Risk factors in onychocryptosis.

A study is described in which the normal toes of 50 patients with unilateral ingrowing toenails were compared with those of 50 healthy subjects matched for age and sex. Twenty-one potential risk factors were compared between the groups. All measurements on patients were derived from unaffected toes in order to avoid anatomical distortion due to the disease process. Statistical analysis revealed significant differences between the groups for three anatomical measures, namely nail fold width (P less than 0.001), medial rotation (eversion) of the great toe (P less than 0.02) and nail thickness (P less than 0.03). Possible discriminating variables were assessed using linear discriminant function analysis and a mathematical equation was derived based on these three factors. This equation was found to possess a potentially high predictive value in that it correctly classified 86 per cent of the patients and 77 per cent of the controls. A further group of 62 unselected patients presenting with unilateral onychocryptosis and 35 unaffected controls were assessed for these three parameters. Of these, 80 per cent of controls and 85 per cent of patients could be classified correctly by the equation. It is thus proposed that, in the majority of subjects with onychocryptosis, a discrete anatomical predisposition exists and that the other factors act only as triggers in the development of the condition. This study provides a rationale for less traumatic surgical approaches to ingrown nail than nail avulsion, with or without nail bed ablation and may also provide a means of identifying high-risk groups.

Double-blind comparative trial of standard (commercial) and antibody-affinity-purified tetanus toxoid vaccines.

Tetanus toxoid purified by antibody-affinity chromatography, was compared with conventionally purified material in a double-blind trial in 205 healthy blood donors. There was neither any difference in immunogenicity as assessed by enzyme-linked immunoassay nor in side-reactions between the two vaccines. This study confirms that side-reactions to tetanus toxoid are not eliminated by purifying it.

A comparison of the reactivity and immunogenicity of RA 27/3 strain rubella vaccine prepared in WI-38 or MRC5 human diploid cells.

The immunogenicity and clinical reactivity of rubella vaccine derived from WI-38 or MRC5 human diploid cells was compared in 125 seronegative adolescent females. Seroconversion rates, assessed by single radial haemolysis testing of paired pre- and post-vaccination samples exceeded 98% (56/57 and 68/68 vaccinees, respectively) for both vaccines. Quantitative assessment of rubella-specific antibodies in 53 post-vaccination sera by an ELISA technique also failed to reveal any difference in immunogenicity between the vaccines. Assessable calendar records documenting the occurrence of local and systemic signs and symptoms in the four weeks following vaccination were returned by 106 subjects. No important statistically significant difference in parameters of clinical reactivity between the vaccine groups was observed although the incidence of pain at the injection site was found to be significantly higher for vaccinees receiving WI-38 derived vaccine.

Prospective, controlled study of a polyvalent pseudomonas vaccine in cystic fibrosis--three year results.

Thirty four children with cystic fibrosis allocated to pseudomonas vaccine and control groups were studied for three years. No significant differences were observed in the numbers colonised by Pseudomonas aeruginosa or in the overall disease progress of the two groups.

A survey of cancer morbidity and mortality in vaccinees seven to 12 years after the administration of live vaccine propagated in human diploid cells.

Using record linkage, cancer morbidity and mortality were examined in 2973 recipients of RA 27/3 strain rubella vaccine propagated in WI 38 cells. During the follow-up reported (mean duration 9.8 years; range seven to 12 years) the rate of cancer notifications and of deaths from cancer were similar to those observed in the equivalent age range of the general population.

A single-blind, placebo-controlled comparison of the reactivity and antigenicity of trivalent oral poliomyelitis vaccine prepared in monkey kidney or human diploid cell substrates.

Vaccination with a single dose of trivalent oral poliomyelitis vaccine elicited fourfold or greater antibody responses to one or more poliomyelitis virus types in 59% of volunteers (16/27) receiving vaccine prepared from virus grown in monkey kidney cells and in 69% of volunteers (16/23) receiving vaccine prepared from virus grown in MRC5 human diploid cells. Type for type the antibody titres and percentages of volunteers responding to the two vaccines were broadly equivalent. The clinical reactivities of both vaccines were similar to that of a placebo in terms of the overall incidence, duration and severity of reactions. The nature of the reactions observed did, however, vary, in that headaches were more frequently reported by recipients of vaccine prepared from virus grown in monkey kidney cells. This difference was not, however, statistically significant.

The efficacy of a new formulation of trimethoprim and sulphadiazine in acute exacerbations of chronic bronchitis.

Thirty-four acute exacerbations of chronic bronchitis were treated using a new formulation of trimethoprim and sulphadiazine. Significant bacterial isolates were obtained in 18 exacerbations of which 12 comprised Haemophilus influenzae. Adverse effects of treatment, principally nausea, occurred in 5 patients. A satisfactory clinical response in association with the achievement of mucoid sputum was obtained in 94% and the mean time for sputum conversion of 3.8 days compares favourably with other antibiotics.

A comparative clinical study of Adsorbed Tetanus Vaccine and Adult-type Tetanus-Diphtheria Vaccine.

A limited assessment of immunity to diphtheria revealed that only 44.8% of adults had protective levels (greater than 0.01 U/ml) of diphtheria antitoxin in their sera. In the light of this information, it was decided to assess the suitability of Adult-type Tetanus-Diphtheria Vaccine as a replacement for Adsorbed Tetanus Vaccine in occupational health schemes. A comparative study of these vaccines showed that a single dose of each produced an equivalent rate and level of tetanus antitoxin responses. Adult-type Td Vaccine elicited more than fourfold increases of diphtheria antitoxin in 76% of vaccinees. No statistically significant differences were observed in the clinical reactivity of the vaccines under test. However, the combined vaccine caused a slightly higher incidence of local reactions (pain, redness and swelling) while recipients of Adsorbed Tetanus Vaccine more frequently experienced pain.