Urease inhibitory activity of H. pylori using selected CDs was determined by measuring the urease catalyzed release of ammonia by Berthelot reaction. 20 In brief, the H. pylori cells were harvested from the BHI broth by centrifugation at 4 °C (4000 g, 5 min) and resuspended in ice-cold 0.1 M sodium phosphate buffer (pH 7.3) containing 10 mM EDTA. Cells were disrupted by sonication

(Sonics Vibra Cell model, USA), and the supernatant obtained after centrifugation at 4 °C (12,000 g, 5 min) was used as a source of enzyme for urease assay. The 96 well microtitre plate reaction mixture contained urea (2, 4, 6, 8, 10 mM), sodium phosphate buffer 30 μl and different concentration NVP-BKM120 mouse of selected CDs 10, 50, 100 μg/ml [3]. After incubation for 10 min at 37 °C 0.66 N hydrogen sulphate 30 μl, sodium

tungstate 30 μl and of 30 μl Nessler’s reagent was added. Absorbance of the reaction mixture was recorded at 625 nm. The amount of ammonia produced was equivalent to the hydrolysis of urea. A high absorption value indicated high urease activity in the reaction mixture. IC50 of the urease inhibition was calculated using GraphPad Prism version 6.00. Docking studies were carried out as per our earlier Baf-A1 concentration investigation.21 The selected CDs were docked onto the ligand binding sites of the H. pylori urease using ArgusLab 4.0.1 (Mark Thmopson and Planaria Software LLC). The X-ray crystallographic structures of the H. pylori urease (PDB ID-1E9Y) complexed with acetohydroxamic acid (ref), were downloaded online (www.rcsb.org) from the Research Collaboratory for Structural Bioinformatics (RCSB). The files were opened in ArgusLab window, the geometry, valency and hybridization of the structure were corrected. The structures of the selected CDs were drawn in working window of ArgusLab and were energy optimized using PM3 semi-empirical QM method. The optimizations were performed up to 500 iterations or an automatic

energy optimization gets converged. The active sites of the selected receptor were defined to include residues within a 3.5 Å radius of the complexed ligand. For docking we have used the ArgusLab scoring GBA3 function AScore, Argus Dock engine, grid resolution of 0.4 Å with a flexible mode of ligand docking. The docking score was calculated as best ligand pose energy (kcal/mol) and the docked complexes were geometry optimized and were further analyzed for the hydrogen bonding. The distance (Å) between hydrogen bond forming residues was measured. The experimental values summarized for (MIC) of CDs against H. pylori are expressed as the mean ± SD. For inhibition of H. pylori urease studies the significance of the difference from the respective controls for each experimental test condition was assayed by using Student’s t test for each paired experiment. A p* value <0.05 was considered as a significant difference when compared with control. Results of the anti-H. pylori activity and MICs of the selected CDs are summarized in Table 1.

, 2012). The findings

presented above may reassure parents and providers who are reluctant to vaccinate due to concerns about risk compensation. However, as noted by Stupiansky and Zimet (2013), “… it is important to remember that risk compensation (real or imagined) is IDO inhibitor not a rationale for withholding vaccine. Instead, it is a rationale for ensuring adequate education both pre- and post-vaccination” (p. 262). Underlying some parental HPV vaccine concerns (e.g., feeling that HPV vaccine is too new) are questions about vaccine safety (Fisher, 2012; Krawczyk et al., unpublished results). Fear-inducing news stories may have contributed to these concerns as they sometimes have misreported Vaccine Adverse Event Reporting System data, incorrectly suggesting that HPV vaccination has often led to severe adverse health effects, including death (see, for example the August, 2007 edition of Maclean’s magazine in Canada; Gulli, 2007). Numerous large-scale studies on HPV vaccine safety have been published and show little or no evidence of severe side-effects associated with vaccination

(Agorastos et al., 2009, Chao et al., 2012, Gee et al., 2011, Klein et al., 2012 and Lu et al., 2011). Dinaciclib The most frequently reported side-effects are similar to those reported with other vaccines and are transient events, such as mild pain and bruising at the injection site, faintness, and syncope (Naleway et al., 2012). It is important to highlight that a reported adverse event after vaccination does not automatically mean that it was caused by the vaccine. A major challenge, however, is how to effectively communicate to parents the evidence that HPV vaccine is quite safe. As noted following, an additional challenge involves communicating Astemizole the very substantial risks of non-vaccination, in the context of generalized, relatively early, sexual debut, delayed marriage, serial monogamy, and the accumulation of risk of HPV infection over

time. Development of effective strategies for clearly and accurately communicating information about risk of vaccines has been an enduring focus of vaccine researchers (Ball et al., 1998, Betsch and Sachse, 2013, Davis et al., 2001 and Offit and Coffin, 2003). Best practices in this regard may rest on the nature of the vaccine (routine versus elective), the controversies that may surround the vaccine (e.g., MMR and autism, HPV and risk compensation), and, importantly, whether parents or patients harbor ongoing concerns about HPV vaccine safety, actively ask about vaccine safety, or have no concerns in this area. Suggestions for communication about HPV vaccine safety include asking patients whether they have any questions about the vaccine and providing accurate information (including credible websites) that can address concerns about safety.

05 ml/fish), a commercial monovalent SAV vaccine (0.1 ml/fish), a placebo adjuvant vaccine (0.1 ml/fish) or PBS (0.1 ml/fish). After a six weeks smoltification period, the fish were distributed to duplicate tanks with seawater. The fish that were to be evaluated in the i.p. injection model, and that served as shedders for the fish in the cohabitation model, were then challenged with the isolate ALV413 at a final dose of 1.15 × 108 TCID50/fish. Samples from heart, pancreas and skeletal muscle were taken for histological analysis from all cohabitant groups 3–5 weeks post challenge (n = 10 per

tank/20 per group, per time point, unless otherwise stated). Heart-tissues were also stored on RNA-later (Ambion) and used for RNA extraction and PCR analyses. Sera were collected from the caudal vein for evaluation of viraemia by isolation of infectious virus in GW-572016 price Chum salmon heart (CHH) cells using previously described techniques [18] and [19]. Samples were also taken from surviving fish in the i.p. challenged groups four weeks p.i. (n = 5 per tank/10 per group, except for in the PBS placebo group where n = 4 and 2 from the two tanks due to few survivors). Tissues were fixed in 10% phosphate-buffered formalin for a minimum of 48 h prior to being submitted

blinded to the Norwegian Veterinary Institute, Oslo, Norway for embedment in paraffin wax, sectioning at 4–5 μm and staining with hematoxylin and eosin according to their standard procedure. Blinded slides were scored for lesion severity using a visual analogous scale as previously described [17] (Supplementary Table 1). Heart Apoptosis Compound Library manufacturer samples were collected aseptically without penetrating the peritoneal cavity, stored on RNAlater and submitted to an accredited commercial laboratory for RNA extraction and Real-Time PCR analyses (PatoGen Analyse AS, Ålesund, Norway). The returned results were treated as positive/negative, or semi-quantitative. In the latter case, raw Ct-values that were obtained with a previously

described Taqman assay targeting the coding sequence of SAV nsP1 [20] were normalized against the Ct-values from an assay targeting the mRNA of cellular elongation factor 1a [21] using the Q-gen software [22]. PCR efficiencies these for the two assays were provided by PatoGen Analyse AS for inclusion in the analysis (slopes = −3.25 for SAV and −3.41 for ElA). Normalized Ct-values were divided by the lowest value in the groups compared and Log2 transformed for presentation. The trial included two cages of Atlantic salmon (Cage 1: n = 109 203, cage 2: n = 126 254), held under industrial conditions at a commercial seawater fish farm in Western Norway. All the fish were of the same strain and origin and were vaccinated in the freshwater stage (January 11th–February 3rd, 2011) with the commercial multi-component vaccine ALPHA JECT micro®6, that does not contain any SAV antigens.

This evidence supported by complete acid hydrolysis yielding glucose in the aqueous layer

of compound 5 only and apigenin was detected in the organic layer in check details both compounds (CoPC). 91H NMR spectrum showing an AX system exhibiting two ortho doublets each integrated for two protons of H-2′/6′, and of H-3′/5′ indicating 1′,4′-disubstituted B-ring of both compounds. The down-field shift of both H-6 and H-8 to 6.43 and 6.74 meta doublet and the anomeric proton signal at δ 5.22 ppm gave evidence for the presence of β-glycosidic moiety at 7-position in compounds 5. 1813C NMR spectra showed the carbon signals characteristic of apigenin nucleus and its glycosidation at 7-OH in compound 5 was indicated by slight up-field shift of C-7. The structure of the compounds was also confirmed by negative ESI-MS molecular ion peak of compound 9 as a free apigenin aglycone at m/z 269 [M–H]− and of compounds 5 at m/z 431 [M–H]− as apigenin glucoside and was compared with published data. 9, 17 and 21 1H NMR spectra of compound 11 showed flavanone structure indicated by the appearance of dd signal at δ 5.47 ppm integrated for one

proton of two J values (J = 12.8 and 2.8 Hz), assigned for H-2 and the dd of dd signal at δ 2.71 ppm, (1H, J = 17.0, 12.8 and 2.8 Hz, H-3). Negative ESI-MS of compound 11 at m/z 301 [M−H]− indicated its structure as naringenin. 17 and 22 Compound 8 was obtained as yellow amorphous powder (30 mg), showed UV spectra of two major absorption bands in methanol at λmax 265 nm (band II) and at λmax 366 nm (band I), Torin 1 chromatographic properties: Rf values; 0.68 (S1), 0.14 (S2); dull yellow spot under UV-light with no change on exposure to ammonia vapors, it gave greenish yellow color with FeCl3 and Naturstoff spray reagents. Negative ESI-MS spectrum exhibited a molecular ion peak at m/z 299 [M−H]−. 1H NMR (300 MHz, DMSO-d6): δ ppm; 12.60 (1H, s, OH-5), 7.80 (2H, d, J = 8.7 Hz, H-2′/6′), 7.34 (2H, d, J = 8.7 Hz, H-3′/5′), 6.40 (1H, d, J = 1.8 Hz, H-8), 6.20 (1H, d, J = 1.8 Hz, H-6), 3.81 (3H,

s, OCH3-4′). 13C NMR (75 MHz, for DMSO-d6): δ ppm 176.39 (C-4), 164.50 (C-7), 161.30 (C-5), 159.20 (C-4′), 156.68 (C-9), 147.35 (C-2), 136.28 (C-3), 130.10 (C-2′/6′), 120.53 (C-1′), 116.90 (C-3′/5′), 104.22 (C-10), 98.75 (C-6), 93.91 (C-8), 56.40 (OCH3-4′). The methylation of the hydroxyl group at 4′ was evident by the downfield shift of 3′/5′ protons (δ 7.34 ppm) and their carbons (δ 116.90 ppm), compared to that of kaempferol (δ 6.85 and 115.0 ppm, respectively) and the slight upfield shift of carbon of C-4 (δ 159.20 ppm) compared to that of kaempferol (δ 160.0 ppm).

This compound was prepared as per the above mentioned procedure purified and isolated as pale yellow solid: yield 72.6% mp 212 °C; IR (KBr) vmax 2950, 2840, 1718, 1290,747 cm−1; 1H NMR (CDCl3) δ ppm; 11 (s, 1H, COOH), 7.24–7.99 (m,11H, Ar–H), 2.47 (s, 3H, SCH3); 13C NMR (CDCl3) δ ppm; 168.4, 157.7, 144.6, 141.6, 139.6, 137.8, 134.4, 130.8, 130.4, 129.4, 129.2, 129.1, 128.7, 127.5, 127.3, 126.4, 124.2,

selleck products 122.6, 15.5; HRMS (EI) m/z calcd for C23H15ClN2O2S2: 450.0263; found: 450.0261. This compound was prepared as per the above mentioned procedure purified and isolated as dark yellow solid: yield 41.10% mp 201 °C; IR (KBr) vmax 2950, 2810, 1719, 1320, cm−1; 1H NMR (CDCl3) δ ppm; 11 (s, 1H, COOH), 7.24–8.10 (m, 11H, Ar–H), 3.79 (s, 3H, OCH3) 2.22 (s, 3H, CH3); 13C Veliparib NMR (CDCl3) δ ppm; 168.2,

162.6, 157.7, 144.2, 139.4, 137.4, 135.3, 133.4, 132.6, 130.2, 129.7, 129.4, 128.6, 126.6, 125.8, 123.6, 121.4, 115.6, 56.2, 22.3; HRMS (EI) m/z calcd for C24H18N2O3S: 414.1038; found: 414.1033. This compound was prepared as per the above mentioned procedure purified and isolated as slight yellowish solid: yield 83.55% mp 201 °C; IR (KBr) vmax 2950,2863, 1710, 1320, cm−1; 1H NMR (CDCl3) δ ppm; 11 (s, 1H, COOH), 7.10–8.10 (m, 11H, Ar–H), 3.90 (s, 6H, OCH3); 13C NMR (CDCl3) δ ppm; 169.2, 162.5, 157.7, 144.5, 139.6, 137.7, 132.5, 129.5, 128.5, 126.8, 125.2, 123.8, 122.4, 115.3, 56.5; HRMS (EI) m/z calcd for C24H18N2O4S: 430.4757; found: 430.4754. This compound

was prepared as per the above mentioned procedure purified and isolated as slight yellowish solid: yield 82.9% mp 203 °C; IR (KBr) to vmax 2950, 2715, 1714, 1220, 1140, cm−1; 1H NMR (CDCl3) δ ppm; 11 (s, 1H COOH), 7.36–8.10 (m, 11H, Ar–H), 2.99 (s, 3H, SCH3), 3.81 (s, 3H, OCH3); 13C NMR (CDCl3) δ ppm; 168.2, 162.7, 157.3, 144.2, 141.2, 139.6, 137.3, 132.5, 129.2, 128.8, 127.3, 127.1, 126.8, 123.6, 121.7, 115.3, 56.2, 15.8; HRMS (EI) m/z calcd for C24H18N2 O3 S2: 446.0759; found: 446.0754. This compound was prepared as per the above mentioned procedure purified and isolated as pale yellow solid: yield 66.3%; mp 210 °C; IR (KBr) vmax 2928, 2831, 1710, 1650, 1270, 740 cm−1; 1H NMR (CDCl3) δ ppm; 11 (s, 1H, COOH), 7.12–8.99 (m, 10H, Ar–H), 2.65 (s, 3H, CH3); 13C NMR (CDCl3) δ ppm; 168.2, 157.2, 144.6, 139.7, 137.7, 137.0, 135.5, 131.7, 130.2, 130.0, 129.3, 129.1, 128.4, 127.7, 126.8, 125.2, 124.2, 122.4, 22.4; HRMS (EI) m/z calcd for C23H14Cl2N2O2S: 452.0153; found: 452.0150.

Although binding of rRmLTI by polyclonal antibodies from mice immunized with tick larva extract indicates that the recombinant polypeptide produced in P. pastoris was as antigenic as the native form of the cognate

larval trypsin inhibitor, it is possible that those antibodies recognized epitopes shared by the several trypsin inhibitors discovered in R. microplus larvae. Antiserum from cattle vaccinated with purified R. microplus trypsin inhibitors recognized rBmTI-6 produced in P. pastoris [21]. Antigenic similarity apparently extends beyond LY2157299 purchase intra-specific boundaries because antiserum against the native form of R. microplus larval trypsin inhibitors cross-reacts with trypsin inhibitors identified in R. sanguineus larvae [27]. Immunogenicity of the rRmLTI is reflected in the kinetics of the bovine humoral immune response. The significant effect on the rate of larvae hatching from eggs laid by female ticks

parasitizing vaccinated cattle, which was amplified by feeding female ticks with purified anti-rRmLTI IgG suggests that potentiation of the humoral response, perhaps Apoptosis Compound Library using other adjuvants, could enhance the efficacy of a polyvalent vaccine with Kunitz inhibitors from R. microplus. Adjuvant choice was shown to influence antibody levels, which correlated with the level of inhibition on malaria parasites [28]. However, no direct correlation was observed between antibodies against rRmLTI and overall efficacy in our study. By comparison, the vast array of Kunitz type inhibitors present in R. microplus was invoked to explain the apparently small all impact silencing the gene coding for boophilin, a double Kunitz type thrombin inhibitor expressed in the gut, had on egg production [29]. Considering the purported involvement of larval trypsin inhibitors and confirmed role of other Kunitz inhibitors in blood feeding, the reduced number of female ticks detaching from vaccinated

cattle may reflect the impact of bovine anti-rRmLTI antibodies on the ability of R. microplus to acquire a blood meal [20] and [29]. However, the physiological roles of RmLTI and BmTI-6 remain to be determined in the larval and adult stages of the cattle tick, respectively, despite similarities in their partial nucleotide and amino acid sequences. Without knowing the function of RmLTI and BmTI-6, it remains possible that the decrease in hatching rates observed in eggs laid by female ticks fed purified IgG antibodies obtained from vaccinated cattle resulted from the effects of antibody binding to epitopes shared by rRmLTI and the native form of BmTI-6 in R. microplus ovaries. The Kunitz family of polypeptides is one of at least 20 families belonging to the canonical type of serine protease inhibitors [30]. A characteristic of proteins belonging to this family is the Kunitz domain that can be present in single or multiple copies. At least 303 Kunitz proteins have been identified in ticks thus far and some of them can contain as many as seven Kunitz domains [31].

Some websites provide general information about BP measurement for non-pregnant patients, but the recommendations are similar enough to

those in pregnancy to be useful. Patients, their partners and care providers should be well educated about the HDP and relevant sites are listed. Implementation of any evidence depends on individual knowledge and beliefs, as well as institutional culture. Strong recommendations should be incorporated into clinical practice. In well-resourced settings, almost all preeclampsia-related maternal deaths involve substandard care [534]. Some recommendations may require additional effort to implement, as highlighted below. • One of the new recommendations regarding blood pressure devices is: ‘The accuracy of all BP measurement devices used in hospitals or offices should be checked regularly against a calibrated device.” selleck products This might be something that not all Canadian hospitals and offices do on a regular basis. There are many areas in which important research is pending, such as the CHIPS

trial of antihypertensive therapy and its impact on perinatal and maternal outcomes and the TIPPS trial of heparin thromboprophylaxis to prevent recurrent placental complications (including preeclampsia). There are also many important research questions for which answers are currently unavailable. Clinicians are encouraged to participate in clinical research. If the paediatric oncology research network can enrol more than 60% of their LBH589 price patients in RCTs, then the maternity care community should be able to improve on the <10%

recruitment rate of women by incorporating clinical research into medical practice [535]. These recommendations have been reviewed and approved by the Hypertension Guideline, Maternal Fetal Medicine and Family Physician Advisory Committees, and Executive and Council of the Society Adenylyl cyclase of Obstetricians and Gynaecologists of Canada. Dr. Magee receives salary support from the BC Women’s Hospital and Health Sciences Centre. Dr. von Dadelszen receives salary support from the Child and Family Research Institute, University of British Columbia (UBC) and the Department of Obstetrics and Gynaecology, UBC. PVD is a paid consultant of Alere International for work not related to the current manuscript. This document reflects emerging clinical and scientific advances and is subject to change. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed. Local institutions can dictate amendments to these opinions. They should be well documented if modified at the local level. This guideline was developed by the Canadian Hypertensive Disorders of Pregnancy Working Group, with support from the SOGC and the BC College of Physicians and Surgeons Library Services. “
“Placental dysfunction has long been implicated in the pathophysiology of pre-eclampsia.

health.gov.au/internet/main/publishing.nsf/Content/AECB791C29482920CA25724400188EDB/$File/PBAC4.3.2(01DEC08).pdf). In some specific circumstances, a possible alternative to NIP listing is a co-funding arrangement (the patient/consumer pays a subsidised proportion of the full cost) under the PBS as applies to publically funded drugs that are prescription-based. The

ATAGI Pre-submission Advice is provided to both PBAC and to the submitting company (known as the buy PLX-4720 sponsor). This process is designed to ensure that the vaccine manufacturer fully understands the formal public health and technical considerations that are material to the public interest, with the exception of cost-effectiveness, which is the province of PBAC. Following submission of a company’s application to the PBAC for NIP or PBS listing of a vaccine, preliminary evaluation by the PBAC Secretariat with key PBAC members may result in further questions to ATAGI regarding a range of matters pertaining to the submission. This may include a request to verify a claim made in the dossier (for example, regarding

an immunologic correlate of protection), or to clarify interpretation of a specific piece of evidence. In response to a formally communicated set of questions copied to the manufacturer, the AWP prepares a post-submission advice that is presented to ATAGI for modification Hydroxychloroquine cost if required and endorsement. This advice is then unless communicated to the PBAC and copied to the manufacturer. Parallel to this, a detailed commentary on the sponsor’s submission is prepared for the PBAC by a consultant under contract to the Department of Health. The PBAC also has an Economic Sub-committee (ESC) that reviews and interprets the economic analyses in these submissions and provides written advice. Both of these documents are also copied

to the manufacturer, which has an opportunity to respond. Formal determination on the application is then made by the PBAC. This process, its assumptions and economic principles remains subject to some continuing debate and discussion [1], [2] and [3], but is widely accepted by industry, and healthcare professionals. Funding decisions for vaccines are made by the Government. If PBAC makes a positive recommendation the Government is not obliged to fund a new vaccine, but the Government cannot fund a vaccine without a positive recommendation from PBAC. There is no time limit set for the Government to make its funding decision. Price negotiation is handled by the Australian Government’s Pharmaceutical Benefits Pricing Authority (PBPA, http://www.health.gov.au/internet/main/publishing.nsf/Content/pbs-pbpa-policies-contents∼pbs-pbpa-policies-intro).

, 2011). The study employing PCMS during adolescence also examined whether this experience protected against further stress exposures in adulthood. Interestingly,

they found rats given PCMS during adolescence were resistant to anxiety- and depressive-like behaviors induced by chronic unpredictable stress (CUS) later in adulthood (Suo et al., 2013). These data suggest that repeated exposure to Hydroxychloroquine cell line mild, predictable stressors during adolescence could immunize the animals against the negative behavioral effects often observed in adult animals induced by CUS (Willner, 1997). Along these lines, Buwalda and colleagues have investigated the short- and long-term effects of adolescent social stress on adult behaviors by exposing Wistar rats to older, more aggressive wild type Groningen (WTG) rats in either social defeat (Buwalda et al., 2013) or visible burrow system (VSB) paradigms (Buwalda et al., 2011). They find that when these Wistar rats

are again exposed to social defeat by WTG rats in adulthood, the Wistar rats that had experienced adolescent stress are attacked less and show greater resistance to anhedonia compared to Wistar rats that did not receive the aggressive, stressful interactions during adolescence (Buwalda et al., 2013 and Buwalda et al., 2011). These data add to the adolescent stress inoculation idea and broaden crotamiton it to ERK inhibitor include aspects of the “match-mismatch hypothesis”, which

basically states that the long-term costs of early life adversity are dependent on how well early life and later life environments match (less cost) or mismatch (greater cost) (Schmidt, 2011, Nederhof and Schmidt, 2012 and Daskalakis et al., 2013). Thus, adolescent stress exposure may instill greater resilience in an individual that will also have to experience similar stressors later in their adult environment. Gene and environment (G × E) interactions are another set of variables that need to be taken into consideration when discussing resilience and vulnerability to stressors (Nugent et al., 2011 and Caspi and Moffitt, 2006). That is, genetic differences can significantly influence the likelihood of developing a physiological or neurobehavioral dysfunction following exposure to stress. For instance, a notable G × E interaction study showed that the effect of early life stress on development of depression in adulthood was moderated in part by a polymorphism in the promoter region of the serotonin transporter gene (5-HTT). In this study it was found that individuals with one or two copies of the short allele of 5-HTT had greater levels of depression and suicidal ideation following early life stress than individuals homozygous for the long allele of 5-HTT (Caspi et al., 2003).

No difference in safety has been observed between children with cancer and healthy children. In the case of poliomyelitis, it has been found that the prevalence of children with preserved protective antibody levels after the completion of chemotherapy is 62–100% [3] and [10]. Moreover, most patients respond to revaccination, thus demonstrating immunological recovery [3] and [24]. This means that, although cellular immune memory is preserved, revaccination

after the completion of chemotherapy may be warranted as a simple and cost-effective means of restoring humoral immunity. All of the studies of poliomyelitis revaccination in oncological children used inactivated poliovirus vaccine because of the potential risk of acute flaccid paralysis due to live attenuated poliovirus

vaccine [3], [10] and [24]. The selleck compound safety profile of the inactivated vaccine seems to be optimal in such patients and similar to that observed in healthy children. However, some years ago, during a nationwide vaccination campaign using of live attenuated poliovirus vaccine, it was found that children with cancer were well-protected against unintended exposure to live polioviruses and there RGFP966 mw was no risk of adverse neurological events [43]. Like other encapsulated bacteria, Hib may cause life-threatening diseases in children with cancer [44] and [45] and, probably because it is the oldest conjugate vaccine, it has been widely studied in such children [24], [46], [47], [48], [49] and [50]. Although there are also some data concerning children with solid tumours [46], most of these studies involved patients with ALL who were vaccinated at various times after discontinuing chemotherapy [24], [47], [48], [49] and [50]. others Regardless of their previous immunisation status, most of the children responded

adequately: short- or long-term protective antibody levels were almost always reached, even when the vaccine was given only 1 month after they had completed chemotherapy. However, the best results were obtained when the revaccination was administered 3 months after the end of chemotherapy [50]. The safety and tolerability of Hib vaccine has always seemed to be very good [24], [46], [47], [48], [49] and [50]. Patients with cancer are at risk of invasive pneumococcal infection but it has been demonstrated that the conjugate 7-valent (PCV7), conjugate 13-valent (PCV13) and polysaccharide 23-valent (PPV23) pneumococcal vaccines respectively cover more than 75%, 80% and 90% of the known serotypes [51]. Only a few studies of the use of pneumococcal vaccines in patients with cancer have been published. However, it is well known that, despite its greater coverage of pneumococcal serotypes, PPV23 is not very immunogenic in the first years of life [52]; moreover, none of the pneumococcal conjugate vaccines is currently licensed for use in subjects who are older than 5 years.