Intrathecal Human Tetanus Immunoglobulin in Early Tetanus

Gupta, P. P.; Goyal, Sandeep; Kapoor, Ram; Batra, Vandana; Jain, BS

doi:10.1016/s0140-6736(80)91883-8

Cited by 67 publications

(25 citation statements)

References 6 publications

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“…El 27.7% de los pacientes inició su enfermedad con disfagia (con o sin trismos), pero a diferencia de los considerado por algunos autores (2), ésta no se asoció significativamente con cuadros severos de tétanos (Tabla N°6). Probablemente esto se deba a que la mayoría de pacientes presentan disfagia como consecuencia del trismos (13,14,20) pero el dato no siempre es indagado adecuadamente.…”

Section: Discussionunclassified

Criterios de pronóstico en el tétanos del adulto.

Légua¹,

Ocharan²

2013

Rev Med Hered

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SUMMARYThe records of 76 patients with tetanus were reviewed. Factors associated with severe/ very severe cases were: age ≥ 70 years, incubation period ≤7 days, a time from first symptom to admission ≤ 4 days and a surgical portal of entry. Three different prognostic classifications were evaluated. Because of the small sample size, letality result found have very wide confident intervals, which do not allow the detection of possible significant differences in letality between confident intervals, whitch do not allow the detection of possible significant differences in letality between the three classifications. We consider that the classification which takes into account the time from first syptom to admission and the presence of spasms, is the most simple and easy to reproduce in an urban and urban-marginal area. ( RESUMENSe revisó las historias clínicas de 76 pacientes con tétanos del adulto. Los factores asociados significativamente a los casos severos/muy severos fueron: una edad ≥ 70 años, un periodo de incubación ≤ 7 días, un tiempo de enfermedad ≤ 4 días y una puerta de entrada quirúrgica. Se evaluó tres clasificaciones de pronóstico diferentes. Debido al tamaño pequeño de la muestra, los resultados de letalidad encontrados tienen intervalos de confianza muy amplios, lo que no permite detectar diferencias significativas en la letalidad entre las tres clasificaciones. Consideramos que la clasificación que toma en cuenta el tiempo de enfermedad y la presencia de espasmos, es la más simple y fácil de reproducir en el medio urbano y urbano-marginal. (Rev Med Hered 1993; 4(4): 165-172)

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Section: Discussionunclassified

Criterios de pronóstico en el tétanos del adulto.

Légua¹,

Ocharan²

2013

Rev Med Hered

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“…The most frequently cited are duration of hospitalization, length of stay in the intensive care unit, the need for and the duration of respiratory assistance, frequency of complications, the clinical progression of the disease, the need for tracheotomy, and the sedative dose needed to control spasms, as well as lethality (1,8,16,19,(24)(25)(26)(27)(28)(29)(30).…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, it may be a tool for the determination of the clinical condition of tetanus patients at a specific time independently of what is suggested by prognostic indicators. These classifications are usually based on clinical manifestations (2,(11)(12)(13)(14)(15)(16)(17)(18) D.B. Miranda- Filho et al and can be used to monitor the evolution of the disease after treatment has been initiated by comparing the classification established upon admission to reclassifications carried out throughout the hospital stay (16).…”

Section: Introductionmentioning

confidence: 99%

“…These classifications are usually based on clinical manifestations (2,(11)(12)(13)(14)(15)(16)(17)(18) D.B. Miranda- Filho et al and can be used to monitor the evolution of the disease after treatment has been initiated by comparing the classification established upon admission to reclassifications carried out throughout the hospital stay (16). However, there are as yet few studies that assess or validate and standardize a classification that encompasses the evolutional dynamics of tetanus.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical classification of tetanus patients

Miranda-Filho¹,

Ximenes²,

Barone³

et al. 2006

Braz J Med Biol Res

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The authors propose a clinical classification to monitor the evolution of tetanus patients, ranging from grade I to IV according to severity. It was applied on admission and repeated on alternate days up to the 10th day to patients aged ≥12 years admitted to the State University Hospital, Recife, Brazil. Patients were also classified upon admission according to three prognostic indicators to determine if the proposed classification is in agreement with the traditionally used indicators. Upon admission, the distribution of the 64 patients among the different levels of the proposed classification was similar for the groups of better and worse prognosis according to the three indicators (P > 0.05), most of the patients belonging to grades I and II of the proposed classification. In the later reclassifications, severe forms of tetanus (grades III and IV) were more frequent in the categories of worse prognosis and these differences were statistically significant. There was a reduction in the proportion of mild forms (grades I and II) of tetanus with time for the categories of worse prognostic indicators (chi-square for trend: P = 0.00006, 0.03, and 0.00000) whereas no such trend was observed for the categories of better prognosis (grades I and II). This serially used classification reflected the prognosis of the traditional indicators and permitted the comparison of the dynamics of the disease in different groups. Thus,

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“…Extensive studies were done to determine the optimal dose of antitoxin and the possible benefit of intrathecal antitoxin, particularly in tetanus neonatorum, a common problem in developing countries (68). Since 1960, a human tetanus immune globulin (TIG) has been available in the United States, but in some areas of the world only equine antitoxin is available.…”

Section: Tetanusmentioning

confidence: 99%