Convulsions associated with sodium cefazolin: a case report

Our patient was severely injured, and had a prolonged period of hypotension. After operation she received moderate doses of cefazolin, intravenously, in the face of acute renal failure. Seizures associated with a serum cefazolin level of 455 mg/ml were observed. Although a cause and effect relationship between high cefazolin levels and neurotoxicity cannot be proven conclusively, the implication of this relationship exists. The clinician should be aware of the potential neurotoxicity of this commonly used drug. The importance of adjusting the dose in patients with renal failure is re-emphasized.

An attenuated influenza virus vaccine: protection against homologous and heterologous strains of virus

An effective influenza virus vaccine should be capable of inducing protection against both the homologous strain of virus and the heterologous strains representing antigenic drift. For evaluation of the protection provided by an attenuated influenza virus vaccine, volunteers were immunized intranasally with either placebo or influenza A/England/42/72 (H3N2) virus vaccine in a double-blind fashion in two doses administered two weeks apart. Forty-seven subjects were challenged 30-100 days after the second dose with either the homologous or a virulent heterologous strain of virus [A/Dunedin/73 (H3N2)]. The vaccine resulted in good clinical protection against challenge with both the homologous and heterologous strains of virus. The rates of protection against infection (as judged by antibody responses, irrespective of signs and symptoms) were also good (72% and 60% against the homologous and heterologous strains, respectively). Thus, immunity induced by this attenuated influenza virus vaccine extends to provide protection against a related but nonidentical influenza virus.

Intramuscular prostaglandin (15S)-15-methyl PGF2alpha (THAM) in midtrimester abortion

Elective termination of second trimester pregnancies in 63 patients by means of intramuscular prostaglandin (15S)-15-Methyl PGF2alpha (THAM) is reported. In 44 of 61 cases with a successful outcome the duration of pregnancy calculated from a last normal menstrual period was between 13 and 17 weeks. An overall success rate of 96.8 per cent was achieved; and this agent and method warrant further clinical evaluation.