Tuberculin reactivity in the elderly. Comparison of PPD-RT23 and PPD-CT68

BACKGROUND: Tuberculin reactivity varies on the basis of the PPD lot and the population studied. AIMS: To compare tuberculin reactivity in the elderly following successive applications of PPD from 2 different lots. POPULATION: Elderly nursing-home residents, from the province of Guadalajara, Spain. METHODS: The elderly were randomly selected and administered with a first Mantoux intradermoreaction of 2 UT of PPD-RT23 or 2 UT of PPD-CT68. The study was performed in a scaled basis, eliminating the reactors (transversal induration > or = 5 mm at 72 h). The non reactors were restudied with a second and third test in alternative arms at a 7-day interval with the same lot and initial dosis of PPD. At one year the scaled study was repeated with 2 UT of PPD-CT68. RESULTS: Eight hundred and thirty elderly persons (79 +/- 9 years) were studied, with 410 receiving PPD-RT23 and 420 receiving PPD-CT68. No differences were observed in the percentage of initial reactors (31% vs 29%; p = 0.26) or in the booster reactors (23% vs 20%; p = 0.16). The PPD-RT23 was found to trigger more intensive reactions than the PPD-CT68 leading to a greater frequency of indurations > 14 mm. After one year, the percentage of stable reactions was similar in both groups (50.5% vs 49.5%; NS). CONCLUSIONS: 1) In elderly nursing-home residents 2 UT of PPD-RT23 and 2 UT of PPD-CT68 showed similar results in regard to the number of reactors and the frequency of booster reactions. 2) The proportion of intense reactions was greater with 2 UT of PPD-RT23 than with 2 UT of PPD-CT68. 3) The stability of the reactions at one year was independent of the lot used in the first phase.     

Human vaginal mucosal immune system: characterization and function

The analysis of 49 fatal cases of venous thromboembolism--VTE (15% of total ambulatory patients number during long observation was performed. The advanced age of patients, multiple risk factors, underlying circulatory and respiratory tract diseases, malignancies, previous episodes of VTE especially with secondary pulmonary hypertension were the most important factors determining fatal prognoses in those patients.     

The role of cholecystokinin in radiographic opacification of the gallbladder

Studies of the effect of cholecystokinin (CCK) on hepatic elimination of intravenously administered iopanoate and on gallbladder opacification were performed using nonoperated dogs with intact enterohepatic circulation and normal endogenous bile salt pool. Intravenous administration of CCK (3 units/kg) resulted in a 32% increase in apparent transport maximum (maximum rate of elimination) of iopanoate and earlier and enhanced gallbladder opacification. This increase in apparent transport maximum was abolished by cholecystectomy, indicating that the increase was a result of the release of bile salts from the gallbladder rather than a direct effect of the hormone on the hepatic elimination of iopanoate. The early gallbladder opacification and increased density of contrast material in the gallbladder were related to CCK-induced emptying of the gallbladder and subsequent filling with opacified bile.