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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Annals of hematology 8 (1962), S. 145-157 
    ISSN: 1432-0584
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Study of the literature and experimental investigations have shown that storage of blood in the ACD stabilizer is not optimal when compared with a phosphate-dextrose-saccharose stabilizer. Further it was shown that the metabolic kinetics and the speed of permeability for anions did not correspond with Arrhenius's law. The divergence was most marked below 10°C. In the usual ice-chest range of temperature (about 4°C) the difference between the course of metabolic processes and permeability leads to increase of lactic acid in the erythrocytes, causing a shift of intracellular pH. In order to intimate physiological conditions as closely as possible, it is suggested that blood should be stored in synthetic containers permitting dialysis and that it should be surrounded by a suitable dialyzable fluid.
    Notes: Zusammenfassung Wir konnten auf Grund von Literaturangaben und experimenteller Untersuchungen im Vergleich mit einem Phosphat-Dextrose-Saccharose-Stabilisator zeigen, daß die Lagerung von Blut in ACD-Stabilisator nicht den optimalen Bedingungen entspricht. Ferner wurde festgestellt, daß die Stoffwechselkinetik und die Permeabilitätsgeschwindigkeit für Anionen nicht dem Gesetz vonArrbenius gehorcht. Besonders augenfällig sind die Abweichungen bei Temperaturen unter 10°C. Die Differenz zwischen Stoffwechselablauf und Permeabilität bei den üblichen Kühlschranktemperaturen um 4°C führt zu einer starken Milchsäureanreicherung in den Erythrozyten, die eine intrazelluläre pH-Verschiebung verursacht. Um die physiologischen Bedingungen anzunähern, wird vorgeschlagen, das Blut in dialysierfähigen Kunststoffbeuteln zu lagern und mit einer geeigneten Dialysierflüssigkeit zu umspülen.
    Type of Medium: Electronic Resource
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  • 12
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 155 (1996), S. 74-76 
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 13
    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
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 157 (1998), S. 395-401 
    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
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  • 15
    ISSN: 1432-1076
    Keywords: Key words Haemophilus influenzae type b  ;   Combination vaccine  ;  Immunological memory
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The lack of an adequate immune response to the major polysaccharide of the Haemophilus influenzae type b (Hib) capsule (polyribosyl ribitol phosphate) (PRP) in very young infants (〈 18 months) can be overcome by conjugating PRP to a T-cell dependent carrier protein. We studied whether administration of a tetanus-PRP conjugate vaccine reconstituted with a diphtheria-tetanus-acellular pertussis-hepatitis B (DTPa-HBV) vaccine as a three dose primary course at 3, 4 and 5 months of age induced PRP-specific immunological memory, by examining the anti-PRP response to a dose of unconjugated PRP given with the DTPa-HBV booster approximately 1 year later. The unconjugated PRP elicited protective anti-PRP antibody levels (≥ 0.15 μg/ml) in all but 3 of the 369 vaccinees, including 13 infants who failed to demonstrate a measurable immune response after the primary course. In a sub-cohort of 54 subjects all had anti-PRP levels ≥ 0.5 μg/ml within 7–14 days of the booster showing a rapid anamnestic type response. Both primary and booster responses were predominantly IgG1 indicating a T-cell dependent response. The DTPa-HBV components elicited protective anti-diphtheria, anti-tetanus and anti-HBs antibody levels in ≥ 98.5% of vaccinees, and immune responses to each of the acellular pertussis vaccine components in 92.3%–97.3% of subjects. Conclusion The tetanus-PRP conjugate vaccine not only elicited a good primary humoral response, but also induced immunological memory so that the infants were able to mount a large and rapid immune response to subsequent exposure to plain PRP, indicating that protection against circulating wild-type Hib had been generated. Successful induction of immunological memory occurred even when there was no measurable humoral anti-PRP response to the primary course. Tetanus-PRP conjugate vaccine can be used in combination with DTPa-HBV vaccine, when administered separately or as a single injection in the same syringe, in primary immunisation schedules at 3, 4 and 5 months of age.
    Type of Medium: Electronic Resource
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  • 16
    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
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  • 17
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 40 (1962), S. 921-928 
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 18
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 40 (1962), S. 1175-1180 
    ISSN: 1432-1440
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    European archives of psychiatry and clinical neuroscience 245 (1995), S. 299-305 
    ISSN: 1433-8491
    Keywords: Frontal lobe degeneration ; Dementia ; Non-Alzheimer type
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report six cases of presenile (five) and senile (one) progressive dementia with a mild-to-marked frontal or frontotemporal atrophy and ventricular dilation (Frontal Lobe Degeneration [FLD]). The most prominent microscopic features were layer-dependet neuronal depletion of the cortex, spongiosis, and cortical and subcortical gliosis. Five cases showed additional degeneration of the S. nigra, and two also had motor neuron disease. Despite the absence of Pick cells and bodies, such cases have many features in common with Pick atrophy. Because Pick cells and bodies are inconstantly occurring features in other-wise typical cases of Pick atrophy, they cannot be regarded as inevitable markers of the latter. In our opinion, cases with mild frontal or frontotemporal atrophy as described herein and by others match the grades 1 and 2 in terms of Schneider's classification of Pick atrophy [37]. As long as the etiology of both Pick atrophy and the socalled FLD is unknown, and we finally have to follow morphological criteria for classification, there is apparently no convincing reason to introduce a separate category, such as FLD or FTA, for the cases with moderate or mild frontal atrophy and dementia of frontal lobe type, which can be sufficiently classified with the Pick spectrum of lobar atrophy.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 1432-8798
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary.  Second generation enzyme immunoassays (EIA-2) for antibodies to hepatitis C virus (anti-HCV) have a higher specificity and sensitivity than first generation enzyme immunoassays (EIA-1). We studied how many anti-HCV-positive blood donors were missed by the EIA-1, how many were false positive, how false-positive donors should be dealt with and how the results of the EIA-2 correlate to demographic data and serum alanine aminotransferase (ALT) level. A total of 208, 544 northern German blood donors, not preselected for anti-HCV negativity, were tested for anti-HCV with EIA-2 and, if repeatably reactive (rr), were retested with a licensed supplementary test (RIBA-2). 0.43% of the donors were EIA-2 rr, but only 0.12% of women and 0.09% of men were RIBA-2 positive. RIBA-2 positivity rates were very low in donors 18 to 27 years old (0.03% and 0.05%) and rose with age in women but not in men. Infected women were significantly more often Rhesus-negative than men. The rate of unspecifically positive EIA-2 results (entirely negative in RIBA-2) increased with age in both sexes and did not correlate with ALT. The ALT distribution was age-dependent with a different pattern for men and women. Confirmation of EIA-2 results with RIBA was rare when ALT was low and frequent when ALT was high. ALT screening before introduction of Anti-HCV detected one out of six infected donors. To exclude this one infectious donation, 46 uninfected donations had to be excluded in addition. Only 8% of the then RIBA-2-positive donors were not detected by EIA-1. Apparent seroconversions in EIA-2 are usually not specific: only 1 out of 66 apparent seroconversions could be confirmed by RIBA-2 suggesting recent HCV infection. 0.15% of the donor population showed an inconsistent EIA-2 pattern during follow-up. We conclude that donors should not be excluded from further donations, even on the basis of multiple EIA-1 positive results or on the basis of only one EIA-2 positive donation. Anti-D-immunoglobulin prophylaxis may have been a source of infection in some Rhesus-negative women. ALT screening should not be discontinued because recent HCV infection can be detected earlier by ALT than by anti-HCV, but exclusion limits should be elevated to increase specificity and limit unnecessary exclusion of donations.
    Type of Medium: Electronic Resource
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