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  • 1
    Electronic Resource
    Electronic Resource
    Immunogenicity and reactogenicity of a Haemophilus influenzae type b tetanus conjugate vaccine when administered separately or mixed with concomitant diphtheria-tetanus-toxoid and acellular pertussis vaccine for primary and for booster immunizations (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 208-214 
    Details
    ISSN: 1432-1076
    Keywords: Key wordsHaemophilus influenzae type b ; Acellular pertussis ; Vaccination ; PRP-tetanus ; Diphtheria
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract With an increasing number of new vaccines available for routine childhood immunization, combination vaccines are needed in order to maintain or achieve a high compliance with recommended immunization programmes. In a prospective, randomized, comparative, multi-centre study, 822 healthy infants were enrolled to receive three doses of either a candidate or a commercially available Haemophilus influenzae type b (Hib) vaccine concomitantly with diphtheria-, tetanus- acellular pertussis (DTaP) vaccine. Study subjects were randomly allocated to one of the following groups: (1) separate, or (2) mixed injection of DTaP and candidate Hib vaccine, or (3) separate injection of DTaP and commercial Hib vaccine. One year later the first 189 study subjects received either separate or mixed injections of the same Hib and DTaP vaccines as booster doses. Evaluation of reactogenicity was based on diary cards completed by parents. Immunogenicity was documented by measuring IgG antibody concentrations in serum samples taken before and 4 weeks after primary and booster vaccination. No serious adverse events occurred and most local and systemic reactions were mild to moderate. Booster doses were more reactogenic than primary doses with all groups. Antibody concentrations against pertussis antigens were similar to those seen with DTaP alone. All but one subject had protective antibody concentrations against diphtheria and tetanus. Primary immune response to the Hib vaccine was significantly lower in the group receiving the mixed Hib-DTaP vaccine, however, ≥95% of vaccinees had anti-Hib antibody concentrations ≥0.15 μg/ml and there was a marked booster response (〉100-fold) in all groups. Conclusions Mixing DTaP and Hib vaccines for primary immunization caused a decrease in anti-Hib antibody response, although after primary immunization as after booster doses, all subjects showed antibody concentrations considered to be protective for invasive Hib disease. Mixing of the vaccines did not result in increased reactogenicity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050797
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  • 2
    Electronic Resource
    Electronic Resource
    Factors influencing the spread of pertussis in households (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 391-394 
    Details
    ISSN: 1432-1076
    Keywords: Key words pertussis ; attack rate ; household ; adult ; erythromycin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The objective of this study was to compare the spread of pertussis in children and adults being secondary contacts after household exposure. The study was nested in an efficacy trial of an acellular pertussis vaccine. The spread of the disease was also monitored with respect to gender and antibiotic therapy. A total of 453 index cases, of which 133 were monitored for adult disease, fulfilled the WHO definition of pertussis. They had contacts to 173 unvaccinated children aged 6–47 months, and a total of 101 adults with pertussis were followed. Detection of the bacteria, or a significant increase of specific antibodies confirmed the diagnosis. Secondary spread of the disease was assumed, when a household member coughed for 7 days or more and had laboratory evidence for pertussis. Crude attack rates (AR) were 69% in children and 31% in adults (P 〈 0.05). AR in children were independent of gender but more women than men (P = 0.02) were affected in those households where the index case was a child. Erythromycin treatment of the index case reduced the AR in exposed toddlers from 80% to 57% (P = 0.06), and in exposed adults from 40% to 21% (P= 0.2). Erythromycin therapy in contacts did not alter the clinical course of the disease significantly. Conclusions In a household study of pertussis, 69% of children and 31% of adults (more women than men) contracted the disease. Erythromycin reduced the number of infections in household contacts, but did not alter the clinical course in those who contracted pertussis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050836
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  • 3
    Electronic Resource
    Electronic Resource
    Economic evaluation of pertussis prevention by whole-cell and acellular vaccine in Germany (1998)
    Springer
    European journal of pediatrics 157 (1998), S. 395-401 
    Details
    ISSN: 1432-1076
    Keywords: Key words Pertussis ; Cost-effectiveness ; Acellular pertussis vaccine ; Whole-cell pertussis vaccine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Acellular pertussis vaccines are less reactogenic than whole cell pertussis vaccines, but they are also more expensive. Based on simulation models, we compared the costs and effects of three alternative pertussis vaccination strategies in German children to ”no prevention”: (1) vaccination with whole-cell vaccine at 45% coverage (vaccine efficacy 90%), (2) vaccination with acellular vaccine at 45% coverage (vaccine efficacy 85%), and (3) vaccination with acellular vaccine at 90% coverage. In the two low coverage scenarios expected annual savings in direct medical costs through prevention of disease were larger for whole-cell than for acellular vaccination (252 vs 216 million DM, respectively). Direct costs for treating the more important adverse events induced by whole-cell vaccination (16.9 million DM annually) did not outweigh the higher direct costs of pertussis infections not prevented with the acellular vaccine and the higher price of the acellular vaccine. However, vaccination with acellular pertussis vaccine rapidly becomes as cost saving as vaccination with whole-cell vaccine as soon as vaccination coverage can be raised from 45% to 52.5% with acellular vaccine. Acellular vaccination is also the superior alternative when considering indirect cost savings resulting from reduction in work-loss due to adverse events. Conclusion In our simulations, the most cost-effective pertussis prevention strategy was the use of an effective whole-cell vaccine with a high coverage rate. Introduction of the more expensive acellular pertussis vaccines becomes cost saving if at least a 7.5% increase in coverage is achieved. If also non-medical indirect costs to parents resulting from vaccine associated side-effects are accounted for, acellular vaccines may be more cost-effective also in countries with already high whole-cell vaccine coverage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050837
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  • 4
    Electronic Resource
    Electronic Resource
    Magnesiumsulfat als adjuvante Therapie zur Behandlung autonomer Störungen bei generalisierter Tetanuserkrankung (1998)
    Springer
    Intensivmedizin und Notfallmedizin 35 (1998), S. 223-227 
    Details
    ISSN: 1435-1420
    Keywords: Key words Tetanus ; autonomic dysfunction ; magnesium sulfate ; Schlüsselwörter Tetanus-infektion ; autonome Störungen ; Magnesiumsulfat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Hintergrund: Für die hohe Letalität bei generalisiertem Tetanus sind häufig autonome Störungen infolge Sympathikusüberaktivierung verantwortlich. Anhand einer Kasuistik wird auf das therapeutische Potential einer adjuvanten Magnesiumtherapie hingewiesen. Fallbericht: Ein 54jähriger Patient entwickelte zwei Wochen nach einer oberflächlichen Hautverletzung zunächst eine Kau-, Schluck- und Sprechstörung und schließlich generalisierte Muskelkrämpfe mit Befall der Atemmuskulatur. Impfschutz gegen Tetanus bestand nicht. Die Basistherapie bestand in Antitoxingabe, Antibiose und hochdosierter Analgosedierung (Midazolam, Sufentanil) und Relaxierung (Cisatracurium) bei künstlicher Beatmung. Zur Beherrschung massiv auftretender autonomer Störungen wurde adjuvant Magnesiumsulfat 10% verabreicht. Hierunter verbesserten sich die enormen Blutdruckschwankungen, verringerte sich die Herzfrequenz und milderten sich die Muskelspasmen. Nach 10wöchiger intensivmedizinischer Therapie und 8wöchiger Rehabilitationsbehandlung war der Patient klinisch unauffällig. Schlußfolgerung: Magnesiumsulfat erwies sich bei einer schweren generalisierten Tetanuserkrankung als adjuvante Therapie zur Kupierung autonomer Störungen und zur Minderung der Muskelspasmen als nützlich.
    Notes: Summary Background: The high mortality rate in severe tetanus frequently is due to sympathetic overactivity. We present a case that demonstrates the usefulness of adjuvant magnesium. Case report: Two weeks after a superficial skin injury a 54-year old patient was admitted because of difficulties in chewing, swallowing, and speech. A few days later generalized muscle spasms occurred involving breathing muscles. He had not been immunized against tetanus by vaccination. Basic therapy included tetanusantitoxin, antibiotics, analgesia (sufentanil), sedation (midazolam) and relaxation (cisatracurium), and mechanical ventilation. There was pronounced autonomic nervous system instability. We used 10% magnesium sulfate to control sympathetic crisis, which resulted in normalization of blood pressure, slight depression of heart rate, and reduction of the muscle spasms. After ten weeks ICU treatment and eight weeks of rehabilitation the patient was in good clinical condition. Conclusion: This experience suggests that adjuvant magnesium is useful in the treatment of sympathetic overactivity and muscle spasms in severe tetanus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050140
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  • 5
    Electronic Resource
    Electronic Resource
    Kinetic energy spectrum and polarization of neutrons from the reaction 12C(p,n)X at 590 MeV (1998)
    Springer
    The European physical journal 2 (1998), S. 411-415 
    Details
    ISSN: 1434-601X
    Keywords: PACS:29.25.Dz Neutron sources – 25.40.Ve Other reactions above meson production thresholds – 13.75.Cs Nucleon-nucleon interactions (including antinucleons, deuterons etc.)
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstact: The kinetic energy spectrum and the polarization of the PSI neutron beam produced in the reaction 12C(p,n)X at 0° with 590 MeV polarized protons were investigated. A strong energy dependence of the neutron beam polarization is observed which was not expected at the time the neutron beam was built.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100500050138
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  • 6
    Electronic Resource
    Electronic Resource
    Neisseria meningitidis serogroup B peritonitis associated with continuous ambulatory peritoneal dialysis (1998)
    Springer
    European journal of clinical microbiology & infectious diseases 17 (1998), S. 341-343 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case ofNeisseria meningitidis peritonitis in a 41-year-old female undergoing continuous ambulatory peritoneal dialysis for end-stage renal failure due to insulin-dependent diabetes mellitus is reported. The bacterial strain was serosubtyped as 4∶PI.15, a rarely encountered type. Surprisingly, the minimal inhibitory concentration of vancomycin for the isolate was low (16 mg/l). This may have contributed to the complete recovery of the patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709457
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  • 7
    Electronic Resource
    Electronic Resource
    Neisseria meningitidis Serogroup B Peritonitis Associated with Continuous Ambulatory Peritoneal Dialysis (1998)
    Springer
    European journal of clinical microbiology & infectious diseases 17 (1998), S. 341-343 
    Details
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  A case of Neisseria meningitidis peritonitis in a 41-year-old female undergoing continuous ambulatory peritoneal dialysis for end-stage renal failure due to insulin-dependent diabetes mellitus is reported. The bacterial strain was serosubtyped as 4 : P1.15, a rarely encountered type. Surprisingly, the minimal inhibitory concentration of vancomycin for the isolate was low (16 mg/l). This may have contributed to the complete recovery of the patient.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709457
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  • 8
    Electronic Resource
    Electronic Resource
    Spin observables in neutron-proton elastic scattering (1998)
    Springer
    The European physical journal 2 (1998), S. 627-641 
    Details
    ISSN: 1434-6052
    Source: Springer Online Journal Archives 1860-2000
    Topics: Physics
    Notes: Abstract. The analyzing power, $A_{oono}$ , and the polarization transfer observables $K_{onno}$ , $K_{os''so}$ and $K_{os''ko}$ have been measured in neutron-proton elastic scattering at 260, 318, 386, 472 and 538 MeV for c.m. scattering angles between 64° and 160°. The data were obtained at PSI with a polarized neutron beam and a polarimeter analyzing the transverse polarization of the outgoing proton. They make a significant impact on the knowledge of the Isospin I = 0 nucleon-nucleon scattering.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100529800880
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