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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vaccinations or booster injections against tetanus, diphtheria and polio shortly before leaving on a journey are both possible and to be recommended. Active hepatitis-A-vaccination can also be applied immediately prior to the journey, and offers better protection than gamma globulins. As a rule, vaccinations against hepatitis B, yellow fever and typhoid must be given one to four weeks before the journey. Effective malaria prophylaxis for last-minute travellers is always possible. In addition to mandatory "exposure prevention", effective chemoprophylaxis is also recommended for travellers to tropical Africa. The dose of the first week should, whenever possible, be taken prior to the start of the journey.
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PMID:[Fast prophylaxis for last-minute travelers. Which measures are still possible 1 week before traveling?]. 1087 Mar 90

In a retrospective study, we analyzed the immune status of 1134 travellers (621 males, 513 females), by comparing actual with recommended vaccinations, in particular with regard to malaria. 61.6% of travellers showed complete immunization against diphtheria, 73.3% against tetanus, and 66.3% against polio. Overall, women have better immunization rates than men. The best immunization rates were seen in young adults (< 20 years). The majority of travellers had destinations in Africa (35.2%), Asia (21.95) and South America (20.9%). Accordingly, vaccinations for yellow fever and hepatitis were the most commonly indicated and implemented vaccinations, and more than 50% received antimalarial chemoprophylaxis.
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PMID:[Study of vaccination for travel shows: serious gaps in polio, diphtheria and tetanus vaccination]. 1149 43

The paper presents patterns of medical admissions into the intensive care unit of the Lagos University Teaching Hospital (LUTH) over an eight-year period from September 1990 to August 1998. Medical admission constituted 15% out of which 1% received surgery for medical complications. Patients with neurological diseases recorded the highest number of admission most of them being for tetanus. The commonest indication for admission was for respiratory insufficiency (33%). All the patients admitted for sub arachnoid haemorrhage, fulminant hepatitis, meningitis and motor neurone disease died. The least mortality was found amongst patients admitted for tetanus who constituted about 44% of the total number of medical admissions. The overall mortality rate was 69% and it was observed that the ages of the patients did not appear to affect the outcome except in patients who were admitted for myocardial infarction and cardiogenic shock. This study emphasizes the need to evolve a system of health evaluation of predicting the survival index of individual patients. There is an urgent need for proper training, motivation of staff and maintenance of equipment used in the ICU.
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PMID:Medical admission into the intensive care unit (ICU) of the Lagos University Teaching Hospital. 1192 24

The country of Cameroon is situated in the western part of Africa on the Gulf of Guinea, about midway between Senegal and the Republic of South Africa. Described are such points as geography, people, history, government, political conditions, economy, foreign relations, defense, and US-Cameroonian relations. In 1987, the population estimate was 10.5 million, 60% of which live in rural areas; the annual growth rate was 7%. Infant mortality rate is 92/1000. Life expectancy stands at 54 years. In health related matters, visitors must have vaccination certificates against yellow fever and cholera, and vaccinations are recommended against tetanus, typhoid, paratyphoid, polio, and hepatitis.
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PMID:Cameroon. 1217 77

The objectives of this study are to determine the trend of maternal mortality at the University of Ilorin Teaching Hospital, to identify the causes of death, and to identify ways of minimizing the frequency of preventable deaths. Analysis of 75 cases of maternal deaths seen over 3 1/2 years (January 1983-June 1986) was conducted. During this period, there were 26,905 births, giving a maternal mortality rate of 279/100,000. 84% of the deaths were due to direct causes while the remaining 16% were classified under the indirect and pregnancy related categories. The main direct causes of death include hemorrhage (35.6%), septicemia (24.7%), and anemia (13.7%). Other direct obstetric causes include eclampsia, anesthetic death, hemoglobinopathy, and ruptured uterus. The most important indirect causes were native drug intoxication (6.8%), fulminant hepatitis (5.5%), and pulmonary embolism (2.7%). The maternal mortality was highest in the age ranges 25-29 years (31.5%). Median age and parity were 27 years and 4.5 respectively. While the maternal mortality rate of 2.8/1000 is an improvement over the previous years' (1972-1982) record of 4.3/1000, it is still unacceptable. The majority of these deaths could have been prevented if delivery had occurred in a well equipped hospital where blood transfusion and surgical facilities are available, if sterile manipulations for pregnant women had been employed, if appropriate antenatal care was available, and if specialist anesthetist services were accessible. Recommendations to reduce the maternal mortality rate include improved education and training of traditional birth attendants, improved immunization of women against tetanus, and increased community involvement through education. Furthermore, policy makers must set new priorities such as encouraging greater investment in improving clinics and hospital facilities, improving access to contraception, increasing awareness of the magnitude of the problem and encouraging community leadership and action.
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PMID:Maternal mortality at Ilorin, Nigeria. 1217 82

Chronic renal failure severely influences the immune functions of the host. Recent work has shown that uremic intoxication as well as its treatment alters distinct aspects of immunity and that the organism has certain mechanisms to compensate, at least in part, for these influences. Failure of the humoral branch of immune function becomes apparent when vaccinations are applied to the dialysis patient. Severely impaired vaccine responses are common, particularly against hepatitis B, tetanus, or influenza. In contrast, patients with chronic renal failure may develop adequate humoral responses against vaccines such as pneumococcus. The degree of impairment of humoral responses is related to the antigen's dependence on T-helper lymphocyte activation, which is high for hepatitis or influenza, and low for large polysaccharide antigens. T-helper cell activation on the other hand is greatly influenced by inflammatory processes, e.g. the secretion of cytokines such as interleukin (IL-)-1 or IL-6. These inflammatory processes are induced by uremic toxins and contacts between blood and extracorporeal surfaces of the dialysis equipment. They are subject to the body's compensatory mechanisms for inflammation, which are mainly based on the anti- inflammatory cytokine IL-10. Genetically determined differences in the secretion capacity for this compensatory cytokine strongly influence humoral immunity in the patient with chronic renal failure and thus allow the definition of a high-risk group for infection and vaccine nonresponse.
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PMID:Humoral immune responses in uremia and the role of IL-10. 1220 99

Studies were performed to elucidate the mechanism of alum gel coagulation upon freezing and drying and its relationship to vaccine potency loss and to develop a novel freeze-drying process for the production of stable alum-adjuvanted vaccine formulations suitable for conventional needle injection and epidermal powder immunization (EPI). The alum hydroxide-adjuvanted hepatitis-B surface antigen (Alum-HBsAg) and the alum phosphate-adjuvanted diphtheria and tetanus toxoids (Alum-DT) were dehydrated by freeze drying (FD), spray drying (SD), air drying (AD), or spray freeze drying (SFD). After drying by FD, SD, or AD, alum gels coagulated when examined by optical microscopy and particle size analysis. In addition, desorption of antigen molecules from the coagulated when examined by optical microscopy and particle size analysis. In addition, desorption of antigen molecules from the coagulated alum gel upon reconstitution appeared to be difficult, as indicated by attenuated band intensity on SDS-PAGE. In contrast, SFD alum gels turned a homogenous suspension upon reconstitution, suggesting minimal alum coagulation. In the mouse model, the in vivo immunogenicity of SFD Alum-HBsAg was preserved, whereas the FD Alum-HBsAg suffered significant immunogenicity loss. Grinding of coagulated FD Alum-HBsAg into smaller particles could partially recover the immunogenicity. In a guinea pig study using EPI, the SD Alum-DT formulation was not immunogenic, but the SFD Alum-DT formulations had a vaccine potency comparable to that of the untreated DT administered by I.M. injection. Overall, the relationship of coagulation of alum gel upon reconstitution and the loss of vaccine potency was established in this study. Alum gels became highly coagulated after dehydration by spray drying and traditional freeze-drying processes. However, freezing rate played a critical role in preserving the adjuvant effect of alum and fast freezing decreased the tendency of alum coagulation. Spraying the alum gel into liquid nitrogen represents the fastest freezing rate achievable and resulted in no discernible alum coagulation. Therefore, SFD presents a novel and effective drying process for alum-adjuvanted vaccine formulations and is particularly valuable for dry powder applications such as EPI.
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PMID:Stabilization of alum-adjuvanted vaccine dry powder formulations: mechanism and application. 1253 82

No longitudinal study has investigated whether autoantibody titres and serum IgG levels correlate with disease activity in autoimmune liver disease. To determine this, we investigated prospectively 19 patients on 254 occasions between 10 months to 5 years from diagnosis. Nine had anti-nuclear and/or anti-smooth muscle antibody (ANA/SMA) positive autoimmune hepatitis (type 1 AIH), 5 liver kidney microsomal type 1 (LKM-1) positive AIH (type 2 AIH) and 5 ANA/SMA positive autoimmune sclerosing cholangitis (ASC). Correlation between IgG levels, titres of ANA, SMA and LKM-1 and levels of the organ specific autoantibodies anti-liver specific protein (anti-LSP), and anti-asialoglycoprotein receptor (anti-ASGPR) with biochemical evidence of disease activity, as measured by serum aspartate amino transferase (AST) levels, was sought during the course of the disease. AST levels correlated with levels of anti-LSP, anti-ASGPR and IgG in type 1 and 2 AIH, but not in ASC. Positive correlation with AST was also observed for LKM-1 titres in type 2 AIH and for SMA titres in type 1 AIH, but not in ASC. In both AIH and ASC, AST levels correlated with the T cell-dependent immune responses anti rubella IgG and anti tetanus toxoid IgG, but not with the T cell-independent IgG2 response to pneumococcal capsular polysaccaride. Our results indicate that measurement of organ and non-organ specific autoantibodies and IgG levels may be used to monitor disease activity in AIH.
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PMID:Organ and non-organ specific autoantibody titres and IgG levels as markers of disease activity: a longitudinal study in childhood autoimmune liver disease. 1276 77

As the average life expectancy increases, retired people want to travel. Five to 8% of travellers in tropical areas are old persons. Immune system suffers of old age as the other organs. The number and the functions of the T-lymphocytes decrease, but the B-lymphocytes are not altered. So, the response to the vaccinations is slower and lower in the elderly. Influenza is a great cause of death rate in old people. The seroconversion, after vaccine, is 50% from 60 to 70 years old, 31% from 70 to 80 years old, and only 11% after 80 years old. But in public health, the vaccination reduced the morbidity by 25%, admission to hospital by 20%, pneumonia by 50%, and mortality by 70%. Antipoliomyelitis vaccine is useful for travellers, as the vaccines against hepatitis and typhoid fever. Pneumococcal vaccine is effective in 60%. Tetanus is fatal in at last 32% of the people above 80 years, therefore this vaccine is very important.
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PMID:Immunity and immunization in elderly. 1462 49

Not many inventions in medical history have influenced our society as much as vaccination. The concept is old and simple. When Edward Jenner published his work on cowpox, "variolation" was quite common. In this procedure, pus of patients with mild smallpox was transferred to healthy individuals. Meanwhile smallpox has been eradicated worldwide. Diseases such as poliomyelitis, diphtheria or tetanus almost disappeared in industrialized countries. The same happened with epiglottitis and meningitis due to Haemophilus influenzae type b (Hib) after vaccination against Hib was introduced in Switzerland in 1990. This success was possible because of routine vaccination. Immunization is a save procedure and adverse events are much lower than complications in the natural course of the prevented diseases. However vaccinations were accused to cause diseases themselves such as asthma, multiple sclerosis, diabetes mellitus, chronic arthritis or autism. Hitherto no large cohort study or case-control-study was able to proof responsibility of vaccines in any of these diseases. Public media are eager to publish early data from surveillance reports or case reports which are descriptive and never a principle of cause and effect. In large controlled trials there was no proof that vaccination causes asthma, hepatitis-B-vaccination causes multiple sclerosis or macrophagic myofasciitis, Hib-vaccination causes diabetes mellitus, rubella-vaccination causes chronic arthritis, measles-mumps-rubella-vaccination causes gait disturbance or thiomersal causes autism. These results are rarely published in newspapers or television. Thus, many caring parents are left with negative ideas about immunization. Looking for the best for their children they withhold vaccination and give way to resurgence of preventable diseases in our communities. This must be prevented. There is more evidence than expected that vaccination is safe and this can and must be told to parents.
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PMID:[Does vaccination cause disease?]. 1627 33


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