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Needle-free jet injection for administration of influenza vaccine Since 2010, the US Centers for Disease Control and Prevention has recommended annual influenza vaccination for all people in the USA aged 6 months or older who do not have contraindications. However, coverage falls far short of this goal, particularly in young adults. Needle phobia and the risk of needle-stick injury may be relevant.This non-inferiority trial aimed to assess the immunogenicity and safety of trivalent influenza vaccine given by needle-free jet injector compared with needle and syringe. The jet injectors use a high-pressure narrow jet of liquid drug to penetrate and deliver the drug to the desired depth. 1250 participants were randomised to receive vaccination by the jet injector or needle and syringe.The researchers report that "the immune response to influenza vaccine given with the jet injector was non-inferior to the immune response to influenza vaccine given with needle and syringe. The device had a clinically acceptable safety profile, but was associated with a higher frequency of local injection site reactions than was the use of needle and syringe."Lancet 2014;384:674–81. Safety of pertussis vaccine in pregnant women in UKA sharp increase in confirmed cases of pertussis observed in the UK during 2011–12 led to the introduction of a pertussis vaccination programme targeting pregnant women in their third trimester aimed at reducing infant morbidity and mortality. This observational study was designed to evaluate the safety of pertussis-containing vaccines in pregnant women in the UK.Over 20,000 pregnant women with a record of vaccination containing pertussis were identified. They were compared with a matched historical unvaccinated cohort. The conclusion reached was that there was no evidence of an increased risk of stillbirth or any of a range of predefined adverse events related to pregnancy after vaccination with a vaccine containing pertussis.An editorial commentator commends the study. He notes that the vaccine used included low-dose diphtheria toxoid and inactivated polio vaccines as well as acellular pertussis vaccine. He speculates that if pertussis vaccine was available without the other components it might encourage more frequent booster doses in the general community.BMJ 2014;349:g4219 & g4518. Self-monitoring and medication self-titration in hypertensive patients at high risk of cardiovascular diseaseSelf-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. This paper reports on a randomised trial comparing these management techniques in patients with a history of stroke, coronary heart disease, diabetes or chronic kidney disease.The primary outcome was the difference in systolic blood pressure between intervention and control groups at the 12-month office visit. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mmHg in the intervention group and to 137.8/76.3 mmHg in the control group, a difference of 9.2 mmHg in systolic and 3.4 mmHg in diastolic blood pressure.So self-management appears to be appropriate for hypertensive patients in the high-risk category.JAMA 2014;312(8):799–808.

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Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

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Needle-free jet injection for administration of influenza vaccine Since 2010, the US Centers for Disease Control and Prevention has recommended annual influenza vaccination for all people in the USA aged 6 months or older who do not have contraindications. However, coverage falls far short of this goal, particularly in young adults. Needle phobia and the risk of needle-stick injury may be relevant.This non-inferiority trial aimed to assess the immunogenicity and safety of trivalent influenza vaccine given by needle-free jet injector compared with needle and syringe. The jet injectors use a high-pressure narrow jet of liquid drug to penetrate and deliver the drug to the desired depth. 1250 participants were randomised to receive vaccination by the jet injector or needle and syringe.The researchers report that "the immune response to influenza vaccine given with the jet injector was non-inferior to the immune response to influenza vaccine given with needle and syringe. The device had a clinically acceptable safety profile, but was associated with a higher frequency of local injection site reactions than was the use of needle and syringe."Lancet 2014;384:674–81. Safety of pertussis vaccine in pregnant women in UKA sharp increase in confirmed cases of pertussis observed in the UK during 2011–12 led to the introduction of a pertussis vaccination programme targeting pregnant women in their third trimester aimed at reducing infant morbidity and mortality. This observational study was designed to evaluate the safety of pertussis-containing vaccines in pregnant women in the UK.Over 20,000 pregnant women with a record of vaccination containing pertussis were identified. They were compared with a matched historical unvaccinated cohort. The conclusion reached was that there was no evidence of an increased risk of stillbirth or any of a range of predefined adverse events related to pregnancy after vaccination with a vaccine containing pertussis.An editorial commentator commends the study. He notes that the vaccine used included low-dose diphtheria toxoid and inactivated polio vaccines as well as acellular pertussis vaccine. He speculates that if pertussis vaccine was available without the other components it might encourage more frequent booster doses in the general community.BMJ 2014;349:g4219 & g4518. Self-monitoring and medication self-titration in hypertensive patients at high risk of cardiovascular diseaseSelf-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. This paper reports on a randomised trial comparing these management techniques in patients with a history of stroke, coronary heart disease, diabetes or chronic kidney disease.The primary outcome was the difference in systolic blood pressure between intervention and control groups at the 12-month office visit. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mmHg in the intervention group and to 137.8/76.3 mmHg in the control group, a difference of 9.2 mmHg in systolic and 3.4 mmHg in diastolic blood pressure.So self-management appears to be appropriate for hypertensive patients in the high-risk category.JAMA 2014;312(8):799–808.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

For the PDF of this article,
contact nzmj@nzma.org.nz

View Article PDF

Needle-free jet injection for administration of influenza vaccine Since 2010, the US Centers for Disease Control and Prevention has recommended annual influenza vaccination for all people in the USA aged 6 months or older who do not have contraindications. However, coverage falls far short of this goal, particularly in young adults. Needle phobia and the risk of needle-stick injury may be relevant.This non-inferiority trial aimed to assess the immunogenicity and safety of trivalent influenza vaccine given by needle-free jet injector compared with needle and syringe. The jet injectors use a high-pressure narrow jet of liquid drug to penetrate and deliver the drug to the desired depth. 1250 participants were randomised to receive vaccination by the jet injector or needle and syringe.The researchers report that "the immune response to influenza vaccine given with the jet injector was non-inferior to the immune response to influenza vaccine given with needle and syringe. The device had a clinically acceptable safety profile, but was associated with a higher frequency of local injection site reactions than was the use of needle and syringe."Lancet 2014;384:674–81. Safety of pertussis vaccine in pregnant women in UKA sharp increase in confirmed cases of pertussis observed in the UK during 2011–12 led to the introduction of a pertussis vaccination programme targeting pregnant women in their third trimester aimed at reducing infant morbidity and mortality. This observational study was designed to evaluate the safety of pertussis-containing vaccines in pregnant women in the UK.Over 20,000 pregnant women with a record of vaccination containing pertussis were identified. They were compared with a matched historical unvaccinated cohort. The conclusion reached was that there was no evidence of an increased risk of stillbirth or any of a range of predefined adverse events related to pregnancy after vaccination with a vaccine containing pertussis.An editorial commentator commends the study. He notes that the vaccine used included low-dose diphtheria toxoid and inactivated polio vaccines as well as acellular pertussis vaccine. He speculates that if pertussis vaccine was available without the other components it might encourage more frequent booster doses in the general community.BMJ 2014;349:g4219 & g4518. Self-monitoring and medication self-titration in hypertensive patients at high risk of cardiovascular diseaseSelf-monitoring of blood pressure with self-titration of antihypertensives (self-management) results in lower blood pressure in patients with hypertension, but there are no data about patients in high-risk groups. This paper reports on a randomised trial comparing these management techniques in patients with a history of stroke, coronary heart disease, diabetes or chronic kidney disease.The primary outcome was the difference in systolic blood pressure between intervention and control groups at the 12-month office visit. After 12 months, the mean blood pressure had decreased to 128.2/73.8 mmHg in the intervention group and to 137.8/76.3 mmHg in the control group, a difference of 9.2 mmHg in systolic and 3.4 mmHg in diastolic blood pressure.So self-management appears to be appropriate for hypertensive patients in the high-risk category.JAMA 2014;312(8):799–808.

Summary

Abstract

Aim

Method

Results

Conclusion

Author Information

Acknowledgements

Correspondence

Correspondence Email

Competing Interests

Contact diana@nzma.org.nz
for the PDF of this article

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