Pneumococcal Vaccination in Splenectomized Patients with Hematological Disorders

Abstract. Seventy splenectomized patients were vaccinated with Pneumovax®, a pneumococcal polysaccharide vaccine. Twenty-four of the patients had a malignant and 30 a non-malignant hematological disorder. The remaining 16 were patients with no known hematological disorder, seven with intra-abdominal carcinomas and nine with non-malignant reasons for splenectomy. About 90% of the patients with non-malignant hematological disorders responded to vaccination with a rise in antibody titres, which was significantly higher than in the other two groups studied. Malignant hematological disorders lowered the response rate to 61–67%. Patients with no known hematological disorder but with intraabdominal carcinomas also responded less frequently, while those in this group with other surgical reasons for splenectomy had a response rate comparable to healthy individuals. No serious side-effects were reported and we therefore conclude that all splenectomized patients should be vaccinated with a pneumococcal vaccine. However, it must always be born in mind that one third of the patients with malignant disease did not respond to vaccination.     

Alcohol-related Death and Associated Risk Factors in Urban Middle-aged Males

ABSTRACT Alcohol-related disorders belong to the spectrum of major non-infectious diseases in Western societies which can be prevented by means that have not yet been fully implemented. Total consecutive mortality in a population of 10 353 middle-age males invited to take a part in a preventive medical population program in Malmö was followed up for 3.5–8.5 years (mean 4.5) after the time of invitation and analysed in relation to participation or non-participation and forensic or in-hospital autopsy. Entry characteristics in the 7935 males who attended the screening were compared in order to evaluate risk factor patterns for the major categories of premature death during the follow-up period. Even in the males participating in the screening, alcohol-related deaths (ARD) constituted a major mortality category, comprising 55 of 218 cases, whereas cancer comprised 61 and coronary heart disease (CHD) 50 of the premature deaths in this group. Both in the ARD and CHD categories of male premature mortality, significant and distinctly differential risk factor patterns were found; in CHD for smoking, cholesterol, serum triglycerides and systolic blood pressure, and in ARD for γ-glutamyltransferase, questionnaire alcoholism screening test and, inversely, serum cholesterol and serum creatinine. In both groups of diseases, these risk factors could be combined into highly predictive multiple logistic risk factor functions. The discriminative power of this instrument was even higher in ARD than in CHD deaths. In consequence, these factors may be applied both as indicators of the ARD risk and as signals and instrument for directed preventive measures in analogy with previously well established and tested methods for the regulation of blood pressure, serum lipids, etc. in the conquest of the cardiovascular diseases.     

β1-Adrenoceptors mediating relaxation of the guinea-pig trachea: experiments with prenalterol,a β1-selective adrenoceptor agonist

In the presence of 17 β-oestradiol, prenalterol, a β₁-selective adrenoceptor agonist, caused a dose-dependent relaxation of the isolated, pilocarpine-contracted guinea-pig trachea. This effect was blocked by the antagonists propranolol (non-selective) and practolol (β₁-selective) but not by IPS 339 [(t-butylamino-3-ol-2-propyl)oximino-9-fluorene HCl] (β₂-selective). The relaxing effect of terbutaline, a β₂-selective adrenoceptor agonist, was more efficiently blocked by IPS 339 than by practolol. These data support the hypothesis that the guinea-pig trachea contains both β₁- and β₂-adrenoceptors mediating relaxation and that the β₁-adrenoceptors are selectively stimulated by prenalterol. The efficacy of prenalterol was less than that of terbutaline, thus confirming its partial agonistic activity. In the absence of 17 β-oestradiol, the ability of prenalterol to relax the pilocarpine-contracted trachea was lost. It is suggested that 17 β-oestradiol may act as a functional antagonist to pilocarpine as it caused a partial relaxation itself.