ABSTRACT
To assess the immunogenicity of pneumococcal vaccine in recipients of heart transplants, we immunized 35 long-term transplantation survivors with pneumococcal vaccine and measured the pre- and postvaccination IgG antibody titers to 5 representative vaccine capsular polysaccharides. Responses of heart transplant recipients to pneumococcal vaccine antigens were generally suppressed.
Subject(s)
Heart Transplantation , Pneumococcal Infections/prevention & control , Pneumococcal Vaccines/administration & dosage , Vaccination , Adult , Aged , Antibodies, Bacterial/blood , Antibody Formation , Bacterial Capsules/immunology , Female , Humans , Immunity, Active , Immunoglobulin G/blood , Male , Middle Aged , Pneumococcal Infections/immunology , Streptococcus pneumoniae/immunologyABSTRACT
BACKGROUND: Influenza vaccine is recommended for heart transplant recipients, but its administration is often deferred because of anecdotal reports of rejection associated with the vaccine. We evaluated the safety of influenza vaccine in a group of stable heart transplant recipients over a 2-year period. METHODS: During the 1993 to 1994 influenza season, stable heart transplant recipients who had undergone transplantation a minimum of 1 year before study entry were randomized to vaccination with a single dose of influenza vaccine versus no vaccination. Routine endomyocardial biopsies and postvaccination influenza serologic studies were performed between 2 and 6 weeks after enrollment/immunization. During the 1994 to 1995 season, patients were given 2 doses of influenza vaccine, separated by 3 weeks; endomyocardial biopsies and serologic studies were performed between 2 and 6 weeks after the second immunization or enrollment (if control subject). Biopsy results were evaluated with respect to vaccine response, immunosuppressive regimens, and patient demographics. RESULTS: Eighteen patients were enrolled in the single vaccine trial and 10 in the booster vaccine trial. Four of 14 vaccine recipients had biopsy specimens consistent with International Society for Heart and Lung Transplantation grades 2 to 3A as compared with 1 of 14 control subjects (grade 2) (p = .326). All episodes of rejection in the vaccine recipients were asymptomatic and responded to a single course of treatment. Rejection was unrelated to the time from transplantation, doses of immunosuppression, age, or number of doses of or response to vaccine. CONCLUSIONS: Influenza vaccine can be safely administered to most heart transplant recipients but may be associated with low-level histologic rejection.
Subject(s)
Heart Transplantation , Influenza Vaccines/adverse effects , Adult , Aged , Antibodies, Viral/analysis , Biopsy , Endocardium/pathology , Female , Graft Rejection/etiology , Humans , Immunization, Secondary , Male , Middle Aged , Orthomyxoviridae/immunologyABSTRACT
This article is the last of a series of four. This article describes in detail the fabrication of a crown connected to a Brånemark implant.
Subject(s)
Crowns , Dental Implantation, Endosseous , Dental Implants , Diastema/surgery , Humans , Incisor , Tooth, ArtificialABSTRACT
This article is the second of a series of four. This article describes in detail the fabrication of a complete fixed-removable prosthesis connected to a dolder bar.
Subject(s)
Dental Implantation, Endosseous , Denture Retention , Denture, Complete, Lower , Dental Impression Technique , Denture Design , HumansABSTRACT
This article is the first of a series of four. Each one summarizes the clinical and technical prosthetic stages of different types of restorations. This article describes in detail the fabrication of a complete fixed prosthesis using screw type osseointegrated implants.
