High (3000 CCA units) and standard low (300 CCA units) doses of formalin-inactivated influenza vaccines purified by zonal ultracentrifugation were evaluated in a double-blind manner for adverse reactions and antibody responses in a high school population and in 2 adult populations.The fewest local and systemic reactions were produced by subcutaneous administration of the low doses of purified monovalent A2/Aichi/2/68, A2/Japan/170/62, and B/Massachusetts/3/66 vaccines. The high doses of A2/Japan and A2/Aichi vaccines produced 2-3-fold greater incidence of adverse reactions but did not exceed that observed with the commercial vaccines. The 3000 CCA units of B/Mass. vaccine produced more frequent and more severe systemic reactions than the polyvalent vaccine.Neither the A2/Japan vaccine nor the commercial vaccines stimulated a significant serum antibody response to A2/Aichi.The homologous serum antibody response to an Aichi vaccine was excellent in all 3 populations. A2/Aichi vaccines produced higher heterologous A2/Japan titres than did the A2/Japan vaccines. It was demonstrated that high doses of purified influenza vaccine can be given safely, and that 10-fold increases in vaccine concentration produce 2-3-fold increases in antibody titre.

Adolescent↗

PubMed1969

Studies with inactivated influenza vaccines purified by zonal centrifugation. 2. Efficacy.

High (3000 CCA units) and standard low (300 CCA units) doses of the monovalent purified vaccines described in an earlier paper were evaluated in a double-blind manner in 2 adult populations for protective effectiveness against illness caused by the Hong Kong influenza virus. Epidemics in both populations occurred 4-6 weeks after single injections of vaccine were given.The attack rates among recipients of low or high doses of A2/Japan vaccines in a prison were virtually identical to those among the control groups receiving B/Massachusetts vaccines. The attack rate among those receiving 3000 CCA units of Aichi vaccine was nearly 70% less than the rate among recipients of A2/Japan or B/Mass. vaccines. Similarly, in a retirement community the attack rate among the recipients of 3000 CCA units of Aichi vaccine was 50%-70% lower than the attack rate among the recipients of the A2/Japan vaccine. In both populations, recipients of high doses of Aichi vaccine who later became ill tended to have less morbidity, fewer and lower fevers, and shorter stays in bed. Attack rates among the groups receiving low doses of Aichi vaccine were somewhat lower than rates among those receiving A2/Japan or B/Mass. vaccines, but the effect was not statistically significant. Divalent and polyvalent commercial vaccines were also without protective effect.The results indicate that optimally constituted influenza vaccines at standard dosage levels have little, if any, effectiveness and that even very large doses of vaccine do not approach the high degrees of effectiveness that have been achieved with other virus vaccines.

Adult↗

PubMedDate not supplied

Gentamicin treatment associated with later nosocomial gentamicin-resistant Serratia marcescens infections.

During a hospital epidemic of infections with gentamicin-resistant Serratia marcescens (GRS), we studied the relation between receiving antibiotics and acquiring GRS. In a five-month period, 22 patients acquired GRS, whereas 18 patients acquired gentamicin-sensitive Serratia (GSS). When compared with patients with nosocomial GSS infection, patients with nosocomial GRS had been in the hospital (p = 0.04) and the intensive care unit (p = 0.003) longer before infection and more had received gentamicin (p = 0.001) or ampicillin (p = 0.02) before infection. To control for the influence of underlying disease, we matched all 12 ICU patients with GRS infection and 12 patients without GRS infection for underlying illness and duration of intensive care. Use of any antibiotic (p = 0.04), or a combination of gentamicin plus ampicillin or cephalosporin (p = 0.047) was more common among patients with GRS infection. The hospital had not significantly increased the use of aminoglycosides from the previous year. We conclude that for the individual patient antimicrobial therapy, especially with gentamicin or ampicillin, creates a risk for later infection by GRS that is independent of the severity of the underlying illness.

Aged↗

PubMedDate not supplied

Comparison of sevral wild-type influenza viruses in the ferret tracheal organ culture system.

Several strains of wild-type influenza A virus were studied in the ferret tracheal organ culture system. Ciliary activity and viral replication were measured. Ciliary activity was reduced more rapidly by A/Hong Kong/45/68 (H3N2) (A/HK) and A/Victoria/3/75 (H3N2) (A/Vic) than by A/New Jersey/8/76 (Hsw1N1) (A/NJ), A/Scotland/840/74(3HN2) (A/Scot), or A/USSR/90/77 (H1N1) (A/USSR). A/HK, A/Vic, and A/Scot produced titers of virus higher than A/USSR or A/NJ during the first three days after infection. Differences in effects of the five viruses on cilia were not related to history of egg passage. The two strains that destroyed ciliary activity rapidly had caused excess mortality in the United States, whereas the three that destroyed ciliary activity more slowly had not. A relationship may exist between the properties contributing to virulence in humans and the destruction of ciliary activity in vitro in this culture system.

Animals↗

PubMedDate not supplied

Comparison of cefpimizole with cefotaxime and penicillin G for treatment of uncomplicated gonorrhea.

One hundred sixteen patients (92 men and 24 women) with suspected uncomplicated gonorrhea were randomized in a double-blind manner to receive intramuscular treatment with 1.0 g of cefpimizole, 1.0 g of cefotaxime, or 4.8 x 10(6) units of aqueous procaine penicillin G (APPG) with 1 g of oral probenecid. Seventeen percent were nonassessable (cultures negative, co-existing syphilis, etc.). Infection sites in 96 assessable patients were urethra (78), cervix (17), pharynx (two), and rectum (two). Of 52 patients treated with cefpimizole, 46 (88%) were bacteriologically cured, as compared with 100% (24 of 24) treated with APPG (P = 0.18) and 90% (18 of 20) treated with cefotaxime (P greater than 0.20). On a weight basis the in-vitro activity of cefpimizole against Neisseria gonorrhoeae was similar to that of APPG. Pain at the injection site was reported by 52% of patients treated with cefpimizole as compared with 27% of those given cefotaxime (P = 0.008) and 17% of those given APPG (P = 0.002). No major organ toxicity was found with cefpimizole, cefotaxime, or APPG. Thus, for acute uncomplicated gonorrhea cefpimizole is similar in efficacy to cefotaxime and APPG but has a higher frequency of pain at the injection site.

Adult↗

PubMedDate not supplied

Local anesthetics and tracheal ring ciliary activity.

The effects of local anesthetics on ciliary activity were studied using ferret tracheal rings maintained in vitro. Ciliary activity was quantitated visually after exposure to varying concentrations of mepivacaine, lidocaine, procaine, chloroprocaine, and bupivacaine. The recovery of ciliary activity was determined after tracheal rings were washed free of the local anesthetic agent. Mepivacaine was the least toxic, with no effect on ciliary activity at a 1.0% concentration. Bupivacaine was the most toxic, with irreversible damage to respiratory epithelium at a concentration of 0.13%. Lower concentrations caused ciliostasis, with some recovery after removal of the anesthetic. Licocaine, procaine, and chloroprocaine also depressed ciliary activity which, in general, was reversible after removal of the anesthetic.

Anesthesia, Local↗

PubMedDate not supplied

Impairment of tracheal ring ciliary activity by halothane.

The effects of varying concentrations of halothane on tracheal ciliary activity were studied using a ferret tracheal organ culture technique. Using 1% and 2% halothane produced no impairment of ciliary activity, while 3% halothane caused some ciliostasis; 4% and 5% halothane produced rapid cessation of ciliary activity. Recovery was prompt and complete after exposure to 4% halothane for as long as 3 days, but after 4 days of exposure recovery was incomplete and after a week of exposure death of ciliary cells occurred.

Anesthesia, Inhalation↗

PubMedDate not supplied

Pulmonary antibacterial defense mechanisms are depressed by halothane.

Pulmonary antibacterial activity was determined by challenging halothane-exposed and control mice to radiolabeled (32P) Staphylococcus aureus produced by an aerosol generator and by determining the relative changes in viable bacterial and radioisotope counts in ground lung immediately after exposure and 4 hours later. Mice that were anesthetized for 4 hours with 1 or 2 MAC halothane and allowed to recover for 1 hour showed higher 4-hour bacterial counts when compared to controls, while radioisotope counts were the same in both groups. These data indicate that 1 and 2 MAC halothane anesthesia is associated with depressed lung bactericidal activity but that physical clearance mechanisms are not depressed.

Aerosols↗