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General Surgery
Published in Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh, 300 Essentials SBAs in Surgery, 2017
Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh
The platelet count usually rises following a splenectomy. Prophylactic antibiotics are indicated to minimise the risk of overwhelming post-splenectomy sepsis (OPSS), but in adults they do not need to be taken daily beyond the first two years after a splenectomy. Prophylactic immunisation with pneumococcal, meningococcal and Haemophilus influenzae type B vaccines should be given pre-operatively where possible.
Adaptive humoral immunity and immunoprophylaxis
Published in Gabriel Virella, Medical Immunology, 2019
Component vaccines are safe, and their use has increased in the last decade. The original component vaccines were mostly made of bacterial toxoids and polysaccharides. Other modalities, such as conjugate vaccines and recombinant component vaccines, have been introduced with considerable success. Bacterial polysaccharide vaccines are widely used for Streptococcus pneumoniae and Neisseria meningitidis. A typhoid fever vaccine made of the Vi capsular polysaccharide is also available. Because of their T-independent nature, polysaccharide vaccines are not very potent (especially in young children) and do not elicit long-lasting memory. While conjugate vaccines (see later discussion) have replaced some polysaccharide vaccines, such as the old Haemophilus influenzae type B vaccine, the Streptococcus pneumoniae 23 serotype vaccine (Pneumovax 23) continues to be widely and successfully used in the adult population.Inactivated toxins (toxoids), such as tetanus and diphtheria toxoids, are prepared with formalin-inactivated toxins that have lost their active site but maintained their immunogenic determinants. Toxoids are strongly immunogenic proteins, induce high titers of antibodies able to neutralize the toxins, and induce long-lasting memory. Chemically inactivated pertussis toxin is also a key component of the acellular pertussis vaccine currently used.Viral component vaccines are based on the immunogenicity of isolated viral constituents. The best example is the hepatitis B vaccine, produced by recombinant yeast cells. The gene coding for the hepatitis B surface antigen (HBsAg) was isolated from the hepatitis B virus and inserted into a vector, flanked by promoter and terminator sequences. That vector was used to transform yeast cells, from which HBsAg was purified. All of the available hepatitis B vaccines are obtained by this procedure.
Utility of the systemic immune-inflammation index to predict serious bacterial infections in infants with fever without a source
Published in Postgraduate Medicine, 2022
Ali Güngör, Aytaç Göktuğ, Raziye Merve Yaradılmış, Muhammed Mustafa Güneylioğlu, Betül Öztürk, İlknur Bodur, Can Demir Karacan, Nilden Tuygun
Our hospital is a tertiary pediatric hospital in Ankara (Capital of Turkey), and approximately 120,000 patients admit to our PED annually during the pandemic period. Infants (aged 1–4 months) were included in this study since the second doses of conjugated pneumococcal and Haemophilus influenzae type b vaccines in our country were completed at the end of the 4th month. Patients aged 1–4 months brought to the PED with a complaint of fever between 1 May 2020, and 1 May 2021, and whose fever source could not be detected on physical examination were included in the study.
Immunization coverage among asplenic patients and strategies to increase vaccination compliance: a systematic review and meta-analysis
Published in Expert Review of Vaccines, 2021
Francesco Paolo Bianchi, Pasquale Stefanizzi, Giuseppe Spinelli, Simona Mascipinto, Silvio Tafuri
The asplenic/hyposplenic subjects have to receive the routine immunization schedule, in compliance with international vaccination programs [5]. Additional and specific vaccinations should be administered to prevent infections associated with splenic dysfunction; indeed, the Centers for Diseases Control and Prevention (CDC) [5] strongly recommends the following vaccines: Anti-pneumococcal vaccines: both 13-valent conjugate (PCV13) and 23-valent polysaccharide (PSSV23). PCV13 is administered first, followed by one dose of PSSV23 at least 8 weeks later. A booster dose of PSSV23 is needed 5 years after the first dose and must be repeated every 5 years after the last one, with the final dose at age ≥65 years.Anti-Haemophilus influenzae type b vaccine: 1 dose.Anti-meningococcal ACYW135: two doses 8 weeks apart and a booster dose every 5 years.Anti-meningococcal B vaccines: two different vaccines are available, with different schedule (2 or 3 doses). One year after the complete cycle, a booster is recommended followed by additional boosters every 2–3 years thereafter.Anti-influenza: 1 dose every year, in October/December.Anti-tetanus, diphtheria, pertussis (Tdap): In the absence of previous Tdap, the vaccine should be administered, followed by a Tdap or Td booster dose every 10 years.Anti-varicella zoster virus: In individuals ≥50 years, a 2-dose series of the recombinant shingles vaccine is needed, even in those already vaccinated with live-attenuated virus [5].
Childhood vaccination coverage in Europe: impact of different public health policies
Published in Expert Review of Vaccines, 2019
Angela Bechini, Sara Boccalini, Alessandra Ninci, Patrizio Zanobini, Gino Sartor, Guglielmo Bonaccorsi, Maddalena Grazzini, Paolo Bonanni
The percentage of children at 24 months of age who have received three doses of Haemophilus influenzae type b vaccine in 2017 is 94.5%. EU’s mean vaccination coverage for Hib3 at 24 months of age has increased from 2009 (95.7%) to 2013 (96.5%), when the highest value was reported; then rates stabilized and decreased in the following years until 2017 (94.5%). (Figure 2).