1/6. trismus: or is it tetanus? A report of a case.Tetanus is a life-threatening infection that is rare in the developed world. trismus and dysphagia are the most common presenting symptoms, and thus oral and maxillofacial surgeons may be involved in the early stages of evaluation of the patient. early diagnosis helps initiate prompt management and referral for intensive therapy. This article is a case report of severe generalized tetanus with a discussion of its diagnosis, pathophysiology, and management.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/6. immunity against tetanus and effect of revaccination 25-30 years after primary vaccination.Fall off in tetanus immunity and the effect of late revaccination were investigated in a randomly selected group of Danes aged 25-30. Routine reinforcing doses of tetanus toxoid are not customary in denmark except at injury and when there are certain occupational risks. 11% of the total group of 418 had antitoxin titres below that required for protection (ie, less than 0.01 IU/ml, determined by neutralisation technique). In those who had received only primary vaccination an exponential fall off in immunity was seen, and 25-30 years after primary vaccination, 28% had serum antitoxin concentrations below the level of protection. Up to 30 years after primary vaccination, one reinforcing dose of tetanus toxoid adsorbed by aluminium hydroxide was sufficient to induce protective titres of antitoxin. There were no serious side-effects and it was concluded that routine reinforcing doses of tetanus toxoid should be given before the age of 20 in denmark and other countries where primary vaccination is given in the first years of life.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/6. Botulinum toxin A for trismus in cephalic tetanus.Cephalic tetanus is a localized form of tetanus. As in generalized forms, trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (clostridium tetani and clostridium botulinum, respectively), and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/6. Healthy aging: guidelines for cancer screening and immunizations.With increasing life expectancy over the past 50 years, screening for treatable illness and active measures to prevent disease and promote a healthy lifestyle have become increasingly important for older patients. In general, the benefits of such efforts have become more apparent, but depend also upon general health and life expectancy of the individual. Tests for malignancies of the breast, cervix, prostate, colon, skin, and oral cavity are considered to meet screening criteria. immunization guidelines have been recently updated, and good evidence supports the benefit of protecting older patients from influenza and pneumococcal pneumonia. counseling on prevention of falls and injuries in the home and on the highways can help reduce the risk of accidents.- - - - - - - - - - ranking = 3keywords = life (Clic here for more details about this article) |
5/6. Neonatal tetanus in the united states: a sentinel event in the foreign-born.BACKGROUND: Neonatal tetanus occurred in a 7-day-old infant born to Mexican immigrant parents in tennessee in February, 1995. This was the first patient with neonatal tetanus reported in the united states since 1989. methods: We interviewed the infant's mother and physicians and reviewed the medical record. We conducted a telephone survey of 103 (17%) of the 609 licensed obstetrician/gynecologists practicing in tennessee to assess vaccination history-taking practices during prenatal care. RESULTS: The mother was a 30-year-old gravida 4 para 3 woman who grew up in rural mexico. After moving to the united states in 1987, she had delivered two children before this delivery. The hospital-based delivery and nursery stay in February, 1995, were uncomplicated. On the sixth day of life the infant became irritable and developed muscle stiffness. The next day he was examined by a pediatrician who diagnosed neonatal tetanus. The infant recovered fully after a 2-month hospitalization. The survey of obstetrical practices revealed that 61 (59%) of 103 respondents asked about the patient's vaccination status during prenatal care. However, of all respondents, only 14 (14%) confirmed that they specifically asked about prior tetanus vaccinations. tetanus toxoid was available in 47% of offices on the day of the survey. CONCLUSIONS: Neonatal tetanus can still occur in the united states. This infant's immigrant mother had multiple missed opportunities to be vaccinated against tetanus during her three pregnancies in this country. health care providers should ask patients about their vaccination status, particularly those patients who are foreign-born or who grew up outside the united states.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/6. Tetanus: critical implications for nursing.In the united states today, tetanus is a rare disease. However, when it occurs, it can be a highly challenging situation for all members of the healthcare team. The majority of care during the course of the disease is supportive. The availability of personnel trained in managing cardiorespiratory emergencies and sustained mechanical ventilation in the ICU environment can have a beneficial effect on patients' outcomes. An awareness of the potential complications of tetanus can hasten recovery and maintain the patient's preexisting quality of life.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |