Patients with end-stage renal disease have an impaired immune response to vaccination against Hepatitis B. The efficacy of different vaccines and vaccine schedules was studied in a group of patients receiving long-term hemodialysis. All patients received an initial 6 month course of intramuscular vaccine with either three doses of Recombivax (48 patients) or four doses of Engerix B (50 patients). This was successful in 71% and 74% of patients, respectively. In 10 patients unresponsive to 4 doses of Engerix B, a second course (2-4 doses) was successful in 5, thus increasing the overall success rate to 84%. Repetitive doses of vaccine intradermally were used as an alternative approach in eight patients who were unresponsive to intramuscular vaccination resulting in seroconversion in six. Finally, booster doses of intramuscular Engerix B have been used in 26 patients who lost their antibodies after successful vaccination.

Adult↗

PubMedDate not supplied

Factors associated with administration route when using midazolam for pediatric conscious sedation.

Midazolam conscious sedation records of pediatric dental patients, one to six years of age, were reviewed retrospectively to: 1) examine the factors associated with the use of oral and nasal routes of administration and their effect on displayed behavior during dental treatment and 2) determine whether a child's compliance with oral administration is predictive of the intraoperative behavior displayed during dental treatment. Two hundred and fifty-seven conscious sedation records for 222 pediatric dental patients sedated with orally or nasally administered midazolam for dental treatment at the University of Florida were reviewed. Data collected included the patient's age, gender, route of administration, dose, compliance with oral administration, appointment type (planned vs. emergency), previous sedation experience with midazolam, operator vs. parent administration of the medication, use of papoose board and nitrous oxide/oxygen inhalation, types of procedures performed (restorations only, extractions only, or both), length of treatment rendered, and preoperative and intraoperative behavioral assessments of the child. The collected data were analyzed with Statview software using ANOVA and Chi-square analyses. There was a statistically significant difference (p < 0.001) between oral and nasal administration for the parameters of age, procedure length, appointment type, procedures performed, previous sedation experience and use of the papoose board and nitrous oxide/oxygen inhalation. While there was no statistically significant influence of chronological age on the preoperative Frankl behavior ratings, there was a statistically significant mean age difference with respect to the administrator of the medication (parent vs. operator), papoose board use, N2O/O2 use and previous sedation experience. Forty-five percent of the subjects were willing to accept oral administration of the medication, however, there was no statistically significant difference (p = 0.114) between the child's compliance to accept the medication and the intraoperative Frankl behavioral ratings displayed during dental treatment. In this review of midazolam conscious sedation records of pediatric dental patients. 1) route of administration was significantly influenced by several patient and procedural variables, resulting in different behavioral outcomes and 2) compliance with oral administration was not predictive of behavior displayed during treatment.

Administration, Intranasal↗

PubMedDate not supplied

[Heart rate and contractile reserve of the aging heart].

In standardized experiments on both conscious and anaesthetized young (n = 11) and old (n = 7) dogs differences in haemodynamics, contractility and myocardial oxygen consumption correlated to age were evaluated. Under resting conditions no significant differences were observed. Following stimulation with catecholamines young (n = 6), and old (n = 6) dogs displayed an almost parallel increase in (dp/dt) max. After administration of orciprenalin, the maximum increase in heart rate was similar in both groups of animals; however, a significant difference in the maximum heart rate following atropine was observed, which was significantly lower in old than in young animals. The decreased performance of the aged myocardium does not appear to be predominantly due to an age-dependent reduction of the contractility reserve. It could result from a deficient sympathetic stimulation of the heart.

Aging↗

PubMedDate not supplied

[Digoxin level in various sections of the human myocardium].

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Adult↗

PubMedDate not supplied

Hemoperitoneum after pericardiocentesis in a CAPD patient.

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Adult↗