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PubMedDate not supplied

Debridement methods in wound care.

Wound debridement is an essential part of effective wound care. There are many methods of debriding wounds and it is important that patients are involved in the decision so that they are able to give informed consent. To make effective clinical decisions and ensure patients are fully informed it is essential that nurses are aware of the different methods of debriding wounds. The nurse should also be aware of the professional requirements for competence and the risks and benefits of each method. A guideline for conservative sharp debridement has recently been published by the Tissue Viability Nurses Association (TVNA 2005), and this article reviews the issues related to the procedure and the alternatives available.

Animals↗
PubMed1990

Intradermal antigen tests in psoriasis.

To assess whether elicitation of delayed hypersensitivity may be superior to trauma in inducing the Koebner reaction in psoriasis, 12 affected patients and 9 control subjects were tested with 0.1 ml intradermal injections of streptokinase/streptodornase (20 mu/5 mu per 0.1 ml), PPD (1 in 1000) and saline control solutions in a double-blind study; Koebner status was also established in the psoriatic patients. Injected sites were examined at 48 h and 7, 14, 21 and 28 days for local development of psoriasis, erythema and induration (diameter). One patient was Koebner-positive and developed psoriasis at all three injection sites. The other, Koebner-negative psoriatic subjects did not develop psoriasis locally. However, compared with non-psoriatic controls they showed a marked delay in resolution of the delayed hypersensitivity reaction to the PPD antigen and a similar but less marked phenomenon was observed for streptokinase/streptodornase. These findings indicate that intradermal antigen, of the nature and amount used in this study, is no more effective in inducing the Koebner phenomenon than injury alone. However, the ability of psoriasis patients to switch off cell-mediated immune reaction appears to be impaired.

Adult↗
PubMed1978

Immune function in ankylosing spondylitics and their relatives: influence of disease and HLA B27.

So as to distinguish the separate influences of ankylosing spondylitis (AS) and possible HLA B27 associated immune response genes on immune response patterns, a battery of immunological tests were performed on fourteen patients with AS and their first-degree relatives. Previously unrecognized AS was detected by clinical and radiological means. Individuals with ankylosing spondylitis had significantly higher serum IgG and IgA concentrations than both their B27 positive and B27 negative relatives. B27 positive relatives had significantly lower phytohaemagglutinin (PHA) lymphocyte transformations than B27 negative relatives (P less than 0.01), while there was no difference between the ankylosing spondylitic and B27 positive groups. Antibody titres to Streptokinase/Streptodornase were significantly higher in the B27 positive individuals, with or without AS, than their B27 negative relatives (P less than 0.005 and P less than 0.02 respectively). These results show that serum immunoglobulin differences were associated with disease, while differences in PHA stimulation and varidase antibody titres were associated with the B27 antigen. These findings may indicate the presence of HLA associated immune response genes including those involved with reactions to a particular antigenic component of Streptokinase/Streptodornase.

Adolescent↗
PubMed1975

T rosettes in alcoholic cirrhosis of the liver.

Thirty patients with alcoholic cirrhosis of the liver were studied for in vivo and in vitro correlates of cellular immunity. Seventy-seven percent failed to be sensitized to dinitrochlorobenzene, indicating impairment of the in vivo cellular immune response. A significant decrease in the number of T-rosette-forming cells was observed in this group of patients (.01 smaller than P smaller than .025). This finding suggests that the active T-rosette test is a valuable tool in detecting partial alterations in cell-mediated immunity in alcoholic cirrhosis of the liver. Our results also suggest that rosette formation is a more sensitive indicator of cell-mediated immunity than phytohemagglutinin-stimulated blastogenesis in patients with alcoholic cirrhosis of the liver.

Alcoholism↗
PubMed1975

Use of transfer factor in patients with depressed cellular immunity and chronic infection.

Two patients with chronic mucocutaneous candidiasis and a defect in cellular immunity received a single injection of dialysable transfer factor from Candida-positive donors in an effort to reconstitute immunologic function. The transfer of cellular hypersensitivity was successful in one of the two patients and was monitored by skin tests and MIF production; however, the effect was temporary and did not change the clinical course of the patient's infection. The other patient did not respond eitherimmunologically or clinically to transfer factor at this time, although she did respond subsequently to repeated doses of transfer factor and amphotericin B therapy (Pabst and Swanson: Brit. med. J. 2:442, 1972). In another instance transfer factor from tuberculin-positive donors was used successfully to eradicate an infection in a patient with progressive primary tuberculosis and an acquired defect in cellular immunity. The patient had not responded clinically or bacteriologically after 7 1/2 months of antituberculous therapy, although the organism was shown to be sensitive in vitro to the drugs she was receiving. She received 6 doses of dialysable transfer factor over a 3-month period and during this time she responded clinically, bacteriologically and roentgenographically.

Adult↗
PubMed1975

Restoration of cell-mediated immune responses with transfer factor.

Five anergic patients with chronic mucocutaneous candidiasis were given transfer factor from donors with positive delayed reactions to Candida. In each recipient, the delayed skin reactions of the transfer factor donors appeared in the recipients and no recipient developed reactivities not possessed by the donor. Prior to injection of transfer factor, in vitro stimulation of the patients' lymphocytes with antigens did not result in MIF production, however, after transfer factor this response was positive. Therapy with transfer factor alone did not have therapeutic benefit, however, in 2 patients treatment with amphotericin-B followed by transfer factor has produced cutaneous remissions of 18 months.

Candida albicans↗
PubMed1975

Immunodepression after major surgery in normal patients.

Multiple parameters of in vivo and in vitro immune function were measured serially before, during, and following nephrectomy in 12 normal renal transplant donors. All in vitro functions studied (total blood lymphocyte count, B-cell count, T-cell count, mitogen blastogenic response, and mixed leukocyte reactivity as both responder and stimulator) decreased on induction of anethesia and continued to fall during and after operation to reach a low point on the evening after nephrectomy. Depth of depression and rate of recovery varied with the individual function, but all were near normal by the fifth postoperative day. The in vivo delayed hypersensitivity response to cutaneously administered recall antigens declined more gradually and was still falling at the fifth postoperative day. Return of preoperative skin response was delayed, being complete for streptokinase/streptodornase (SK/SD) by 10 to 14 days but incomplete as long as 2 to 3 weeks for mumps and Candida antigens. Serum immunoglobulins did not change. These findings suggest incomplete correlation among the responses to the commonly used in vitro assays of cellular immunity and poor correlation with the in vivo tests. Although surgery and anesthesia results in measurable depression of immune response, clinically significant problems did not arise in these patients.

Adolescent↗
PubMed1975

Studies on the production of MIF and mitogenic factor using highly purified human T and B lymphocytes.

Human lymphocytes were separated into highly purified populations using an immunoadsorbent column technique. It was previously reported that both T and B cells exhibited increased 3H-thymidine incorporation in response to PHA, Con A and pokeweed mitogens, whereas only T cells showed increased incorporation in response to specific antigen. In the present studies, the cellular basis of MIF and mitogenic factor production was studied. Both T and B cells produced MIF in response to antigen. The MIF produced by both T and B cells elutes from Sephadex G-100 columns in the same fraction. Studies using BUdR and light suggest that the T cell which produces MIF is also a proliferating cell, whereas the B cell producing MIF is not. Only T cells produce mitogenic factor in response to antigen. The mitogenic factor produced, however, causes both T and B cell populations to increase 3H-thymidine incorporation. The present studies indicate that antigen induced mitogenic factor production and increased 3H-thymidine incorporation are properties of T cells per se, whereas antigen-induced MIF is made by both T and B cells.

Antigens, Bacterial↗
PubMed1975

Immunodeficiency in Hodgkin disease.

The immunodeficiency in Hodgkin disease is characterized by a defect in cell-mediated immunity. Recent studies have reported that delayed hypersensitivity responses (DHR) are normal in untreated patients with early disease. The present study evaluated the DHR of 218 untreated patients using 2,4-dinitrochlorobenzene and a battery of intradermal antigens. The results confirm an immune deficiency in early stages which is not an all-or-none phenomenon and may be unmasked by using lower concentrations of antigens.

Adolescent↗
PubMed1975

Bone marrow and thymus transplantation in ataxia-telangiectasia.

Serum IgA concentrations were found to be normal in a boy with ataxia-telangiectasia and selective IgA deficiency several months after an infusion of bone marrow cells from an HL-A and MLR compatible normal sib. In addition, transient improvements were noted in both his in vivo and in vitro cellular immune responsiveness through the third month posttransplant. Despite this, no evidence of chimerism could be detected in karyotypic studies of his peripheral blood lymphocytes and bone marrow cells. No clinical or significant immunologic improvement was noted in his affected female sib following implantation of a fetal thymus or injection of transfer factor.

Ataxia Telangiectasia↗
PubMed1975

Transfer factor therapy: evidence for nonspecificity.

Four patients were treated with multiple doses of dialyzed transfer factor in which one Wiskott-Aldrich patient with abnormal IgG monocyte receptors obtained benefit. All patients converted skin reactivity, and had improved in vitro lymphocyte responses to varying degrees. Three patients developed positive reactivity to allogeneic cells in MLC, and one patient developed DNCB reactivity. These latter two findings suggest transfer factor may act by inducing a nonspecific maturation of lymphocyte function. A possible mechanism for the action of transfer factor is discussed.

Antibody Formation↗
PubMed1975

Suppression of lymphocyte activation by a factor produced by Mycoplasma arginini.

Mycoplasma arginini, when grown in broth or in cultures of human lymphoblast cell lines, inhibits activation of lymphocytes by allogeneic cells of mitogens. This inhibition can also be produced by cell free media obtained after the growth of this organism. Inhibition is not species specific and inhibits both B and T cell activation in the mouse. The inhibitory factor is required during the first 3 days of the mixed leukocyte culture, but has no effect on the latter phase of this reaction when thymidine uptake is greatest. The factor is stable to treatment at 60 degrees, but not 90 degrees, for 30 min.

Animals↗
PubMed1976

Immediate and delayed hypersensitivity in chronic dermatophytosis.

Delayed hypersensitivity (DH) to seven common antigens was examined in 38 men with chronic dermatophyte infections and in 20 controls. A similar percentage of the infected and the control groups reacted to four antigens. In addition to showing a low frequency of DH to trichophytin, the infected group also showed a significant reduction in their reactions to intradermal mumps skin test antigen and to a Rhus oleoresin patch test. Two members (5%) of the infected group were anergic to all tests. Patients with chronic dermatophytosis appear to have a relatively specific defect in DH to trichophytin, but their cell-mediated responses to other antigens may also be somewhat decreased. The subjects studied did not appear to suffer excessive morbidity from infectious diseases, other than dermatophytosis.

Adult↗