history of wheezing, according to Jamie Lacey, a company spokeswoman in Gaithersburg. She called the study “the pivotal trial” supporting the request.The company expects to hear an initial response from the FDA by May 28, Lacey told CIDRAP News. “We’re prepared for approval of this expanded indication for next [flu] season. That’s what we’re gearing up for,” she said.Study included 16 countriesThe study involved 249 physcians’ offices and clinics in 16 countries, with about half of the sites in the United States. The researchers recruited more than 8,300 children, of whom 7,852 completed the study. Children with a history of severe asthma or a recent history of wheezing were excluded, but those with mild or moderate asthma were included.Both FluMist and the injectable vaccines used in the trial, made by Aventis Pasteur, contained the three virus strains recommended by the FDA for the 2004-05 season. In equal numbers, children were randomly assigned to receive either FluMist or the injectable vaccine, and each participant also received a placebo version of the other vaccine (FluMist recipients received dummy injections, and injectable-vaccine recipients received a placebo dose of nasal spray). Participants and medical workers were blinded to the treatment assignments.The researchers reported 153 cases of flu in the FluMist group, for an attack rate of 3.9%. This was 54.9% lower than the 338 cases in the conventional vaccine group, with an attack rate of 8.6% (P<.001). For culture-confirmed flu cases, the attack rates were 5.0% for the FluMist group and 10.0% for the inactivated vaccine group.The live vaccine worked well against both well-matched and mismatched flu strains. Compared with the inactivated-vaccine group, the FluMist group had 89.2% fewer cases of influenza A/H1N1, a strain for which the vaccine was well-matched, and 79.2% fewer cases of A/H3N2, which the vaccine did not match well, the report says. Both differences were significant.The 2004-05 season saw several strains of influenza B, of which some matched the vaccine and some did not. The FluMist group had 16.1% fewer cases of type B flu than the other group, a nonsignificant difference.As for vaccine safety, 6.1% of FluMist recipients between 6 and 11 months old were hospitalized for any cause within 180 days after vaccination, versus 2.6% of children in that age range who received inactivated vaccine, a significant difference. There was no significant difference in hospitalization rates between the two groups overall.The investigators also noted that among children who had a history of wheezing, there was a trend toward a higher rate of all-cause hospitalization among 6- to 47-month-olds in the FluMist group, though it was not significant.The researchers found no significant difference between the two groups in the overall rate of wheezing episodes. But among previously unvaccinated children, 3.8% of FluMist recipients aged 6 to 11 months had a wheezing episode within 42 days after their first vaccine dose, as compared with 2.1% of the same age-group among inactivated vaccine recipients (P=.076). The episodes occurred in the second, third, and fourth weeks after vaccination, after the peak of viral replication, the report says.Overall, the authors write, the findings suggest that FluMist can play an important role in controlling flu. "On the basis of our results, the risk-benefit ratio for live attenuated vaccine appears favorable among children 12 to 47 months of age who have no history of wheezing."Until additional data are available, the observations related to medically significant wheezing and rates of hospitalization will restrict the use of live attenuated vaccine in children younger than 1 year and in children 12 to 47 months of age who have a history of asthma or wheezing," the report states.Though 'definitive,' study lacked placebo groupTreanor, a veteran vaccine researcher and professor of medicine, microbiology, and immunology, commented, "I think one of the things about the study that's remarkable is how carefully done it was and its size. It's quite definitive."He said the study strengthens his general impression that the immune response to live attenuated flu vaccines varies with age. "It really does look like younger children support the replication of the cold-adapted [intranasal] virus more than do adults," leading to a stronger immune response, he commented.Evidence about immune responses and the ability of the vaccine virus to replicate in the nose suggests that the live vaccine probably works better than inactivated vaccine in children, Treanor said. In young and middle-aged adults it appears that the two types are roughly equivalent, though the live vaccine may be slightly better, while inactivated vaccine seems to work better in elderly people, he added."This all reflects the impact of the host on the ability of the live vaccine to replicate and induce an immune response," Treanor said. He said the immunogencity of live vaccines "starts to tail off as you get older and have been exposed to the flu many times," though it's not clear where the age boundaries are.Treanor also commented that in the FluMist study, the flu attack rate of 8.6% in the inactivated-vaccine group is "a reminder that flu vaccines are not perfect in young kids."One limitation of the FluMist study is that the investigators "did not feel they should include a placebo group," Treanor said. That limits the ability to assess the relative benefits of FluMist and the conventional vaccine as compared with no vaccine—a point also made in a NEJM editorial by Nancy J. Cox, PhD, and Carolyn Buxton Bridges, MD, of the CDC."It's hard to have a placebo group in a population where a vaccine is already recommended as a routine step," Treanor said. "But this gap in the knowledge will make it harder for policy makers."For example, he said, the CDC's Advisory Committee on Immunization Practices may eventually want to consider making a specific recommendation about the use of FluMist in small children. Given the likelihood of cost differences and safety issues to consider, "the lack of a placebo group will make that decision more difficult," he said.In their editorial, Cox and Bridges say the live attenuated vaccine may offer "significant advantages" for children, because it doesn't involve needles and may provide better protection against flu than conventional vaccines do."However, enthusiasm for the vaccine must be tempered" by the signs of an increased risk of wheezing and of hospitalization in children less than 1 year old, they write. Although the results are "encouraging, further discussion and careful review of the safety data" will be necessary before policy decisions are made, they add.Belshe RB, Edwards KM, Vesikari T, et al. Live attenduated versus inactivated influenza vaccine in infants and young children. N Engl J Med 2007 Feb 15;356(7):685-96 [Abstract]Cox NJ, Bridges CB. Inactivated and live attenuated influenza vaccines in young children—how do they compare? (Editorial) N Engl J Med 2007 Feb 15;356(7):729-31See also:Jan 9, 2007, CIDRAP News story "FDA approves refrigerated form of FluMist"
Michalik will oversee Germany and Austria. Sven Simonis leads the institutional business in this area, with Hagen Schremmer in charge of retail.Manuel Faccio, previously CEO of DWS in Switzerland, is now head of southern Europe, France and MENA. Reporting to him are: Olivier Dubost, responsible for France and MENA; Mauro Castiligioni, head of Italy; Mariano Arenillas, covering Spain; and Pascal Imhof for Switzerland.Elsewhere, Sandra Niethen has been appointed head of institutional and client strategy, including consultant relations and pension advisory services. She was previously chief of staff.Michalik told staff that the changes were part of DWS’ “strategic ambitions” and were aimed at “creating an efficient coverage model that has clearly-defined responsibilities”.Yesterday, DWS reported an 18% increase in profits before tax in the third quarter of 2018, compared with the previous three months. The group’s assets under management grew by €5bn, with market performance offsetting client withdrawals of €2.7bn.This week the group also announced an extension of its partnership with Italian insurance giant Generali to provide unit-linked insurance products via Generali’s networks in France, Switzerland, Italy and Germany.The deal followed a partnership announced last week between DWS and French investment house Tikehau specialising in alternatives. DWS has reshuffled senior staff roles in the wake of its IPO earlier this year, creating a number of regional leadership roles.The €692bn asset manager told staff this week of the changes, which involved grouping individual country heads into four regions: northern Europe, southern Europe with the Middle East and north Africa (MENA), Asia Pacific, and Germany and Austria.In a note to staff seen by IPE, Thorsten Michalik, head of coverage at DWS, said: “This streamlined structure is designed to provide a more consistent global operating model that will foster greater communication between our various teams.”Effective this week, Maria Ryan, head of UK, has taken on additional responsibility for the Nordic and Benelux regions, with head of Nordics Thomas Lindahl and head of Benelux Pieter Furnee reporting to her.
Promoted ContentBirds Enjoy Living In A Gallery Space Created For ThemBest Car Manufacturers In The World9 Facts You Should Know Before Getting A TattooWhy Do So Many Digital Assistants Have Feminine Names & Voices?Top 10 Enemies Turned Friends In TV13 kids at weddings who just don’t give a hootThese Are The Best Stargazing Locations You Can Find On EarthTop 10 Tiniest Phones Ever Made5 Of The World’s Most Unique Theme Parks7 Facts About Black Holes That Will Blow Your MindCouples Who Celebrated Their Union In A Unique, Unforgettable WayWho Earns More Than Ronaldo? Speaking on Instagram live with the Super Eagles media team, the former OSC Lille of France shot-stopper revealed that he holds no grudges against Oliseh, insisting if he had his way he would sit and have breakfast with the 45-year-old.“I have nothing against Oliseh. What happened in the past is in the past.“I still have his number on my phone and probably he has mine. If I have my chance I would sit and have breakfast with him.” Ahmed Musa was later declared the captain, with the decision generating uproar in the team which subsequently forced Enyeama to end his international career. Read Also: Napoli ready to rival Chelsea for Super Eagles forwardInterestingly, Enyeama earned 101 caps for the Super Eagles, helping the side win the 2013 Africa Cup of Nations in South Africa.The former Hapoel Tel Aviv goalie featured for Nigeria in the 2002 World Cup as well as the 2010 and 2014 editions before unceremoniously leaving the national team.FacebookTwitterWhatsAppEmail分享 Former Super Eagles shot-stopper Vincent Enyeama says he doesn’t have any issue with the former handler of the side Sunday Oliseh, insisting what happened between them is bygone.Advertisement Loading… The pair clashed in 2015 following Oliseh’s decision to strip Enyeama of the captaincy.
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But Van Gaal’s resolute defence of his methods is starting to pay dividends, with the club up to third in the Premier League and FA Cup favourites after Wednesday night’s fourth-round replay win over Cambridge. Evans said: “I think when you get as many attacking players on the pitch as we’ve got you are always going to entertain. “But the manager has done a lot of work in trying to steady the team and making sure everyone knows their jobs. Once we get that nailed on, and everyone knows their defensive jobs, then I think we’ll be able to push on from that and be really entertaining again. “You can look at the formation changes and the personnel changes as well, plus the fact that there’s a lot of players who haven’t played together before, and he [the manager] is doing fantastically well in getting us organised. And as players we’re really benefiting from that.” Evans, who made his United debut in 2007, insists it is inevitable the squad will take time to fully adapt to Van Gaal’s methods following the departure of Sir Alex Ferguson and the tumult of David Moyes’ brief and unsuccessful regime. “I think the lads have taken a lot on board,” added Evans. “At times it has been tough and it takes time. We’ve been used to playing a certain way for a number of years, then the change happens and he wants us to play a certain way. “So it does take time for those things to become second nature. But I think you are starting to see that now.” Van Gaal’s tactics have come under fire from some United fans who are keen to see him revert back to the tried-and-tested 4-4-2 formation. And United midfielder Adnan Januzaj admitted this week that Van Gaal’s system often made it “more difficult for me to play”. Manchester United defender Jonny Evans is adamant Louis Van Gaal’s Old Trafford revolution will soon see his side back at their entertaining best. Press Association United may have limped past lowly Cambridge at the second attempt but Evans thinks it could spell the start of the club’s first FA Cup triumph since 2004. Shock defeats for Chelsea and Manchester City have left United as the highest-ranked team left in the competition, giving Van Gaal a superb chance of capping his first season in charge with a major trophy. Evans said: “Our record in the FA Cup hasn’t been good over the last few years. “It’s an old cliche that you want to win everything but it is such a historic trophy, especially for Manchester United, and the fact that the league is still not gone but not looking likely, the FA Cup looks our best chance of a trophy, especially considering some of the teams that have gone out. “We’re the highest ranked team left in the competition now. It was a bit of a shock sitting at home hearing the news that Chelsea and City had gone out. But we know from our own experiences all about upsets.”
“He’s committed himself to make sure DeMarcus is comfortable and to make sure DeMarcus feels like this is home,” teammate Draymond Green said, via The Mercury News . “He’s never been a guy that is not welcoming of anyone. When that’s the face of your franchise, that is important.”In fact, Curry made sure he was close to Cousins at team dinners, asked how his rehab was going and catered food to Cousins’ hotel room. And it wasn’t just random catering — instead he sent dishes from International Smoke, an upscale Southern restaurant owned by his wife, Ayesha. “That’s one of my new favorite places,” Cousins said of International Smoke, adding he loves the ribs. “It’s incredible.”Cousins finally made his Warriors debut on Jan. 18 and hasn’t looked back as he’s averaged 15.9 points and 8.0 rebounds in 24 games. When asked how Curry has benefited Cousins as a player, Cousins lauded Curry for letting players be themselves.“What has he done for me?” Cousins repeated the question. “He’s opened my game up. He takes all the attention away and lets me be me.” DeMarcus Cousins on free agency: ‘Right now, I don’t give a sh—’ The Warriors made a gamble signing DeMarcus Cousins as he was rehabbed a torn Achilles, but one teammate made sure Cousins was brought into the fold through homecooked food.Stephen Curry and the rest of the Warriors had no idea on how long it would take for Cousins to come back onto the court, but Curry took it upon himself to make sure Cousins felt like a member of the team. Related News
He fought three times for the UFC featherweight title and lost all three bouts — twice to Jose Aldo and once to Conor McGregor. Mendes, 34, is stepping away with an 18-5 record as a professional (9-5 UFC). He lost four of his last six fights, including his most recent bout, a TKO defeat to Alexander Volkanovski in December at UFC 232. I just want to say THANK YOU to all my fans and everyone that tuned in to watch me battle! With 29 years of competing and 11 year in the Mma game, I feel it’s time for the next chapter in my life! It’s been an… https://t.co/zKdiEbPeNW— chad mendes (@chadmendes) July 10, 2019He told Okamoto that he came to his decision while he was taking time away from the sport.”I have no regrets,” he told Okamoto. “I’ve had an amazing time.”Join DAZN and watch more than 100 fight nights a year (Getty Images) https://images.daznservices.com/di/library/sporting_news/47/eb/mendes-volkanovski-071019-getty-embedjpg_tyc9jr4y1az9140x8dms1d09e.jpg?t=-615814973&w=500&quality=80 Chad Mendes said Tuesday that he’s putting the gloves down for good.Mendes announced his retirement from mixed martial arts, first to ESPN’s Brett Okamoto and then to the public.
Four police officers were killed in a knife attack at Paris police headquarters by a man who was then shot dead, say French reports.The event appears to be a case of workplace violence.The assailant was an administrative intelligence employee at police headquarters who was “death and dumb.”French reports say the assailant went on the rampage with a ceramic knife, stabbing several colleagues in his office and the surrounding area before being shot dead by an officer.Police sources said the assailant was “in conflict” with his superiors.The police headquarter’s on the île de la Cité has been cordoned off and emergency services and interior minister Christophe Castaner and prime minister Edouard Philippe, have arrived at the scene.
DHAKA, Bangladesh, (CMC): All-rounder Darren Sammy’s cameo failed to save Rajshahi Kings as they slumped to heart-breaking three-run defeat to Khulna Titans in the Bangladesh Premier League here yesterday. Chasing 134 for victory at the Shere Bangla National Stadium, Kings came up short on 130 all out off their 20 overs, to lose their opening game of the tournament. The right-handed Sammy, who is leading the Kings this season, slammed an unbeaten 31 off 23 deliveries but it was not enough to get his side over the line. His three sixes came down the stretch and kept Kings in the hunt but he perished at the start of the 18th over, bowled by seamer Shafiul Islam. They needed seven runs off the last over but lost three wickets to see their challenge fizzle. Sammy was one of just three players in double figures with opener Mominul Haque stroking a top score of 64 off 57 deliveries. Opting to bat first earlier, Titans reached 133 for eight off their 20 overs, with West Indies Twenty20 batsman Nicholas Pooran getting only 14. Captain Mahmudullah and Riki Wessels both top-scored with 32. In the other game at the venue, former Barbados and West Indies batsman Dwayne Smith failed with 10 as his Chittagong Vikings went down to Rangpur Riders by nine wickets.
The body of a 53-year-old Golden Grove, East Coast Demerara (ECD) man was on Tuesday afternoon discovered floating in a trench at Nabaclis, ECD.Dead is Terrence James of Lot 16 Sancho Street, Golden Grove, ECD. His body was found about 14:00h.According to reports, the man, who was said to be in the habit of imbibing alcohol, was last seen on Monday night at a bar at Nabaclis Public Road.However, about 14:00h, a welder, who was exiting his yard, saw James’s body floating face down in a trench.The Police were summoned, and the body was examined. No marks of violence were found.The Police are investigating.