[Immunity against tetanus 3 years after revaccination].
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Biomedical subjects
Publications and source records attributed to M Bozović.
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Physical urticarias represent a specific reaction of the skin, which is characterised by local erythema, edema and pruritus at the site where the physical stimulus has been applied. However, local changes can be associated with various systemic manifestations. Specific cutaneous reactions due to physical factors may be the first manifestation of a systemic and/or infectious disease, which should be taken into account as physical urticarias generally occur in young patients. In view of the above mentioned, as well as unpredictable course of the disease and relatively limited therapeutic effects, the etiology and pathogenesis of the physical urticarias are one of the most interesting fields of investigation in contemporary medicine.
Investigations were performed on 20 patients with mild and moderately severe forms of bronchiale asthma or chronic obstructive bronchitis. Theophylline for oral use (sustained release form) and Ranitidine (second generation H2-blocker) were used in the first group of patients (7 females and 3 males, average age 37.9). Dosage of theophylline from patients sera was monitored at 3, 6 and 12 hours, beginning with the initial morning dose. The second group of patients (9 females and 1 male, average age 46.3) were on Ranitidine therapy, along with 250 mg intravenous theophylline-ethylene-diamine. Fractionated dosage of theophylline was done within 12 hours. Pharmacokinetic parameters were calculated according to the concentration of theophylline in the sera of patients in the second group. Significant differences were not found by statistical analysis (T-test) in the pharmacokinetic parameters of theophylline although significantly higher concentrations of theophylline were found in the sera of patients in the first group. This indicated that there are individual differences on the metabolism of theophylline drugs with concomitant use of Ranitidine.
The paper comprises 63 patients with diagnosed vasculitis of the skin who had abnormal findings in the urine. Thirteen of these patients had positive skin findings and abnormal findings in the urine, with concomitant attacks of dyspnea as seen in bronchial asthma. These patients account for 20% of the entire group, while there was an incidence of 37% of systemic manifestations. Skin findings: 45% had a maculopapular rash, 36% had urticarial findings, 13% had urticaria and angioedema and 6% had angioedema alone. Nonspecific biologic syndrome of evolution was statistically significant while no significant changes were found in the number of white blood cells and eosinophils. The degree of proteinuria ranged from 0.1 g/L to 1.16 g/L. Most patients with proteinuria above 0.25 g/L had microhematuria. Slightly over 50% of the patients had signs of complement activation by the alternative pathway, along with the presence of cryoglobulins. Increased histamine in the serum was found in over 50% of the patients although the values of histamine did not correlate with the degree of proteinuria. Proteinuria was not detected in patients with very high values of histamine (and without signs of vasculitis), which indicates that histamine itself responsible for changes in the glomeruli. There is a possibility that local tissue hyperhistaminemia is responsible for the increased permeability of the basal membrane of the glomeruli. According to the obtained results, the etiology of proteinuria and microhematuria should be pursued in the pathogenesis of vasculitis as signs of complement activation indicate. Other possible causes for proteinuria were excluded. The proteinuria was selective, benign according to its course and degree, occurred concomitantly with skin findings and was absent during remission of the disease.
The introduction deals with the main characteristics of two representatives of high risk pregnancies: diabetes mellitus and EPH gestoses. Particular interest was shown in risks that may occur in pregnant diabetics, with which they must be acquainted. Some theories are given on the pathogenesis of EPH gestoses. The aim of our investigation was to determine the concentration at which immunoglobulins G, M and A pass in cord blood, amniotic fluid and urine, and whether there is a significant difference between control group and among pregnant diabetics or those with EPH gestoses. The investigation was performed by the nephelometric technique on the Immunochemistry Analyzer. Each group consisted of 20 women, with a total of 60. Immunoglobulins A, M and G were determined in the mothers' sera, cord blood or amniotic fluid. IgG was obtained in urine in measurable concentrations. A significant increase of IgG was found in the urine of pregnant diabetics. IgM was significantly increased in the sera of diabetic mothers. IgA was significantly increased in pregnant diabetics, while both high risk pregnancy groups had an increased IgA in cord blood. The values of IgA in amniotic fluid were decreased in the EPH gestoses group in comparison to the group of diabetics. The authors find these variations interesting and feel they should be followed in other high risk pregnancy groups.
Immunologic response in persons revaccinated against tetanus was dealt with in this paper. Out of 35 examined patients with the mean age of 47.4 years on the day of revaccination 20% of them had titres of antitetanus antibodies on the lower limit which guaranteed antitetanus protection (0.01-0.02 i.j./m.). Values of titre were below 1.00 i.j./m. in one third of patients. A high degree of negative correlation was statistically established between the age of patients and the height of titre (p less than 0.001). Mean geometric titre (GMT) of the patients amounted to 1.32 i.j./ml on the day of revaccination. Seven days following revaccination GMT was 10.41 i.j./ml and it was the best illustration of immunity "eruption" induced by one dose of Te Al vaccine a 0.5 ml. Optimal values of the titre (over 1.00 i.j./ml) occurred in all examined patients. Dependence of revaccinated titre upon age was of less significance (P = 0.01). A high degree of dependence of revaccinated titre upon the values on the day of revaccination was statistically established (p less than 0.001). It was concluded that by revaccination of persons with the lowest protective titre as well a safe antitetanus protection was provided in a 7-day period. This conclusion also necessitated obligatory immunization against tetanus at an older age too whereby a more expensive active-passive treatment of injured persons would de avoided.
The authors present a patient with delayed-type allergy against insulin preparations of different species including highly purified monocomponent insulin and human semisynthetic insulin. Positive results for cutaneous delayed-type hypersensitivity and for lymphocyte blastogenesis suggested a type IV immunopathogenic reaction. Intradermal tests performed with various components of insulin preparations revealed delayed-type allergy to insulins of different species (bovine, porcine and human) but not to any of the other components.
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