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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In our previous studies, we hypothesized that activation and subsequent collapse of GABA-mediated inhibition during tetanus is an important seizure-triggering mechanism in the kindled epileptogenic focus. To examine this hypothesis, in the present study, we investigated the effects of pharmacological manipulations of the kindled amygdala with several drugs, and measured the kindled seizures as well as the EEG events during tetanus. The results obtained were: (i) The selective GABA-A agonist, muscimol (1 and 5 nM/1 microliter), suppressed kindled seizures in a dose-dependent fashion, and the 5 nM muscimol significantly prolonged EEG suppression and reduced the number of oscillations in the subsequent rhythmic synchronous discharge. Similar effects followed systemic injection of diazepam (2 mg/kg). (ii) The selective GABA-B agonist, baclofen (5 nM), had no effect on kindled seizures nor on the EEG events during tetanus. (iii) The NMDA antagonist, 2-amino-5-phosphonovaleric acid (80 nM), significantly reduced the afterdischarge duration and significantly delayed the appearance of the rhythmic synchronous discharge. However, these effects were not observed immediately, but 24 to 72 h after microinjection. (iv) The muscarinic cholinergic antagonist, atropine (40 and 80 nM), suppressed kindled seizures in a dose-dependent fashion, but the atropine caused marked synchronous discharge both in the awake resting EEG and during tetanic stimulation. We conclude that the GABA-A system, including the benzodiazepine system, is more involved in the seizure-triggering mechanism of amygdala kindling than the GABA-B system, that there is an interaction between the GABA-A and NMDA system, and that the cholinergic participation is independent of the primary seizure-triggering mechanisms.
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PMID:Kindling-induced changes in EEG recorded during stimulation from the site of stimulation. III. Direct pharmacological manipulations of the kindled amygdala. 288 27

A total of 150 patients were treated for tetanus in the tetanus ward of the J. J. Hospital, Bombay, between October 1983 and January 1986. The complications of tetanus and the mode of management in the presence of restricted resources are outlined. Intensive care, proper nutrition, early tracheostomy and ventilator support in severe tetanus were chiefly responsible for an overall reduction in mortality from 30 to 12%. The mortality in severe tetanus was reduced from 70 to 23%. Sudden death due to unexpected cardiac arrest was an important complication in severe tetanus. We observed that an abrupt marked rise in rectal temperature (greater than 107 degrees F, 41.7 degrees C), if undetected, could lead to sudden circulatory collapse and death. Well-marked hypoxaemia was observed in all patients with severe tetanus, and was related to ventilation perfusion inequalities and to an increase in the true venous admixture (increased Qs/Qt) in the lungs. Bronchopulmonary infections and the adult respiratory distress syndrome added significantly to morbidity and mortality. Autonomic cardiovascular disturbances included bradycardia alternating with tachycardia, and hypertension which was either labile, paroxysmal or sustained. Persistent hypotension was of ominous significance. Amongst numerous complications involving other systems, sepsis and septic shock were associated with a high mortality.
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PMID:Tetanus and its complications: intensive care and management experience in 150 Indian patients. 342 73

Although present day progressive respiratory management has decreased the tetanus mortality rate, tetanus-related autonomic overactivity remains a lethal condition. The cause, pathophysiology, and treatment of this condition are controversial and no animal model has ever been reported. So we tried to make a rabbit model of this condition. At first we injected 30 micrograms of purified tetanus toxin intravenously. Blood pressure oscillation occurred, but the degree of oscillation was smaller than that was seen in the clinical cases. The degree of oscillation had not changed by addition of 30 micrograms purified toxin 12 hours after first injection. Secondly, 7 days before the experiment we injected 0.5 micrograms of purified tetanus toxin intravenously. On the experiment day, we injected 30 micrograms of purified toxin again. By this method there occurred blood pressure oscillation as same as that was seen in the clinical cases. But no rabbits progressed to circulatory collapse by purified toxin. Then to the last group of rabbits, we injected crude tetanus toxin for purified toxin. The degree of blood pressure oscillation was same as that of cases in which purified toxin was injected, and all rabbits progressed to circulatory collapse.
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PMID:[Development of an animal model of autonomic over-activity in tetanus]. 382 11

The incidence and type of reactions after administration of plain and adsorbed diphtheria-tetanus-pertussis vaccine were recorded in a blind controlled prospective study of 2041 vaccinations in 1075 infants receiving routine childhood immunization. There was no significant difference in the total incidence or type of general reactions after plain and adsorbed vaccine, but local reactions were significantly less frequent after plain vaccine. General reactions were recorded after 41.5% of vaccinations with plain vaccine and after 40.8% of vaccinations with adsorbed vaccine. Local reactions were reported in 66.7% and 76.5% of recipients respectively. The most commonly reported systemic reactions were irritability and fever. Three recipients of plain vaccine and one of adsorbed vaccine suffered hyporesponsiveness or collapse. One recipient of each vaccine suffered a convulsion. No persisting sequelae were recorded.
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PMID:The incidence and type of reactions to plain and adsorbed DTP vaccines. 389 84

Voluntary reporting of vaccine reactions was intensified in a single large region for 7 years Anaphylaxis and collapse, convulsion, and neurological disorder were reported most frequently after diphtheria/tetanus/pertussis (DTP). The greater frequency of recorded reactions after DTP than after DT could have been due to bias caused by the adverse publicity accorded to pertussis vaccine, since no major difference was found when the immunisation histories of children admitted to hospital with such conditions were compared. No convincing evidence that DTP caused major neurological damage emerged from this large and lengthy study.
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PMID:A 7-year survey of disorders attributed to vaccination in North West Thames region. 613 93

Political and social conditions deteriorated in Somalia during the 1980s before the onset of civil war in 1990. A cohort study of mortality among children under age 5 years was conducted in Lama-Doonka and Buulalow villages during 1987-89, a period of economic and political collapse in the rural parts of the country. Mortality among the children increased from 211/1000 in 1987 to 323/1000 in 1988 and 414/1000 in 1989. Boys and infants were at greater risk of death relative to girls and children aged 1-4 years, respectively. Respiratory infections, diarrheal diseases, fever/malaria, and tetanus during the prenatal period were the major signs before death. Mortality rates for diarrheal diseases increased significantly over the period, while rates for respiratory infections and diseases preventable by immunization increased more slowly. The increasing trend in under-five mortality was more pronounced when the mother derived her major income from sources other than farming and in larger households.
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PMID:Child mortality in a collapsing African society. 900 35

Pertussis, also known as whooping cough, is a highly contagious disease, which is most dangerous to infants less than one year old. About half of the babies reported nationally to the Centers for Disease Control and Prevention (CDC) as having the disease are hospitalized. As many as 16/100 babies reported with pertussis get pneumonia, and about 2/100 have convulsions. For those babies reported to have pertussis, about 1/500 has brain problems, some of which can become permanent, and about 1/250 will die because of complications from the disease. Serious illness is less likely in older children and adults. Pertussis vaccine is generally administered in combination with diphtheria and tetanus vaccines, known as DTP vaccine. A primary series of DTP keeps 70-90/100 children from getting pertussis, usually through the elementary school years at least. About half of the children who receive DTP vaccine will not experience any discomfort at all. Some will have minor problems such as soreness, swelling and redness where the shot was given; fever; fussiness; drowsiness; and loss of appetite lasting 1-2 days. Once per 100 to 1000 shots, moderate problems can occur: crying non-stop for 3 hours or more, fever of 105 degrees (F) or higher. For 1 shot in 1750, a child may experience a seizure (convulsions, fits, spasms, twitching, jerking, or staring spells) usually caused by fever, or collapse or fainting (becoming blue, pale, limp, and non-responsive). Very rarely, DTP causes long seizures, decreased consciousness, or coma that usually does not last. Permanent brain damage can very infrequently follow such acute brain problems. There are no tests that can tell in advance if a child will be adversely affected by the DTP vaccine. Definitely the benefits from the DTP vaccine far outweigh the risks for almost all children.
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PMID:Facts about pertussis and DTP vaccine. 1234 38

We have reviewed evidence of adverse events after exposure to aluminium-containing vaccines against diphtheria, tetanus, and pertussis (DTP), alone or in combination, compared with identical vaccines, either without aluminium or containing aluminium in different concentrations. The study is a systematic review with meta-analysis. We searched the Cochrane Vaccines Field Register, the Cochrane Library, Medline, Embase, Biological Abstracts, Science Citation Index, and the Vaccine Adverse Event Reporting System website for relevant studies. Reference lists of retrieved articles were scanned for further studies. We included randomised and semi-randomised trials and comparative cohort studies if the report gave sufficient information for us to extract aluminium concentration, vaccine composition, and safety outcomes. Two reviewers extracted data in a standard way from all included studies and assessed the methodological quality of the studies. We identified 35 reports of studies and included three randomised trials, four semi-randomised trials, and one cohort study. We did a meta-analysis of data from five studies around two main comparisons (vaccines containing aluminium hydroxide vs no adjuvant in children aged up to 18 months and vaccines containing different types of aluminium vs no adjuvants in children aged 10-16 years). In young children, vaccines with aluminium hydroxide caused significantly more erythema and induration than plain vaccines (odds ratio 1.87 [95% CI 1.57-2.24]) and significantly fewer reactions of all types (0.21 [0.15-0.28]). The frequencies of local reactions of all types, collapse or convulsions, and persistent crying or screaming did not differ between the two cohorts of the trials. In older children, there was no association between exposure to aluminium-containing vaccines and onset of (local) induration, swelling, or a raised temperature, but there was an association with local pain lasting up to 14 days (2.05 [1.25-3.38]). We found no evidence that aluminium salts in vaccines cause any serious or long-lasting adverse events. Despite a lack of good-quality evidence we do not recommend that any further research on this topic is undertaken.
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PMID:Adverse events after immunisation with aluminium-containing DTP vaccines: systematic review of the evidence. 1517 37

Vaccinations protect to a high degree against infectious diseases, but may cause side effects. In the Netherlands since 1962 the adverse events following immunizations are registered and analysed by the National Institute of Health and Environment (RIVM). Since 1983 a permanent Committee of the Dutch Health Council reviews adverse events reported to the RIVM. With the so-called killed vaccines the side effects are mainly local (redness, swelling, pain) or general (fever, listlessness, irritability, sleep and eating problems). They are seen mainly after DPT-IPV vaccination against diphtheria, pertussis, tetanus and poliomyelitis. Some side effects occur rarely (collapse reactions, discoloured legs, persistent screaming and convulsions) and very rarely serious neurological events are reported. After MMR vaccination against measles, mumps and rubella, cases of arthritis, thrombocytopenia and ataxia are reported sporadically. Usually, they have a spontaneous recovery. During recent years a scala of diseases or symptoms have been associated with vaccination (presumed side effects). Careful and extensive investigations have shown that such hypotheses could not be supported. Examples are allergic diseases as asthma, diabetes mellitus, multiple sclerosis (after hepatitis B vaccination), autism and inflammatory bowel disease (after MMR vaccination) and sudden infant death syndrome. The total number of cases where at least a possible relation between side effects and vaccination is observed--apart from local reactions and moderate general symptoms--is very rare (about 0.25 per 1000 vaccinations) and does not balance the benefits from vaccination. There appears increasing doubt about the use and safety of vaccinations. More research is needed about the motives of people to choose for and against vaccination. The education about vaccination for parents and professionals who are involved with vaccination has to be improved. Internet can play an important role.
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PMID:[Childhood vaccinations anno 2004. II. The real and presumed side effects of vaccination]. 1503 89

Injuries from marine life encompass a wide spectrum, from mild stings to severe bites. Fortunately most of the injuries are mild, although some may be significant, resulting in death. Most of these injuries can be treated by family physicians with a knowledge of the cause of the pathology. Over the years, there have been many treatment options. Some have actually caused an increase in severity. An important rule in treating these injuries is to inactivate the venom, treat the local reaction or injury, and treat the systemic sequelae. Jellyfish stings are the most common type of marine injury. The tentacles possess nematocysts, which are stinging units that are inactivated by the application of vinegar. Sea urchin and stingray injuries require the removal of the imbedded spines after the wound is soaked in hot water. Coral, sea bathers eruption, and swimmer's itch require thorough scrubbing and irrigation. Sea snakes, cone shells, and venomous fish possess a neurotoxin that requires close monitoring in the event of cardiopulmonary collapse. All of these injuries require tetanus status monitoring and consideration of coverage for infectious sequelae.
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PMID:Diagnosis and management of injuries from dangerous marine life. 1636 31


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