Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tetanus”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed1993

[Tetanus --observations in the I Clinic of Infectious Diseases, Silesian Medical Academy in Bytom in the years 1988-1992].

Fifteen patients with tetanus were treated in the I Clinic of Infectious Diseases in Bytom in the period 1988-1992; the clinical and epidemiologic analysis was carried out of them. Severe tetanus occurred in 66% of patients and 46% of them needed mechanical ventilation. The percentage of mortality was high (46.7%). It was found that the information about tetanus was inadequate among health service personnel (physicians) and the population. Attention is called to inadequate knowledge of tetanus prophylaxis in the first line of patient's contact with the health service, which increases the risk of tetanus development. For reducing the incidence of tetanus and for improvement the efficacy of treatment this disease the authors suggest the need of adequate tetanus prophylaxis (passive and/or active immunization) in high risk injured patients.

Adult↗
PubMed1993

Unusual and iatrogenic sources of tetanus.

In order to successfully treat tetanus one has to be aware of its causes. Therefore, sources of tetanus were examined in a series of 106 patients with tetanus diagnosed in Finland during the period 1969-1985. The primary injuries which were identified in 100 (94.3%) of them included puncture wound, minor injury, excoriation, animal bite, cut wound, open fracture, burn, undefined wound and other sources. The latter group included nine patients in two of whom tetanus was caused by an operation on a closed injury and in one patient by a decubitus ulcer during hospital care. Six patients had an unusual source of tetanus: frostbite, poor teeth, ulceration in the gum under a denture, infected molluscum contagiosum, a scratched atheroma cutis and an infected granuloma pyogenicum. Two of these nine patients died; the mortality in the whole series was 12 patients (11.3%). It is important to be aware of even the rare sources of tetanus, as the rarity or absence of a primary injury may delay the diagnosis and treatment of tetanus and worsen the prognosis of the patients.

Adolescent↗
PubMed1996

[Electromyography as a diagnostic aid in tetanus].

In developing countries tetanus is still a real problem because of its high incidence and mortality. In all countries with high medical standards it has become rare. For this reason many clinicians are no longer familiar with the disease and its diagnosis. Until now no laboratory test has been readily available to confirm or rule out tetanus. However, the diagnosis can be performed by a simple and readily available electromyogram (EMG). We performed EMGs in 13 patients in whom tetanus was suspected but whose case history or clinical findings left some doubt. In 7 cases the EMG was typical for tetanus, showing spontaneous activity of motor units which could not be suppressed voluntarily and with shortening or absence of the silent period after a stretch reflex or after electrical stimulation of the nerve. In 2 cases we found one of the two diagnostic features. In all these 9 cases the diagnosis of tetanus was confirmed by the further development of the disease. In the remaining 4 patients the EMG was normal and in the course it was confirmed that they were not suffering from tetanus. Therefore, we consider electromyography a very useful and reliable tool either to confirm or rule out the diagnosis of tetanus.

Adult↗
PubMedDate not supplied

Tetanus prophylaxis following ocular injuries.

The administration of prophylaxis against tetanus following a corneal abrasion is routinely performed in many acute care facilities, despite a lack of support in the literature for its necessity. The risk of developing clinical tetanus from three different types of injuries to the eye was evaluated in an animal model. Clinical tetanus was induced in unimmunized mice by injecting Clostridium tetani organisms or toxin into the anterior chamber. Immunized mice injected intracamerally did not develop signs of tetanus. Tetanus was not induced by topical inoculation of either live organisms or toxin following corneal epithelial debridement or stromal scarification of unimmunized and immunized mice. The results of this study support the administration of prophylaxis against tetanus following perforating ocular injuries. However, our results do not support its routine use following uncomplicated corneal abrasions or other types of nonperforating ocular injuries.

Animals↗
PubMed1998

Clinical acceptability and immunogenicity of a pentavalent parenteral combination vaccine containing diphtheria, tetanus, acellular pertussis, inactivated poliomyelitis and Haemophilus influenzae type b conjugate antigens in two-, four- and six-month-old Chilean infants.

BACKGROUND: In recent years additional parenteral vaccines have been recommended for routine immunization of infants in the US and elsewhere. The ability to administer multiple vaccines as a single injection without unacceptably increasing reactogenicity or decreasing immunogenicity of any component would offer many practical advantages. METHODS: A randomized, open, controlled trial was conducted to assess the tolerance profile and immunogenicity, as well as to identify potential antigenic interferences, resulting from administration of a parenteral combination vaccine for infants. The vaccine contains diphtheria and tetanus toxoids, acellular pertussis antigens (DTaP), enhanced inactivated poliovirus (eIPV) and Haemophilus influenzae type b-tetanus toxoid conjugate (PRP-T). Infants (n=711) were randomly assigned to receive 1 of 5 regimens as the primary series at 2, 4 and 6 months of age, by group: (1) DTaP plus oral polio vaccine (OPV); (2) DTaP plus eIPV (separate injections); (3) DTaP-eIPV combined as a single injection; (4) DTaP-eIPV combined, plus a separate injection of PRP-T; or (5) DTaP-eIPV combined and reconstituting PRP-T, as a single injection. At 3, 5 and 7 months Groups 1, 2 and 3 received PRP-T. At 12 months all infants received a booster dose of DTaP reconstituting PRP-T as a single injection, plus a separate injection of measles, mumps and rubella vaccine. Groups 2, 3, 4 and 5 received OPV at 7 months, and all infants received OPV at 13 months. Serum immune responses were measured to the primary series at 2 and 7 months and to the booster dose at 12 and 13 months. RESULTS: Reaction rates were similar among groups. In the primary series combining eIPV with DTaP decreased geometric mean titers (GMTs) to diphtheria, tetanus and pertussis. In addition concomitant PRP-T (either simultaneous or combined) with DTaP-eIPV lowered anti-PRP and further decreased tetanus GMTs. Nonetheless in 100% of infants protective titers were achieved against diphtheria and tetanus (>0.01 IU/ml each) and against the poliovirus types 1, 2 and 3 after eIPV (Groups 2 to 5); 99% of infants (Groups 4 and 5) had protective titers against PRP (> or = 0.15 microg/ml). After boosting with DTaP/PRP-T decreased GMTs to diphtheria and PRP antigens were observed in the groups that received DTaP and eIPV combined. Nonetheless protective titers to diphtheria, tetanus and PRP occurred consistently. In contrast concomitant PRP-T with DTaP-eIPV enhanced the pertussis GMTs. CONCLUSIONS: We conclude that combined DTaP, eIPV and PRP-T in a single injection is well-tolerated and elicits an acceptable immune response to each component.

Adhesins, Bacterial↗
PubMed2001

Fifth vaccination with dipthteria, tetanus and acellular pertussis is beneficial in four- to six-year-olds.

OBJECTIVE: Diphtheria, tetanus and pertussis serum antibody titers were assessed before a fifth dose of diphtheria-tetanus-acellular pertussis (DTaP) or diphtheria-tetanus-whole cell pertussis (DTwP) vaccination at age 4 to 6 years. METHODS: Healthy children who had participated in a series of National Institutes of Health-sponsored trials assessing DTwP and DTaP vaccines provided prevaccination sera before a fifth dose of DTwP or DTaP. The trial design was prospective, randomized and double blind. Diphtheria, tetanus and pertussis antibody titers were measured by enzyme-linked immunosorbent assay. Pertussis results are expressed in enzyme-linked immunosorbent assay units/ml based on US Food and Drug Administration reference sera. Tetanus and diphtheria toxin concentrations are expressed in IU/ml with a WHO international reference sera as a standard. RESULTS: For diphtheria 100% of the children had antibody titers above the minimum protective level of 0.01 IU/ml and 86 to 100% (depending on prior vaccine product) had titers >0.1 IU/ml. However, only 0 to 40% of the children had antibody titers > or =1.0 IU/ml, a titer associated with more certain durable protection. For tetanus none of the children had an antibody titer below 0.01 IU/ml, and 93 to 100% had titers > or =0.1 IU/ml, a titer associated with more certain, durable protection. For pertussis the geometric mean concentrations of antibody before booster were uniformly very low, and the percentage of children exceeding the minimum detectable titer of antibody by 4-fold was also low. CONCLUSION: Before a 4- to 6-year-old booster, a large proportion of children have titers of antibody to diphtheria below the certain, durable protective level. Because serologic correlates and minimum protective titers of antibody to pertussis antigens have not been established, the relevance of the low titers determined in the current study is unknown but a potential concern.

Antibodies, Bacterial↗
PubMed1975

Combined diphtheria-tetanus immunization of adults.

The administration of a combined adult-type diphtheria-tetanus vaccine to a group of 35 adults seeking booster tetanus immunization produced a secondary immune response to the diphtheria antigen in 26. A satisfactory response to the tetanus antigen was noted in all those who gave a reliable history of active tetanus immunization, including eight individuals who had not received a dose of toxoid for 25 to 28 years. No systemic reactions were observed, but significant correlation was found between local reactivity and a high post-booster titre of tetanus antitoxin. Selective use of the combined vaccine instead of tetanus toxoid alone offers a means of raising the diphtheria immunity in the adult population.

Adult↗
PubMed1959

Consistency in potency assay of tetanus toxoid in mice.

The use of mice for the assay of tetanus toxoids would offer considerable advantages over the use of guinea-pigs, but mice cannot readily be immunized with the fluid tetanus toxoid at present designated as the International Standard. This study shows, however, that the mouse is a very suitable laboratory animal for the comparison of adsorbed tetanus toxoids, and that an AlPO(4)-adsorbed vaccine, which is stable at 4 degrees C, is a satisfactory reference preparation. The log-dose-response lines of toxoids adsorbed on different quantities of AlPO(4) and on various quantities of another adsorbent ran parallel to those of the reference vaccine. The 95% confidence limits for the potencies of tetanus vaccines, diphtheria-tetanus vaccines, and diphtheria-pertussis-tetanus vaccines, determined by assay against the reference vaccine in mice, showed a high degree of reproducibility of the results.

Animals↗
PubMed1996

Validation of the toxin-binding inhibition (ToBI) test for the estimation of the potency of the tetanus toxoïd component in vaccines.

A validation study has been performed to determine the suitability of the toxin binding inhibition (ToBI) test for the serological estimation of the potency of the tetanus toxoïd component in vaccines. 37 Murine serum pools over a wide range of antibody levels were titrated in both toxin neutralization (TN) and ToBI test. A good correlation was found between both assays. Sixteen DPT-polio, twelve DT-polio and seven T vaccines were tested in the mouse lethal challenge test and the in vitro serological test, using the ToBI test for determining vaccine-induced tetanus antibodies. For all three types of vaccine a statistically valid correlation between both assays was found. However, for two batches of DPT-polio vaccine an "overestimation" of the tetanus potency was observed in the serological assay compared to the challenge assay. This phenomenon could not be explained by the difference in immunization period nor by misinterpretation of the ToBI test of DPT-polio-induced antibodies. In the LPF test high LPF activity was observed for the deviating DPT-polio vaccines. Therefore, the effect of pertussis toxin (PT) on the potency of the tetanus component in the serological assay was examined. The addition of 2 micrograms of PT to a "normal" DPT-polio vaccine resulted in a nearly twofold increase of the tetanus potency. It was concluded that pertussis toxin has a vaccine dose-dependent adjuvant effect on the potency of tetanus toxoïd resulting in high potency values when determined by ToBI procedure. It is unclear how these findings should be interpreted with respect to the behaviour of such vaccines in man.

Animal Testing Alternatives↗
PubMed1976

Single - dose immunization of human subjects against tetanus.

A study was performed on human subjects to assess the effectiveness of single-dose immunization with 20 CU (1 ml) of adsorbed tetanus toxoid followed by revaccination with 10 CU (0.5 ml) 1 year later. Out of 1187 students, only those were selected for observation whose blood serum did not contain tetanus antitoxin (titre less than 0.001 IU/ml); this group counted 283 students. After administering the 20 CU (1 ml) of toxoid the antitoxin titre was repeatedly checked on days 10--15 and persons whose titre had risen to over 0.01 IU/ml were excluded from observation. The remaining 109 persons were tested for the antitoxin level 1 year later and revaccinated with 10 CU of tetanus toxoid. After 10--15 days their postrevaccination titre was determined. The single-dose immunization with 20 CU of tetanus toxoid in human subjects not given tetanus antigen previously was accompanied by a gradul rise in the antitoxin titre up to the protective level and its maintenance for 1 year (observation time) until revaccination. Revaccination with 10 CU of toxoid provided in 10--15 days a multiple (100--197fold) increase of the antitoxin titre, many times exceeding the protective level. The usefulness of transition to the shortened immunization scheme for tetanus prophylaxis of the adult population is discussed.

Adolescent↗
PubMed1978

Kinetics of oxygen consumption after a single isometric tetanus of frog sartorius muscle at 20 degrees C.

The time-course of the rate of oxygen consumption (QO2) has been measured in the excised frog sartorius muscle after single isometric tetani of 0.1-1.0 s at 20 degrees C. To measure deltaQO2(t), the change in QO2 from its basal level, a novel method was devised, based on the validity in this tissue of the one-dimensional diffusion equation for oxygen, established in the preceding paper. After a tetanus, deltaQO2 reached a peak within 45-90 s, then declined exponentially, and could be well fit by deltaQO2(t) = QO + Q1(epsilon -k1t - epsilon-k2t). tau2 (= 1/k2), which characterized the rise of deltaQO2, was a decreasing function of tetanus duration (range: from 1.1 +/- 0.28 min [nu = 5] for a 0.1-s tetanus, to 0.34 +/- 0.05 min [nu = 8] for a 1.0-sec tetanus). tau1 (= 1/k1), which characterized the decline of deltaQO2, was not dependent on tetanus duration, with mean 3.68 +/- -.24 min (nu = 46). A forthcoming paper in this series shows that these kinetics of deltaQO2 are the responses to impulse-like changes in the rate of ATP hydrolysis. The variation of tau2 with tetanus duration thus indicates the involvement of a nonlinear process in the coupling of O2 consumption to ATP hydrolysis. However, the monoexponential decline of deltaQO2(t), with time constant independent of tetanus duration, suggests that during this phase, the coupling is rate-limited by a single reaction with apparent first order kinetics.

Animals↗
PubMed1983

Correlated reduction of velocity of shortening and the rate of energy utilization in mouse fast-twitch muscle during a continuous tetanus.

Isometric tetani of slow-twitch soleus and fast-twitch extensor digitorum longus (EDL) muscles of the mouse were studied at 20 degrees C. The total energy cost for 3- and 9-s isometric tetani was measured as a function of length above L0 and partitioned into a filament overlap-dependent fraction and a smaller filament overlap-independent fraction. In both muscles, the rate of filament overlap-independent energy cost did not change with tetanic duration. In the EDL, but not in the soleus, the rate of filament overlap-dependent energy utilization was greater in a 3-s tetanus than in a 9-s tetanus. The force-velocity relationships were studied after 3 and 9 s of isometric tetanus. In the soleus, Vmax was 2 fiber lengths/s and was not dependent on the duration of isometric tetanus. In contrast, in the EDL, Vmas decreased from 5.9 fiber lengths/s at 3 s to 3.9 fiber lengths/s at 9 s. The velocity of unloaded shortening (Vus) was examined by the slack test method as a function of the duration of isometric tetanus duration over the range of 1-15 s. In the soleus, Vus did not change, whereas in the EDL, Vus declined progressively from 6.4 to 3.2 fiber lengths/s after an isometric tetanus of increasing duration from 1 to 15 s. These results cannot exclude the hypothesis that in a maintained tetanus there is a decrease in the intrinsic cross-bridge turnover rate in the fast-twitch EDL, but not in the slow-twitch soleus muscle.

Animals↗
PubMed2005

Analysis of the unfused tetanus course in fast motor units of the rat medial gastrocnemius muscle.

The course of unfused tetani with the sag effect in fast motor units of rat medial gastrocnemius was studied. The analysis of the course of successive contractions within these tetani showed that the high peak force at the beginning of tetanus before the sag resulted from temporary, very efficient sum mation of contractions at this phase, both in FF (fast fatigable) and FR (fast resistant to fatigue) units. The process of summation developed in spite of parallel shortening of the contraction and relaxation. The peak of tetanus force was visible on the average at the 2nd contraction in FF units and at the 5th contraction in FR units. After the tetanus peak the process of the efficient summation was completed and the force decreased what was visible as a sag. In the following part of the tetanus, mainly in FF units, the potentiation occurred and the force of successive contractions increased. The rise of force was visible in spite of shortening of the contraction time and was due to prolongation of the relaxation in this part of the tetanus. These observations indicated that the processes of the summation of successive contractions before sag and during the potentiation underwent different mechanisms discussed in this paper. Considerable release of Ca2+ ions from the sarcoplasmic reticulum was proposed as a possible mechanism responsible for a very efficient summation at the beginning of the tetanus whereas phosphorylation of regulatory light chain of myosin (RLC) in muscle fibers was considered as the reason of potentiation. Moreover, the present analysis revealed that previously found differences in tetani profiles between FF and FR units resulted from faster development of described changes in the course of contractions summating into the tetanus in FF motor units.

Animals↗
PubMed1979

[In-vitro effect of X-irradation on respiration and glycolysis of Ehrlich-ascitic carcinoma cells of the mouse--an experimental comparison with the mouse tumour-tetanus assay (author's transl)].

Depending on the dose of X-rays, in-vitro irradiation of Ehrlich-ascitic carcinoma cells of the mouse affected both respiration and glycolysis. 15,000 R irradiation suppressed the aerobic and anaerobic energy metabolism rather strongly followed by a reduction of the "take" and growth of the subcutaneously injected tumour cells, as opposed to the growth behaviour of non-irradiated cells. In analogy, tetanus mortality rates were reduced in the mouse tumour-tetanus assay with 15,000 R irradiated cells. On the other hand, irradiation with 2,000 R of Ehrlich carcinoma cells resulted in unchanged rates of respiration and glycolysis, in spite of the strongly limited growth capacity of the tumour cells. The tumour-tetanus assay of the mouse showed good correlation with subcutaneous tumour growth; no such correlation was found in the tetanus assay and the manometric values of respiration and glycolysis with 2,000 R irradiated tumour cells.--After subcutaneous injection of mixed cell suspensions consisting of 1 x 10(5) viable and 1 x 10(6) 15,000 R irradiated Ehrlich-ascitic carcinoma cells as well as of 3 x 10(2) tetanus spores per single dose, we observed similar rates of tumour growth, or tetanus mortality, respectively, if 1 x 10(5) viable tumour cells alone were administered together with 3 x 10(2) tetanus spores, without addition of irradiated tumour cells.

Animals↗
PubMed2005

Combined tetanus, diphtheria, and 5-component pertussis vaccine for use in adolescents and adults.

CONTEXT: Increasing reports of pertussis among US adolescents, adults, and their infant contacts have stimulated vaccine development for older age groups. OBJECTIVE: To assess the immunogenicity and reactogenicity of a tetanus-diphtheria 5-component (pertussis toxoid, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3) acellular pertussis vaccine (Tdap) in adolescents and adults. DESIGN, SETTING, AND PARTICIPANTS: A prospective, randomized, modified double-blind, comparative trial was conducted in healthy adolescents and adults aged 11 through 64 years from August 2001 to August 2002 at 39 US clinical centers. INTERVENTIONS: A single 0.5-mL intramuscular dose of either Tdap or tetanus-diphtheria vaccine (Td). MAIN OUTCOME MEASURES: Antibody titers to diphtheria and tetanus toxoids for Tdap and Td were measured in sera collected from subsets of adolescents and adults, before and 28 days after vaccination. For pertussis antigens, titers in sera from Tdap vaccinees were assessed vs those from infants who received analogous pediatric diphtheria-tetanus-acellular pertussis vaccine (DTaP) in a previous efficacy trial. Safety was assessed via solicited local and systemic reactions for 14 days and adverse events for 6 months following vaccination. RESULTS: A total of 4480 participants were enrolled. For both Tdap and Td, more than 94% and nearly 100% of vaccinees had protective antibody concentrations of at least 0.1 IU/mL for diphtheria and tetanus, respectively. Geometric mean antibody titers to pertussis toxoid, filamentous hemagglutinin, pertactin, and fimbriae types 2 and 3 exceeded (by 2.1 to 5.4 times) levels in infants following immunization at 2, 4, and 6 months with DTaP. The incidence of solicited local and systemic reactions and adverse events was generally similar between the Tdap and Td groups. CONCLUSIONS: This Tdap vaccine elicited robust immune responses in adolescents and adults to pertussis, tetanus, and diphtheria antigens, while exhibiting an overall safety profile similar to that of a licensed Td vaccine. These data support the potential routine use of this Tdap vaccine in adolescents and adults.

Adolescent↗
PubMed2003

An experimental divalent vaccine based on biodegradable microspheres induces protective immunity against tetanus and diphtheria.

In an endeavor towards development of multivalent vaccines based on biodegradable microspheres, we tested the immunologic performance of several divalent microsphere formulations against tetanus and diphtheria. Microspheres were made by separate microencapsulation of tetanus and diphtheria toxoid in poly(lactide-co-glycolide) by either spray-drying or coacervation. Guinea pigs were subcutaneously immunized by a single injection of the divalent vaccines or, for control, an equivalent dose of a licensed vaccine containing both antigens adsorbed on aluminium hydroxide. All microsphere formulations were strongly immunogenic, irrespective of particle size and hydrophobicity. End point titers of ELISA antibodies, mainly of the IgG1 subtype, were comparable to those obtained after immunization with the licensed vaccine. The microspheres provided increasing levels of antibodies, during the 16 weeks of testing, and the antibodies were weakly polarized towards tetanus. The induced antibodies were also toxin neutralizing, as determined for both diphtheria (1-4 IU/mL) and tetanus (5-9 IU/mL) 8 weeks after immunization. These neutralization levels were several orders of magnitude above the level considered minimum for protection (0.01 IU/mL). When the animals were challenged with tetanus or diphtheria toxins 6 weeks after immunization, microsphere vaccines produced protective immunity that was comparable to or better than that induced by the licensed divalent vaccine. In conclusion, this study showed that a single administration of biodegradable microsphere vaccines provided protective immunity against diphtheria and tetanus, and that this immunization approach might be feasible for multivalent vaccines.

Animals↗
PubMed1989

Combined estimation of tetanus and diphtheria antitoxin in human sera by the in vitro Toxin-Binding Inhibition (ToBI) test.

The use of the principle of inhibition of toxin binding to an antitoxin coated immunoassay plate as described in a previous paper for tetanus antitoxin titration, was adapted for the estimation of diphtheria antitoxin in human sera. With a few modifications, a Toxin-Binding Inhibition (ToBI) test was developed which could be used for a combined estimation of both tetanus and diphtheria antitoxin levels. The application of streptavidin-biotinylated peroxidase complex when using small serum samples (less than 50 microliters) is discussed. Antitoxin titres (both diphtheria and tetanus) of 0.002 IU ml-1 were detectable by the ToBI test, this being far below the level considered to be protective in man. Sera from 140 adults with different vaccination histories were titrated for both tetanus and diphtheria antitoxin. Good correlations were found between the estimates obtained by the ToBI test and those obtained by the toxin-neutralization (TN) test in mice (tetanus antitoxin) and those obtained in the in vitro neutralization test in VERO cells (diphtheria antitoxin). It is concluded that the ToBI test is a simple and reliable alternative to the functional models currently in use for the estimation of diphtheria and tetanus antitoxin levels. In addition, the ToBI test eliminates the need for laboratory-animal or cell-culture facilities and can be performed with small quantities of serum as required in field trials.

Animals↗
PubMed1987

Human T4+ T-lymphocyte clones specific for the B fragment of tetanus toxin.

Two T4+ cloned T-lymphocyte lines specific for a papain digest product of tetanus toxin are functionally characterized. The two clones were obtained from peripheral blood mononuclear cells activated in vitro by tetanus toxoid, expanded with IL-2, and cloned in soft agar. Both clones could be induced to undergo blastogenesis with tetanus toxoid, tetanus toxin, and the B fragment but not the C fragment of tetanus toxin. In addition, both clones caused cytolysis of plastic adherent cell targets cocultured for 18 hr with either tetanus or the B fragment. Antigen specific proliferation and cytolytic activity were MHC-class I restricted.

Cell Line↗