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Biomedical subjects

D Palmović

Publications and source records attributed to D Palmović.

At least 19 recordsLinked to original sources
PubMed1994

Vaccination against hepatitis B: results of the analysis of 2000 population members in Croatia.

The results of the analysis of vaccination against hepatitis B performed in 2,000 persons of high-risk groups in Croatia are described. All susceptible non-immunocompromised persons (HBsAg, anti-HBs, and anti-HBc negative) received either plasma-derived vaccine (HB-Vax MSD, 20 micrograms per dose) or recombinant HB vaccine (ENGERIX-B, SKB, 20 micrograms per dose) according to a 0.1 and 6-month schedule. Hemodialysis patients received four doses of HB vaccine (40 micrograms per dose). Seroconversion occurred in 98% of health care workers, 98.5% of family members of HBsAg chronic carriers, 98% of infants born to HBsAg carrier-mothers and 92% of hemodialysis patients. The percentage of poor-responders (titer of anti-BHs = 1-10 mIU/ml) for the groups was 2, 2, 8 and 20%, respectively, while low-responders (titer of anti-BHs = 10.1-100 mIU/ml) were 5, 4.5, 12 and 26%, respectively. A significant prevalence of non-responders, poor-responders and low-responders among male health care workers was noticed (p = 0.01, 0.026 and 0.002, respectively). Females significantly prevailed among excellent-responders (p = 0.0039). In hemodialysis patients, there were 8% non-responders, 19.5% poor-responders, and 26% low-responders. A significant difference between the percentage of good-responders (titer of anti-HBs = 101-1,000 mIU/ml) and excellent-responders (titer of anti-HBs over 1,000 mIU/ml) among health care workers and hemodialysis patients was documented (91% versus 46.5%, p < 0.0001). The combined passive-active immunization (hyperimmune hepatitis B globulin + hepatitis B vaccine) was effective in 98% of infants born to HBsAg carrier-mothers, and only one boy developed subclinical HBV infection (HBsAg and anti-HBc positive findings with normal ALT-values).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Results of vaccination with the hepatitis B vaccine in patients and personnel at the Hemodialysis Center in Karlovac].

Hepatitis B remains a significant risk to patients and staff members of hemodialysis unit. Prior to immunization, 38 hemodialysis patients and 24 staff members were screened for HBs antigen, HBc antibodies and HBs antibodies using ELISA method (Abbott). Of 18 (47%) patients, five were chronic carriers of HBsAg and 13 had anti-HBs and anti-HBc while anti-HBs and anti-HBc were found in four (17%) members of medical staff. A total of 20 (53%) susceptible patients (mean 51.2 years) and 19 (79%) susceptible staff members (mean 28.1 years) received hepatitis B vaccine (H-B-VAX, Merck, Sharp and Dohme). Between patients were four (20%) non-responders and seven (35%) low-responders while among medical staff were two (10.5%) non-responders and one (5.2%) low responder only. The geometric mean titer of anti-HBs was 724 IU/L in patients and 3407 IU/L in staff members. Non-responders (5 of 6) who were given a fourth vaccine dose also failed to mount an antibody response. In none of vaccinated patients antibody to human immunodeficiency virus (HIV-1) occurred in their sera three and six months after complete vaccination. Consideration should be given to a prevaccinal screening of presumptive vaccinees between patients and staff members of hemodialysis units because of high level of preexisting HBV infection among them. The data suggest a high non-responder and low-responder rate in vaccinated hemodialysis patients and serial surveillance for anti-HBs is warranted especially in persons aged over 40 years. Additional booster dose or some doses of HB vaccine should be given to low-responders and they should be retested thereafter. Non-responders still remain the unresolved problem.

Adult↗
PubMed1987

Prevention of hepatitis B infection in health care workers after accidental exposure.

The efficacy of hepatitis B immune globulin (HBIg) alone or combined with hepatitis B (HB) vaccine in preventing hepatitis B virus (HBV) infection after accidental exposure to blood of HBV carriers was studied in a controlled trial. HBIg (0.06 ml/kg) was administered intramuscularly within 3 days after exposure to 56 recipients. A second dose was given 1 month later. In another group of 28 persons, a single dose of HBIg was given within 3 days followed by the first dose of HB vaccine (HEVAC-B Pasteur 10 micrograms) within 7 days after exposure. A control group consisted of 53 health care workers who reported more than 3 days after exposure and who did not receive any specific immuno-prophylaxis. The recipients were followed for at least 10 months. Immunisation, both passive and combined passive and active, was clearly effective since none of the recipients developed acute symptomatic HBV infection compared with four (8%) of 47 not immunised (Fisher's exact test P = 0.02). The number in each group immunised was too small to allow valid comparison of the relative efficacy of the two schedules. Nevertheless, in the absence of evidence of lesser efficacy for the combination of HBIg and HB vaccine after exposure, the combined passive/active schedule would seem the treatment of choice since it offers the additional benefit of long-term protection.

Antibodies, Viral↗