Further, aluminum is also added to the vaccine serum because it is an adjuvant, meaning it further enhances the immune response.The vaccines polysaccharide sugars are grown separately in soy peptone broths. Through reductive amination, the sugars are directly conjugated to the protein carrier CRM197 to form the glycoconjugate. CRM197 is grown in C. diphtheriae strain C7 in a medium of casamino acids and yeast extracts.The Prevnar seven-valent formulation contained serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F, and resulted in a 98% probability of protection against these strains, which caused 80% of the pneumococcal disease in infants in the U.S. PCV7 is no longer produced.In 2010, Pfizer introduced Prevnar 13, which contains six additional strains (1, 3, 5, 6A, 19A and 7F), which protect against the majority of the remaining pneumococcal infections.In June 2021, the U.S. Food and Drug Administration (FDA) approved Prevnar 20, an icosavalent pneumococcal conjugate vaccine, which includes the serotypes 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F, and 33F for adults 18 years of age and older. As of August 2022, seven serotypes remain experimental and were authorized only under "accelerated approval" by FDA, based on opsonophagocytic activity ("OPA") assay. Maintenance of this approval is ongoing and "may be contingent upon verification and description of clinical benefit in a confirmatory trial. "In February 2022, the European Medicines Agency Approves Pfizers Prevnar 20 (PVC20) under the brand name Apexxnar. Synflorix
Synflorix (PCV10) is produced by GlaxoSmithKline.
Angiomatosis is a non-neoplastic condition characterised by nests of proliferating capillaries arranged in a lobular pattern, displacing adjacent muscle and fat. It consists of many angiomas.These tend to be cavernous hemangiomas, which are sharply defined, sponge-like tumors composed of large, dilated, cavernous vascular spaces. Presentation
Associated
They often appear in:

Von Hippel–Lindau disease: It can be associated with Von Hippel–Lindau disease and is a rare genetic multi-system disorder characterized by the abnormal growth of tumours in the body. Symptoms may include headaches, problems with balance and walking, dizziness, weakness of the limbs, vision problems and high blood pressure. Bacillary angiomatosis
Klippel–Trénaunay syndrome
Sturge–Weber syndrome

Histology
It is a vascular malformation wherein blood vessels proliferate along with accompanying mature fat and fibrous tissue, lymphatics and sometimes nerves. They may involve skin, subcutaneous tissue, skeletal muscle and occasionally bone. Prognosis
Prognosis depends on the size and location of the tumour, untreated angiomatosis may lead to blindness and/ or permanent brain damage. Death may occur, with complications in the kidney or brain. See also
Angioma
Hemangioma
List of skin conditions

References


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