[Current possibilities of optimizing emergency tetanus immunization]. / Posibilitati actuale de optimizare a imunizarii antitetanice de urgenta.

Retrospective analysis of the tetanus cases, admitted over a six year period, shows the high risks involved by the insufficient immunoprotection. The failure of emergency immunization, with its effects on the incidence and evolution of the disease, may be accounted for by : the difficulty in establishing the vaccination past history, probable decrease of protection with time due to basal immunization, inconstant response to the booster dose, immunodepressive side effects, the drawbacks of antitoxic serum. With reference to their own experience and the published data concerning the methods applied for obtaining a more rapid response to anatoxin and possible optimizing of the protective titre concurrent with the incubation period of tetanus. Experimental investigations have demonstrated the superiority of repeated, multifocal inoculations for obtaining an earlier antitoxic immunity.

[Risks of therapy in infectious shock]. / Riscurile terapiei în socul infectios.

On the basis of their experience in the intensive therapy unit, correlated with modern pharmacokinetic data, the authors discuss the adverse effects induced by polyvalent therapy in septic shock, and which may be listed in the group of iatrogenic pathointerference. To the biochemical and functional alterations of shock may be added the possible effects of antibioticotherapy, corticotherapy, plasma expanders, lipid emulsions, crystalloid solutions, alkaline correcting solutions, osmotic diuretics, oxygenotherapy, vasoactive drugs, heparin and epsilon-amino-caproic acid. The possible summation of these effects should be indicated in the rules for observance by the medical staff of intensive therapy units.

[Mucoproteinuria in complicated scarlet fever]. / Mucoproteinuria in scarlatina complicata.

Mucoproteinuria, determined by Bugard's semiquantitative method, revealed values of 100-350 mg/24 h in common scarlet fever and of 300-882 mg/24 h in scarlet fever complicated by early nephritis, pseudorheumatism and acute diffuse glomerulonephritis. These alterations appear to lend support to the recent hypothesis concerning the mucoprotein substrate of the autoimmune mechanism in the complications of streptoccal infection.

[Pathogenicity expressed by inhibition of the Pasteur effect]. / Patogenitatea exprimata prin inhibitia efectului Pasteur.

The experiments carried out demonstrate that under the influence of tetanus exotoxin, Gram-negative bacteria endotoxins, staphylococcal infection and infestation with Tr. spiralis, inhibition of the Pasteur effect occurs. Recently published data show that the same manifestation of pathogenicity is induced by diphtheria alpha and delta exotoxin, staphylococcal toxin, Pseudomonas aeruginosa exotoxin, staphylococcal enterotoxin, streptolysin O, infections with Cl. perfringens, Pasteurella and Rickettsia and hepatitis viruses in man. These data confirm a previous hypothesis according to which inhibition of the Pasteur effect represents the expression and metabolic measure of pathogenicity and toxicity. The inhibitory effect was proportional to the amount of pathogenic agent or toxin, just as the respective anatoxin or toxin + endotoxin mixture does not influence the Pasteur effect. The metabolic criteria of the Pasteur effect, i.e. inhibition of hyperlactacidaemia and decrease of the organic P/inorganic P ratio, are thus the direct indices of pathogenicity and toxigenicity. This also accounts for deep alteration of the Pasteur effect in infections generating states of infectious and endotoxinic shock.

[Immunopathological circumstances in the structure of complications appearing after smallpox vaccination]. / Circumstante imunopatologice în structura accidentelor survenite dupa vaccinarea antivariolica

Investigations were carried out concerning the dynamics of antivaccinal antibodies and the structure of serum proteins in relation to the clinical manifestations following upon smallpox vaccination. In general, immunity is not apparently influenced by postvaccinal complications may be associated with immunoprotein perturbations, manifested by an increase in the alpha2-globulin fraction and, inconstantly, in the gamma-globulin fraction. Immunoelectrophoretic determinations revealed a relatively constant IgM and IgG deficiency. Postvaccinal dysglobulinemia may accompany various clinical forms, suggesting a temporary deficient immunological response. In one case of agammaglobulinemia, revaccination produced a deep vaccinal ulcer, with extensive necrosis (giant necrotic vaccinia). In order to decipher the substrate of the reaction in the clinical forms with distal manifestations or generalized vaccinia, skin biopsies were performed. The lesional vasculoallergic substrate of the skin lesions does not exclude the local aggression of the vaccinal virus, which was isolated by viral determinations.

[Fuctional-metabolic disorders in typhoid infection]. / Tulburari fuctional-metabolice in infectia tifica

The complex biologic investigation of thyphoid fever is dictated by the necessity of instituting a pathogenetic therapy, especially in the toxic and complex forms. Performing 178 fuctional-metabolic tests in 50 cases of typhoid fever (of which 10 severe and complicated forms), the authors established the prognostic value energy deficiency (approximately P), lactate, alkaline reserve and GPT. Azotemia is only characteristic in the forms with renal involvement, and the other transaminases may be positive even whe the liver is not enlarged. In one case of repeated digestive hemorrhage no evidence could be found of the mechanism of consumption coagulopathy.

[Possibilities of correcting some metabolic disorders in experimental endotoxic shock by treatment with a combination of alpha-lipoic acid and epsilon aminocaproic acid]. / Posibilitati de corectare a unor tulburari metabolice din socul endotoxic experimental prin asociatia acid alpha-lipoic--acid epsilon-aminocaproic

Alpha-Lipoic acid associated with xi-aminocaproic acid proves to have a protector effect in the posttreatment of endotoxinic shock in rabbits, produced by the administration of E. coli O111, in doses of 1.5 mg/kg body weight. This effect was observed when administered early in the stage of energy privation, and was manifested by a longer survival, diminution of lactacidemia and protection of labile phosphate reserves.

[Major objectives of pathogenic therapy of septicemia]. / Objective majore în terapia patogenica a septicemiilor

On the bases of the published data and their own experience the authors outline the context of the functional biochemical alterations that give an orientation in the choice of the major objectives of pathogenic therapy in the course of septicemias. Analysis of the frequency and intensity of these alterations make it possible to establish therapeutical priorities. In this sense it is demonstrated that hyperazotemia, hyperalbuminemia, low alkaline reserve, elevated serum lactate and a decrease in the plasma Na+/K+ ratio are characteristic of septicemia with a state of toxiinfectious shock.