Spontaneously reported adverse reactions after diphtheria–tetanus revaccination at 4–6 years of age—a comparison of two vaccines with different amounts of diphtheria toxoid

On 1 January 1996, diphtheria-tetanus revaccination at the age of 5 years was implemented in the Danish Childhood Vaccination Programme. Initially, a combined DT vaccine containing 25 Lf diphtheria toxoid was used. Due to a high frequency of spontaneously reported adverse reactions, however, concerns were raised that the diphtheria dose was too high, and it was reduced to 6.25 Lf. This survey presents the rates of spontaneously reported adverse reactions following diphtheria-tetanus revaccinations of 4-6-year-old from 1996 to 2002. The change to the lower dose of diphtheria toxoid resulted in a remarkable reduction in the yearly rates of injection site reactions: in 1996, the rate was 180 injection site reactions per 100,000 vaccinations; from 1998 to 2002, this changed to between 12 and 24 reactions per 100,000 vaccinations. Furthermore, the rates of systemic reactions such as fever were reduced.

Systemic absorption of metronidazole after application of a metronidazole 25% dental gel

Systemic absorption of metronidazole was studied after one application of a metronidazole 25% dental gel into inflamed periodontal pockets. 14 patients with periodontal disease participated. Metronidazole gel was applied into the pockets of all teeth with probing depth > or = 5 mm, minimum 10 teeth/patient. Excess gel was carefully collected in order to calculate the amount of metronidazole applied into the pockets. Blood samples for analysis of metronidazole in plasma were taken before and up to 72 h after application. To determine the bioavailability of metronidazole administered as gel, the patients were later given an i.v. dose of 100 mg metronidazole. Metronidazole was quantified by HPLC. The mean actual dose of metronidazole in gel was 55 mg (SD: 24 mg, range: 29-103 mg). Allowing for the fact that excess gel corresponding to about 60% of the applied amount of metronidazole under normal clinical conditions may be swallowed, the systemic load after one application of metronidazole 25% dental gel will still be less than after one metronidazole 250 mg tablet. Peak plasma concentrations varied between 223 and 1303 ng/ml (mean: 581 ng/mk, SD: 320 ng/ml) and were reached within 2 to 8 h (mean: 4.4 h). The mean bioavailability of metronidazole dental gel was 71%.

[Assessment of the diet of malnourished outpatients with chronic obstructive respiratory insufficiency]

We investigated the daily diets of malnourished patients with chronic obstructive ventilatory insufficiency. A total of 28 patients with body weights of less than 80% of ideal body weight were included. The patients were all ambulatory and in a stable phase of their illness. Their diets were assessed by dietary registration covering seven days. Basal energy expenditure was calculated using the Harris-Benedict equation. On an average these patients had a daily energy intake of 205% of their total energy expenditure, which is significantly higher than the value of 150% of basal energy expenditure considered sufficient for normal daily activity (p less than 0.0001). We conclude that low energy intake is not the cause of low body weight in these patients. They seem to be in a hypermetabolic state which may be due to the increased energy demand of the exertion of breathing.

[Diet and health. A survey of diet and health in women 40-50 years of age]

During the period 1980-1986, the Housekeeping Committees of the Danish Rural Institute carried out individual investigations of the diets of 513 women aged 23-50 years. Out of these, 124 were in the age group 40-50 years and this group was selected for health investigation. A Danish version of the Cornell Medical Index questionnaire with 138 enquiries about current and previous health conditions was sent to the 108 women who agreed to participate. All of these were visited in their homes by a doctor who reviewed the replies to the questionnaire and collected supplementary information for use in the diagnostic history. Only few cases of diseases of civilization were found and there were no cases of cancer. The current state of health was assessed summarily on the basis of the number of affirmative replies in the questionnaire. A statistical connection was found between the state of health and the combination of the fat-energy percentage and the vegetable roughage in the diet.

Nutritional repletion in malnourished patients with emphysema

We examined the effect of nutritional supplementation for 13 wk on anthropometric, pulmonary function, and immunological status in malnourished ambulant patients with pulmonary emphysema (EP). The study was placebo controlled, randomized and double blind. Twenty-eight patients were included. Thirteen patients in the fed group were provided with a nutritional formula providing 20% protein, 30% fat, and 50% carbohydrate, 1 Kcal/ml, 400 ml/day. The control group was provided with a reference product of the same consistency and taste containing 0.1 Kcal/ml, 400 ml/day for 13 wk. The fed group had a mean weight gain of 1.5 kg during the study period, the control group increased concomitantly 0.16 kg, the difference being significant (p less than 0.01). Sum of four skinfolds increased 2.7 mm in the fed group, and decreased 0.9 mm in the control group the difference being significant (p less than 0.01). No difference were observed regarding pulmonary function or immunological status. We also found a high habitual energy intake in our study group (204% Basal Energy Expenditure). We conclude that nutritional supplementation produce weight gain in malnourished patients with EP, but it does not change other indices of well-being.

Benign mesenchymoma in the trachea of a patient with the nevoid basal cell carcinoma syndrome

A case of benign mesenchymoma within the trachea of a patient with the nevoid basal cell carcinoma syndrome (NBS) is presented. The patient presented himself with stridor. After excision the tumour recurred twice, confirming that the treatment of choice is wide, local excision.

Preoperative swabs for the treatment of draining ears after middle ear surgery

The value of a preoperative swab for the treatment of postoperative infection after middle ear surgery was investigated. In a selected group of 80 patients with postoperative infection a preoperative swab was available, and the variability was analysed for each species. The well-known pathogens Pseudomonas aeruginosa, Staphylococcus aureus, Proteus and Escherichia coli showed good correlation between pre- and postoperative swabs. In contrast to this all other species found in preoperative swabs were of little value postoperatively. This observation is important for the treatment of infection after middle ear surgery, and should be considered if prophylactic antibiotics are planned.