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1
Celichowski, Jan, and Kazimierz Grottel. "The influence of a doublet of stimuli at the beginning of the tetanus on its time course." Acta Neurobiologiae Experimentalis 58, no. 1 (March 31, 1998): 47–53. http://dx.doi.org/10.55782/ane-1998-1258.
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The influence of a pair of stimuli generated in a short time sequence (doublet) at the beginning of stimulation on the time course of the following tetanus was investigated. Experiments were performed on single motor units in rat's medial gastrocnemius. The doublet evoked an increase in tetanic tension, tetanic fusion and the area under tension record. These effects were measured in tetani fused to varying degrees. It was found that for all types of motor units the strongest influence of the doublet was observed in half- fused tetani. Moreover, the doublet influenced the first part of tetanus significantly more as compared to the second. Slow motor units showed greater sensitivity of the tension and the tetanus area to the doublet than fast units. The results show that slow units are characterized by better summation of their tension at the beginning of a tetanus.
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Carp, J. S., P. A. Herchenroder, X. Y. Chen, and J. R. Wolpaw. "Sag During Unfused Tetanic Contractions in Rat Triceps Surae Motor Units." Journal of Neurophysiology 81, no. 6 (June 1, 1999): 2647–61. http://dx.doi.org/10.1152/jn.1999.81.6.2647.
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Sag during unfused tetanic contractions in rat triceps surae motor units. Contractile properties and conduction velocity were studied in 202 single motor units of intact rat triceps surae muscles activated by intra-axonal (or intra-myelin) current injection in L5 or L6 ventral root to assess the factors that determine the expression of sag (i.e., decline in force after initial increase during unfused tetanic stimulation). Sag was consistently detected in motor units with unpotentiated twitch contraction times <20 ms. However, the range of frequencies at which sag was expressed varied among motor units such that there was no single interstimulus interval (ISI), with or without adjusting for twitch contraction time, at which sag could be detected reliably. Further analysis indicated that using the absence of sag as a criterion for identifying slow-twitch motor units requires testing with tetani at several different ISIs. In motor units with sag, the shape of the force profile varied with tetanic frequency and contractile properties. Simple sag force profiles (single maximum reached late in the tetanus followed by monotonic decay) tended to occur at shorter ISIs and were observed more frequently in fatigue-resistant motor units with long half-relaxation times and small twitch amplitudes. Complex sag profiles reached an initial maximum early in the tetanus, tended to occur at longer ISIs, and were more common in fatigue-sensitive motor units with long half-relaxation times and large twitch amplitudes. The differences in frequency dependence and force maximum location suggested that these phenomena represented discrete entities. Successive stimuli elicited near-linear increments in force during tetani in motor units that never exhibited sag. In motor units with at least one tetanus displaying sag, tetanic stimulation elicited large initial force increments followed by rapidly decreasing force increments. That the latter force envelope pattern occurred in these units even in tetani without sag suggested that the factors responsible for sag were expressed in the absence of overt sag. The time-to-peak force (TTP) of the individual contractions during a tetanus decreased in tetani with sag. Differences in the pattern of TTP change during a tetanus were consistent with the differences in force maximum location between tetani exhibiting simple and complex sag. Tetani from motor units that never exhibited sag did not display a net decrease in TTP during successive contractions. These data were consistent with the initial force decrement of sag resulting from a transient reduction in the duration of the contractile state.
3
Ćakić, Elena, Suzana Hađina, Krešimir Martinković, Vladimir Stevanović, Matko Perharić, Iva Šmit, Josipa Habuš, and Zrinka Štritof. "Tetanus u pasa." Veterinarska stanica 53, no. 6 (April 29, 2022): 757–68. http://dx.doi.org/10.46419/vs.53.6.10.
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Tetanus je akutna zarazna bolest u pasa koja nastaje uslijed djelovanja neurotoksina bakterije C. tetani. Ulazna vrata su najčešće ubodne rane ili ozljede na koži. Inkubacija može trajati u vremenskom rasponu od tri dana do tri tjedna. Razlikujemo dva klinička oblika bolesti: lokalizirani i generalizirani. Kod lokaliziranog oblika vidljiva je ukočenost ekstremiteta na kojem se nalazi ozljeda ili rana. Tipični klinički znaci generalizirang oblika bolesti su grč muskulature lica, a tijekom progresije bolesti dolazi do generalizirane ukočenosti svih ekstremiteta, intermitentnih toničkih grčeva dišne muskulature te spastične paralize. Bolest je popraćena brojnim komplikacijama, a letalan ishod posljedica je respiratornog ili srčanog zastoja. Dijagnostika se temelji na detaljnoj anamnezi i tipičnoj kliničkoj slici. Liječenje tetanusa uključuje kiruršku obradu rane, neutralizaciju slobodnog neurotoksina antitoksinom, sprječavanje daljnjeg umnažanja bakterije C. tetani antimikrobnim pripravcima te potpornu terapiju. Sam proces liječenja je dugotrajan, a prognoza i ishod bolesti ne ovise samo o obliku i tijeku bolesti već i o njezinom pravovremenom prepoznavanju te adekvatnom liječenju. Uz sve navedeno potrebno je naglasiti da još uvijek ne postoji jedinstveni pristup liječenju ove bolesti u pasa. Imunoprofilaksa tetanusa u pasa se ne provodi.
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Popoff, Michel R. "Tetanus in animals." Journal of Veterinary Diagnostic Investigation 32, no. 2 (February 18, 2020): 184–91. http://dx.doi.org/10.1177/1040638720906814.
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Tetanus is a neurologic disease of humans and animals characterized by spastic paralysis. Tetanus is caused by tetanus toxin (TeNT) produced by Clostridium tetani, an environmental soilborne, gram-positive, sporulating bacterium. The disease most often results from wound contamination by soil containing C. tetani spores. Horses, sheep, and humans are highly sensitive to TeNT, whereas cattle, dogs, and cats are more resistant. The diagnosis of tetanus is mainly based on the characteristic clinical signs. Identification of C. tetani at the wound site is often difficult.
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Hao, Nguyen Van, Nguyen Ngoc My Huyen, Nguyen Thi Han Ny, Vo Thi Nhu Trang, Nguyen Van Minh Hoang, Duong Bich Thuy, Nguyen Thanh Nguyen, et al. "The Role of the Gastrointestinal Tract in Toxigenic Clostridium tetani Infection: A Case-Control Study." American Journal of Tropical Medicine and Hygiene 105, no. 2 (August 11, 2021): 494–97. http://dx.doi.org/10.4269/ajtmh.21-0146.
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ABSTRACT. Tetanus arises from wound contamination with Clostridium tetani, but approximately one fifth of patients have no discernable entry wound. Clostridium tetani is culturable from animal feces, suggesting the gastrointestinal tract could be an endogenous reservoir or direct-entry portal, but human data are lacking. In this study of 101 Vietnamese adults with tetanus and 29 hospitalized control subjects, admission stool samples were cultured for C. tetani. Anti-tetanus toxin antibodies were measured by ELISA. Clostridium tetani toxigenicity was evaluated using polymerase chain reaction and sequencing. Toxigenic C. tetani was cultured from stool samples in 50 of 100 (50%) tetanus cases and 12 of 28 (42.9%) control subjects (P = 0.50), and stool samples of 44 of 85 (52.4%) tetanus cases with clinically identified wounds compared with 6 of 15 (47.6%) patients without clinically identified wounds (P = 0.28). Nine of 12 (75%) control subjects with toxigenic C. tetani in their stool samples lacked protective antibody concentrations. These findings fail to show evidence of an association between gastrointestinal C. tetani and tetanus infection, but emphasize the importance of increasing vaccination coverage.
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Andrade, Luiz Augusto F., and Sonia Maria D. Brucki. "Botulinum toxin A for trismus in cephalic tetanus." Arquivos de Neuro-Psiquiatria 52, no. 3 (September 1994): 410–13. http://dx.doi.org/10.1590/s0004-282x1994000300021.
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Cephalic tetanus is a localized form of tetanus. As in generalized forms , trismus is a prominent feature of the disease, leading to considerable difficulty in feeding, swallowing of the saliva and mouth hygiene. These difficulties often precede respiratory problems and aspiration bronchopneumonia is a frequent life-threatening complication. Muscle relaxants other than curare drugs may show a limited benefit for relieving trismus. Tetanospasmin, the tetanic neurotoxin, and botulinum toxin share many similarities, having a closely related chemical structure, an origin from related microorganisms (Clostridium tetani and Clostridium botulinum, respectively), and presumably, the same mechanisms of action in the neuron. The difference between the two lies in their peculiar neurospecificity, acting in different neurons. Injection of minute doses of botulinum toxin in the muscles involved in focal dystonias or other localized spastic disorders have proved to be very effective in these conditions. We describe the use of botulinum toxin A in the successful treatment of trismus in a patient suffering from cephalic tetanus. We believe that this form of treatment may be of value in lowering the risk of pulmonary complications in tetanic patients.
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Möller, Jens, Max Edmund Kraner, and Andreas Burkovski. "More than a Toxin: Protein Inventory of Clostridium tetani Toxoid Vaccines." Proteomes 7, no. 2 (April 16, 2019): 15. http://dx.doi.org/10.3390/proteomes7020015.
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Clostridium tetani is the etiological agent of tetanus, a life-threatening bacterial infection. The most efficient protection strategy against tetanus is a vaccination with the C. tetani neurotoxin, which is inactivated by formaldehyde-crosslinking. Since we assumed that besides the tetanus toxin, other proteins of C. tetani may also be present in toxoid preparations, we analyzed commercially available vaccines from different countries in respect to their protein content using mass spectrometry. In total 991 proteins could be identified in all five analyzed vaccines, 206 proteins were common in all analyzed vaccines and 54 proteins from the 206 proteins were potential antigens. The additionally present proteins may contribute at least partially to protection against C. tetani infection by supporting the function of the vaccine against the devastating effects of the tetanus toxin indirectly. Two different label-free protein quantification methods were applied for an estimation of protein contents. Similar results were obtained with a Total Protein Approach (TPA)-based method and Protein Discoverer 2.2 software package based on the minora algorithm. Depending on the tetanus toxoid vaccine and the quantification method used, tetanus neurotoxin contributes between 14 and 76 % to the total C. tetani protein content and varying numbers of other C. tetani proteins were detected.
8
B.B.V, Ramanan, Ajit Kumar Pegu, Anupam Dutta, Arjit Das, and Sanchu T. K. Sreeraj. "Cephalic Tetanus without Injury – A Rare Presentation of Tetanus." Journal of Evolution of Medical and Dental Sciences 10, no. 20 (May 17, 2021): 1555–57. http://dx.doi.org/10.14260/jemds/2021/324.
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Tetanus is a rare, severe, and potentially life-threatening disease caused by Clostridium tetani, which accounted 58,900 deaths worldwide in 2013.1 Usually tetanus is generalized, rarely it can be localized also. 20-30% of cases will not have any puncture wound. In this case report, we present a case of tetanus with rare manifestation (localized tetanus presented with trismus without any puncture wound). Multiple rare associations like tetanus presenting with trismus, tetanus occurring in the absence of puncture wound strengthens the need for reporting this case which if left unnoticed would have been detrimental to the patient.
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Ali, Rizvan. "Management of Tetanus in Burns: Current Clinical Guidelines in the Emergency Department." Scholars Journal of Applied Medical Sciences 12, no. 05 (May 29, 2024): 682–83. http://dx.doi.org/10.36347/sjams.2024.v12i05.027.
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Tetanus remains a significant concern in patients with burns due to the potential contamination of wounds with Clostridium tetani spores. Prompt and appropriate management in the emergency department (ED) is vital to prevent tetanus-related complications. This article provides a comprehensive overview of the current clinical guidelines for the management of tetanus in burns in the ED setting, emphasizing tetanus vaccination, wound management, tetanus immune globulin (TIG) administration, antibiotic prophylaxis, and monitoring strategies.
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Catherine, K., Johny Vakayil Francis, and Sarath Babu. "Successful management of severe tetanus in a 10-year-old unvaccinated girl: A case report." Journal of Pediatric Critical Care 11, no. 2 (2024): 89–91. http://dx.doi.org/10.4103/jpcc.jpcc_79_23.
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Tetanus is a potentially fatal disease caused by Clostridium tetani, which produces muscle spasms, autonomic dysfunction, and respiratory failure by the action of a powerful neurotoxin. Tetanus can be prevented by vaccination, proper wound care, and tetanus prophylaxis, but it remains a significant public health concern in regions with inadequate vaccination coverage. We report a case of severe tetanus in an unvaccinated 10-year-old girl following a tetanus prone injury on her right big toe and was treated with antibiotics, tetanus immunoglobulin, tetanus toxoid, sedatives, neuromuscular blockers, and tracheostomy with mechanical ventilation. She recovered after 28 days of supportive multi-disciplinary intensive care and was discharged with no neurological sequelae.
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Pagehgiri, Elma Shari, Dian Kusumastuti Anggraeni Putri, Ni Wayan Nurlina Ekasari, and Bagus Ngurah Mahasena Putera Awatara. "KASUS SERIAL: TETANUS GENERALISATA PADA PASIEN USIA LANJUT." Jurnal Medika Malahayati 8, no. 1 (April 15, 2024): 95–101. http://dx.doi.org/10.33024/jmm.v8i1.12725.
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Abstrak: Kasus Serial: Tetanus Generalisata Pada Pasien Usia Lanjut. Tetanus merupakan penyakit infeksi yang dapat dicegah dengan vaksin dan mengancam jiwa di negara berkembang. Infeksi ini disebabkan oleh neurotoksin yang dihasilkan oleh Clostridium tetani. Kami memaparkan tiga kasus tetanus generalisata yang masuk RSD Mangusada selama Juli 2023. Ketiga kasus tersebut merupakan tetanus generalisata pada lansia yang tidak memiliki status imunisasi. Semua pasien telah menerima terapi yang memadai dengan antitoksin, antibiotik, dan perawatan suportif. Dari 3 kasus tersebut, 1 pasien menunjukan perbaikan kondisi dan 2 pasien meninggal. Sebagai kesimpulan, pengenalan dini gejala tetanus dan meningkatkan kesadaran akan perlunya vaksinasi tetanus sangat penting dilakukan. Prognosis penyakit tetanus bervariasi dan dipengaruhi oleh beberapa faktor.
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Selim, A. M., E. M. Ibrahim, Meshad El, and F. K. Hamouda. "Development of IgY antibodies for control of tetanus." Biotehnologija u stocarstvu 31, no. 1 (2015): 109–22. http://dx.doi.org/10.2298/bah1501109s.
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Tetanus is a cut and often highly fatal infectious disease that affects both human and animals; the disease caused by exotoxin which produced by C. tetani. In the current study, we try to get hyperimmune IgY in chicken egg against tetanus toxin and use it as prophylaxis and therapeutic treatment for tetanus. The obtained IgY titer after inoculation of tetanus toxin in chicken eggs was 1320 limit of flocculation (Lf-eq) after 72 hr. IgY in adose of 4500 Lf-eq can be protect donkey after artificial infection by 1 minimum lethal dose (MLD) of C. tetani. While a dose of 30000 Lf-eq IgY intramuscularly two times daily for 2 injections, with 9500 Limit of flocculation Lf-eq IgY intrathecally in subarachnoid space was 100% curative for a donkey which was challenged with 1 MLD of C. tetani. Furthermore, IgY was evaluated experimentally in comparison with IgG in mice. IgY has equally efficacy to IgG in prophylaxis and treatment of tetanus.
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Chawla, Dr Anil Kumar, Chandrani Das, Paramdeep Singh, Mansha Tiwari, and Dr Seema Chaudhary. "Production of tetanus toxin by using media substantially free from meat and blood." Asian Journal of Pharmaceutical and Clinical Research 9, no. 6 (November 1, 2016): 284. http://dx.doi.org/10.22159/ajpcr.2016.v9i6.14410.
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The present study was to redesign the conventional Mueller and Miller medium to produce tetanus toxin from Clostridium tetani. Meat based ingredients (such as Bovine Heart/ Brain/ Liver Infusion) were replaced with vegetable peptone & alternate casein hydrolysate and scaled up from 100mL to 1000mL. Modified Mueller and Miller Medium containing vegetable peptone (substitute of BHI) and alternate casein hydrolysate were used for production and scale -up of tetanus toxin. Detoxification of tetanus toxin was carried out by using formaldehyde to produce tetanus toxoid. Purification of tetanus toxoid was achieved by fractional precipitation. It was found that under optimum conditions, use of meat free media leads to production of tetanus toxin with equal limes flocculation (Lf) titer and high antigenic content at par with conventional meat based media without any post vaccination infections. The yield of toxin was improved during scale-up of the process. The present study provides a method for growth of Clostridium tetani that maximizes tetanus toxin production without any use of animal-derived components.
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Celichowski, J. "Tetanic depression: a phenomenon influencing the production of tension in fast-twitch motor units in rat medial gastrocnemius." Acta Neurobiologiae Experimentalis 61, no. 2 (June 30, 2001): 119–23. http://dx.doi.org/10.55782/ane-2001-1392.
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The influence of an increase or a decrease in the stimulation frequency on tension development during a tetanus was studied in motor units of the rat medial gastrocnemius muscle. These effects were tested in one tetanus evoked at two frequencies of stimulation, a lower immediately followed by a higher one or the reverse. For all fast motor units it was observed that after the first part of a tetanus at a lower frequency of stimulation the tension of the following part, of the better fused contraction, was depressed. This effect was called a tetanic depression. When the lower stimulation frequency was followed by the higher one, the depression was visible in some motor units only whereas in the remaining units a potentiation of the second part of the tetanus was visible. The tetanic depression was larger in fast resistant than in fast fatigable motor units. In slow motor units tetanic depression was not observed. The tetanic depression is a phenomenon which can influence the production of contractile tension by fast motor units.
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Lai, Xiaofei, Felycia Fernanda Hosyanto, and Lei Xu. "Risk of Clostridium tetani infection in an elderly patient following hemorrhoid ligation." Journal of International Medical Research 48, no. 10 (October 2020): 030006052096398. http://dx.doi.org/10.1177/0300060520963983.
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Tetanus after gastrointestinal surgery is an extremely rare but very dangerous disease caused by infection with Clostridium tetani. Tetanus can occur due to bacterial infection during surgery or dressing change, or the bacteria may exist in the patient’s intestines and be discharged with feces. This report describes a 71-year-old woman who developed tetanus 3 days after a hemorrhoidal ligation. Clinicians need to be aware of symptoms of C. tetani infection that might present in patients who have undergone gastrointestinal procedures.
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Seo, Seung Won, Jaewon Lee, Bong-Goo Yoo, Jehun Kim, and So-Young Huh. "Autonomic instability in severe tetanus: a case report." Annals of Clinical Neurophysiology 23, no. 2 (October 29, 2021): 117–20. http://dx.doi.org/10.14253/acn.2021.23.2.117.
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Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.
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Barclay, C. J. "Effect of fatigue on rate of isometric force development in mouse fast- and slow-twitch muscles." American Journal of Physiology-Cell Physiology 263, no. 5 (November 1, 1992): C1065—C1072. http://dx.doi.org/10.1152/ajpcell.1992.263.5.c1065.
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Changes in the rate of isometric force development with fatigue were measured in vitro (25 degrees C) using mouse soleus and extensor digitorum longus (EDL) muscles. Muscles were fatigued using 30 tetanic contractions. Rate of force development was determined from the rate constant of an exponential curve fitted to the rising force phase of a tetanus. For both muscles, when the intertetanus interval was 3 s, maximum isometric force and relaxation rate were significantly reduced in the final tetanus relative to the values in the first tetanus. Rate of force development in soleus muscles transiently increased and then decreased a small amount. The final rate was 92.7 +/- 3.3% (n = 4) of the initial rate. In contrast, the rate of force development in EDL muscles increased to 133.7 +/- 3.3% (n = 4) of the initial rate. This increased rate was evident from the second tetanus of the series, was fully established after 5 tetani, and the magnitude of the increase in rate was inversely proportional to intertetanus interval and was independent of presumed energy expenditure. The enhanced rate decayed with a time constant of 14.3 +/- 2.0 s and was independent of presumed energy expenditure. Most of these observations can be explained by the effects of P(i) on cross bridge kinetics. Other possible mechanisms, involving more rapid activation, are also suggested.
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Pouillon, JM, and BD Caldwell. "The risk of tetanus in podiatric medicine." Journal of the American Podiatric Medical Association 88, no. 7 (July 1, 1998): 349–52. http://dx.doi.org/10.7547/87507315-88-7-349.
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Although tetanus is a preventable disease, several cases are reported to the Centers for Disease Control and Prevention each year. Many conditions treated by podiatric physicians carry the risk of infection by Clostridium tetani, and it is advisable for podiatrists to update a patient's tetanus immunization status if the patient presents with a tetanus-prone wound.
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Hirka, E. I., and M. S. Popov. "IMMUNOLOGICAL EFFICIENCY OF THE TETANUS TOXOID USE FOR THE URGENT SPECIFIC TETANUS PREVENTION IN PATIENTS WITH THE WOUND INFECTION." Kharkiv Surgical School, no. 3 (March 20, 2020): 54–57. http://dx.doi.org/10.37699/2308-7005.3.2020.11.
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Summary. Aim. The present study aimed to analyze the effectiveness of tetanus toxoid administration during the urgent specific tetanus prevention.
Materials and methods. The determination of tetanus immunity levels in patients with the wound infection before immunization, then 2 and 4 weeks after vaccination. Studies of blood sera of patients were carried out in dynamics by enzyme-linked immunosorbent assay using a set of test systems for determining IgG antibodies to tetanus toxoid «Clostridium tetani toxin IgG», ELISA, Nova Tec Immundiagnostica GmbH, Germany. Results of the study were measured in International Units per milliliter (IU / ml).
Results. The tetanus toxoid AP-Biolik using for the urgent specific tetanus prevention is induce protective tetanus immunity levels 2 weeks after vaccination and long-term specific immunity protection 4 weeks after vaccination.
Conclusions. The immunological efficiency of AP-Biolik using was established during its applying for urgent specific tetanus prevention in patients with the wound infection.
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Simovanyan, E. M., E. L. Goncharova, and V. B. Denisenko. "Tetanus is a difficult diagnosis in children." CHILDREN INFECTIONS 18, no. 4 (December 6, 2019): 70–72. http://dx.doi.org/10.22627/2072-8107-2019-18-4-70-72.
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The sporadic incidence of tetanus, the identity of symptoms with the clinical picture of a number of common neuroinfections, the high frequency of various background pathologies create difficulties in disease diagnosing in children. On the case history example of a 3 years 9 months old child with two diseases (tetanus, enterovirus infection) that developed against the background of the active form of herpesvirus infection, an algorithm of diagnostic and therapeutic measures is presented.A differential diagnosis was made between the generalized form of tetanus and meningoencephalitis of enteroviral etiology. Lack of vaccination, living in rural areas, violation of the integrity of the skin and soil contamination testified in favor of tetanus. The clinical symptoms of tetanus were revealed: a triad of symptoms (trismus, «sardonic smile», dysphagia), tetanic cramps against a background of clear consciousness, muscle hypertonicity in the interictal period. The patient received complex treatment; 100 thousand IU of anti-tetanus serum and tetanus anatoxin were introduced. Discharged on the 23rd day of illness with recovery.
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ALTRINGHAM, J. D., and I. A. JOHNSTON. "Activation of Multiply Innervated Fast and Slow Myotomal Muscle Fibres of the Teleost Myoxocephalus Scorpius." Journal of Experimental Biology 140, no. 1 (November 1, 1988): 313–24. http://dx.doi.org/10.1242/jeb.140.1.313.
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A nerve-muscle preparation from the sculpin Myoxocephalus scorpius was used to study the membrane response of fast and slow muscle fibres to stimulation of the spinal nerves. There was no significant difference between resting potential in fast (−81.9mV) and slow fibres (−80.8mV). Fast fibres responded to a suprathreshold stimulus in the spinal nerve with an action potential. Overshoots of up to +32 mV were recorded. Both junction potentials and overshooting action potentials were observed in the slow fibres. The twitch/tetanus characteristics of myotomal muscle were investigated using isolated bundles of ‘live’ fast and slow fibres. Both fibre types responded to a single stimulus with a mechanical twitch. Fused tetani were obtained at around 50Hz in fast fibres and 20 Hz in slow fibres. In the slow fibres, tetanic tension increased with frequency up to around 50Hz. At frequencies giving maximum tetanic tension, the twitch/tetanus ratio was 0.70 for fast fibres and 0.29 for slow ones. These results are discussed with reference to the polyneuronal/multiterminal innervation pattern of the myotomal muscle in teleost fish and its role in locomotion.
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Ahmed, Hafizuddin. "Tetanus Following Root Canal Surgery." KYAMC Journal 3, no. 1 (February 5, 2013): 265–68. http://dx.doi.org/10.3329/kyamcj.v3i1.13663.
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2400 years ago Hippocrates recognised Tetanus as a dreadful disease.It is caused by a straight slender gram positive anaerobic rod-Clostridium Tetani, the toxin of which interferes with acetylecholine/cholinesterase balance at peripheral motor end plate of central nervous system causing sustained tonic spasm. Children are routinely immunized these days everywhere against Diptheria,Pertisis,Tetanus,Poliomyelitis etc.But this does not apply with aged people who were not routinely immunized during their infancy making them vulnerable to these diseases including Tetanus. Majority of Tetanus cases follow wounds(war,accidents,post-operative) contaminated with soil,manure or other external sources.Following is a rare case where tetanus occured without so called wound i.e.Clostrdium Tetani infected pulp space in the root of the tooth following root canal surgery.As the pulp space becomes a closed chamber after filling it with inert material in R.C.T. so anaerobic infection can occur here as it occured in this case of 42 year old female school teacher.All wounds however trival from whatever cause should be considered tetanus prone.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13663 KYAMC Journal Vol. 3, No.-1, June 2012 pp.265-268
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van den Bosch, W. J. H. M. "Tetanus, nieuwe richtlijnentetanus tetanus, richtlijnen tetanus, vaccinatie tetanus, booster tetanus, TIG." Bijblijven 19, no. 10 (October 2003): 400–402. http://dx.doi.org/10.1007/bf03059743.
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Ishraq Ahmed Chiad and Ban Yousif Yaaqoob. "Pregnant women’s knowledge of Tetanus disease and immunization against Tetanus disease in the City of Baghdad." Journal of the Pakistan Medical Association 73, no. 9 (October 6, 2023): S36—S39. http://dx.doi.org/10.47391/jpma.iq-07.
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Objective: To estimate the understanding of tetanus and tetanus toxoid injections among pregnant women.Method: The cross-sectional study was conducted at the Baghdad General Hospital and a primary healthcare centrein Bab-Almuadham, Iraq, from November 15, 2020, to January 15, 2021, and comprised 100 pregnant women aged15-45 years. Data was gathered through face-to-face structured interviews using a complete self-assessmentquestionnaire. Data was analysed using SPSS 27.Results: Of the 100 women with mean age of 28.4±10.6 years (range: 15-44 years), 27(27%) were aged 20-24 years,70(70%) were from the urban areas, 40(40%) had primary education, 69(69%) were housewives, and 85(85%) had hadfull or partial tetanus toxoid vaccine doses. With respect to knowledge about tetanus disease, 60(60%) subjectsanswered correctly that tetanus is a serious disease, 52(52%) knew that tetanus infection could also kill the foetus,and 30(30%) recognised that tetanus produces significant side effects. Besides, 80(80%) women considered the vaccinea necessity, and the most common source of information about tetanus vaccination was the health authorities 76(76%).Conclusion: The pregnant women studied were found to have an acceptable level of knowledge about tetanus andtetanus toxoid immunisation.Keywords: Pregnancy, Tetanus, Clostridium tetani, Asymptomatic infections, Tetanus toxoid, Nervous system,Demography, Uterus, Foetus
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Taribuka, Netty, and Mirna Heluth. "Penyuluhan Tentang Suntik Tetanus Toksoid Kepada Ibu Hamil Primigravida Di Pesisir Loun." Jurnal Pengabmas Masyarakat Sehat (JPMS) 1, no. 4 (October 30, 2019): 256–60. http://dx.doi.org/10.33992/ms.v1i4.1362.
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In 2008 there were cases of Tetanus Neonatorum with 91 cases of death or a Case Fatality Rate (CFR) of 55%. Most of the cases of Tetanus Neonatorum were babies whose deliveries were assisted by traditional birth attendants. Tetanus neonatorum is a tetanus disease that occurs in neonates (infants less than 1 month old) caused by Clostridium tetani, which is a germ that releases toxins that attack central nervous system. Risk factors that cause neonatal tetanus are delivery that does not meet cleanliness, namely umbilical cord care does not meet health requirements and administration of Tetanus Toxoid immunization to pregnant women is not carried out or is incomplete or not in accordance with program provisions. TT immunization is one solution to prevent tetanus neonatorum (TN). WUS who are the targets of TT immunization are women aged 15-49 years consisting of pregnant women (pregnant women) and non-pregnant women. TT immunization on WUS is given as many as 5 doses at certain intervals, starting before and or during pregnancy which is useful for lifelong immunityKeywords: tetanus, pregnancy, primigravida.
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Tejaya, Novi, and Marina Musyawwirina Desiprimayanti Ruslan Ramli. "Generalized Tetanus in A Patient with Infected Sutured Wound: A Case Report." AKSONA 3, no. 1 (January 31, 2023): 13–19. http://dx.doi.org/10.20473/aksona.v3i1.37362.
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Highlight: Tetanus in patients with infected sutured wound. Complications of death in generalized tetanus. The importance of education about tetanus. ABSTRACT Introduction: Tetanus is a disease caused by Clostridium tetani, which produces an exotoxin. Tetanus can rapidly progress into life-threatening muscle spasms accompanied by respiratory insufficiency with or without autonomic dysfunction. Case: A 43-year-old male patient was referred from the public health center to Tora Belo Hospital with mouth stiffness and difficulty swallowing food. He also had stiffness and pain in the neck, abdomen, and lower back. Seven days prior, the patient received lacerations on his right forearm caused by a machete. The patient’s wound had been stitched up without an anti-tetanus injection at the public health center. The symptoms worsened on the second day of admission, and the patient died from respiratory failure. Conclusion: It is very important to enhance public awareness that tetanus is a preventable disease, with proper vaccination and sanitization potentially lowering mortality and morbidity.
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Moniuszko, Anna, Agata Zajkowska, Ewa Tumiel, Krzysztof Rutkowski, Piotr Czupryna, Sławomir Pancewicz, Ryszard Rutkowski, Agnieszka Zdrodowska, and Joanna Zajkowska. "Meningitis, Clinical Presentation of Tetanus." Case Reports in Infectious Diseases 2015 (2015): 1–2. http://dx.doi.org/10.1155/2015/372375.
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Background. Tetanus is an acute disease caused by a neurotoxin produced byClostridium tetani. Tetanus immunization has been available since the late 1930s but sporadic cases still occur, usually in incompletely vaccinated or unvaccinated individuals.Case Report. An elderly previously vaccinated female contracted tetanus following foot injury. Clinically she presented with meningitis causing diagnostic and therapeutic delays.Why Should Physician Be Aware of This?Even in developed countries the differential diagnosis of meningitis, especially in the elderly, should include tetanus. Treatment in intensive care unit is required. General population might benefit from vaccine boosters and education on this potentially fatal disease.
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Bernal, O. R. Aguilar, M. A. Bender, and ME Lacy. "Efficacy of Dantrolene Sodium in Management of Tetanus in Children." Journal of the Royal Society of Medicine 79, no. 5 (May 1986): 277–81. http://dx.doi.org/10.1177/014107688607900507.
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The effectiveness of dantrolene sodium in controlling tetanic spasms was evaluated in 21 children (aged 4 days-13 years) with tetanus. These dantrolene-treated patients were compared with an historical control group of 26 children previously treated for tetanus by traditional means at the same institution. The groups were comparable in terms of age, other treatments, and severity of disease. All patients received standard treatments for tetanus, including sedatives, antibiotics, and tetanus-immune globulin. Patients in the dantrolene-treated group also received dantrolene, either intravenously (Dantrium® Intravenous) or orally, in divided doses totalling 4–6 mg/kg/day. Mortality was 73% (neonates 83%, non-neonates 50%) in the control group, compared with 33% (neonates 50%, non-neonates 0%) in the dantrolene-treated group. Dantrolene did not cause additional respiratory depression when administered alone or in combination with other drugs routinely used to treat tetanus. In this study, the use of dantrolene with traditional conservative therapy significantly reduced mortality from tetanus.
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Chua, Michael, and Angela F. Dulhunty. "Diazepam reveals different rate-limiting processes in rat skeletal muscle contraction." Canadian Journal of Physiology and Pharmacology 65, no. 2 (February 1, 1987): 272–73. http://dx.doi.org/10.1139/y87-048.
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The action of the tranquilizer diazepam on rat skeletal muscle showed that relaxation of isometric twitches is controlled by different processes in extensor digitorum longus (fast-twitch) and soleus (slow-twitch) muscles. Diazepam caused an increase in the amplitude of twitches in fibres from both muscles but increased the twitch duration only in soleus. The amplitude of fused tetani were reduced in both muscles and the rate of relaxation after the tetanus slowed by as much as 34% when the amplitude of the tetanus was reduced by only 11%. The slower tetanic relaxation indicated that calcium uptake by the sarcoplasmic reticulum was slower than normal in slow- and fast-twitch fibres. We conclude therefore that calcium uptake by the sarcoplasmic reticulum is rate limiting for twitch relaxation in slow-twitch but not fast-twitch fibres and suggest that calcium binding to parvalbumin controls relaxation in the fast fibres.
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Gobbur, R. H., P. Jagruthi, Anilkumar Sajjan, and S. S. Kalyanshettar. "An unusual cause for neck rigidity?" IP International Journal of Medical Paediatrics and Oncology 7, no. 3 (October 15, 2021): 161–63. http://dx.doi.org/10.18231/j.ijmpo.2021.031.
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Otogenic tetanus is a subtype of cephalic tetanus, limited to the head & neck, but can progress to a more generalized form. Caused by the spore-forming bacillus, Clostridium tetani, It produces a potent toxin, tetanospasmin, preventing inhibitory neurotransmitters' release, hence causing rigidity.
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Sunarsih, Sunarsih, Ana Mariza, Fijri Rachmawati, and Putu Candrawati. "Edukasi Imunisasi TT (Tetanus Toxoid) pada Calon Pengantin." JURNAL KREATIVITAS PENGABDIAN KEPADA MASYARAKAT (PKM) 5, no. 7 (July 1, 2022): 2238–42. http://dx.doi.org/10.33024/jkpm.v5i7.6305.
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ABSTRAK Pemeriksaan kesehatan pranikah lebih memfokuskan pada kesehatan reproduksi. Salah satu bentuk pemeriksaan yang juga merupakan syarat yang harus dipenuhi adalah imunisasi Tetanus Toxoid yang bertujuan untuk mencegah tetanus neonatorum. Penyakit tetanus neonatorum adalah penyakit tetanus yang terjadi pada neonatus (bayi berusia kurang 1 bulan). Angka kematian kasus (Case Fatality Rate) sangat tinggi. Pada kasus tetanus neonatorum yang tidak dirawat, angkanya mendekati 100%, terutama yang mempunyai masa inkubasi kurang dari 7 hari. Tujuan edukasi adalah untuk meningkatkan pengetahuan masayarakat tentang imunisasi TT. Edukasi dilakukan di wilayah kerja Puskesmas Pakuan Ratu tanggal 16 maret 2021. Pelaksanaan kegiatan terdiri dari 3 tahapan yaitu pretest, pemberian materi dan post test. Terdapat peningkatkan pengetahuan calon pengantin saat post test dengan selisih nilai sebanyak 60%. Kata Kunci: Edukasi, Tetanus Neonatorum, Calon pengantin ABSTRACT Premarital health checks are more focused on reproductive health. One form of examination that is also a requirement that must be met is the Tetanus Toxoid immunization which aims to prevent the occurrence of Tetanus Neonatorum. Tetanus Neonatorum is a disease that occurs in neonates (babies less than 1 month old). The case fatality rate is very high. In cases of untreated neonatal tetanus, the rate is close to 100%, especially those with an incubation period of less than 7 days. Purpose of the education is an increase of knowledge of the bride and groom about Tetatus Toxoid. The education was carried out in the work area of the Pakuan Ratu Health Center on March 16, 2021. The implementation of the activity consisted of 3 stages, that is pretest, giving materials and post-test. There is an increase in the knowledge of the bride and groom during the post test with a difference in value of 60% Keywords: Education, Neonatorum, Premarital
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Malinovská, Z., E. Čonková, and P. Váczi. "Tetanus in Animals — Summary of Knowledge." Folia Veterinaria 64, no. 3 (September 1, 2020): 54–60. http://dx.doi.org/10.2478/fv-2020-0027.
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AbstractTetanus is a neurologic non-transmissible disease (often fatal) of humans and other animals with a worldwide occurrence. Clostridium tetani is the spore producing bacillus which causes the bacterial disease. In deep penetrating wounds the spores germinate and produce a toxin called tetanospasmin. The main characteristic sign of tetanus is a spastic paralysis. A diagnosis is usually based on the clinical signs because the detection in the wound and the cultivation of C. tetani is very difficult. Between animal species there is considerable variability in the susceptibility to the bacillus. The most sensitive animal species to the neurotoxin are horses. Sheep and cattle are less sensitive and tetanus in these animal species are less common. Tetanus in cats and dogs are rare and dogs are less sensitive than cats. Clinically two forms of tetanus have been recognized, i. e. localized and generalized. The available treatment is not specific because the toxin in neuronal cells cannot be accessed by antitoxin antibodies. The aim of the therapy is to: neutralise the unbound neurotoxin, inhibit C. tetani growth in the wound, and provide supportive care to mitigate the effects of the neurotoxin. The treatment is difficult with an unclear prognosis.
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Guyennet, Eloïse, Jean-Laurent Guyomard, Emilie Barnay, Franck Jegoux, and Jean-François Charlin. "Cephalic Tetanus from Penetrating Orbital Wound." Case Reports in Medicine 2009 (2009): 1–3. http://dx.doi.org/10.1155/2009/548343.
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Tetanus is a neurologic disorder caused by tetanospasmin, a protein toxin elaborated by Clostridium tetani. Cephalic tetanus is a localized form of the disease causing trismus and dysfunction of cranial nerves. We report the case of a man who presented with facial trauma, complete ophthalmoplegia, exophthalmos, areactive mydriasis, and periorbital hematoma. An orbital CT revealed air bubbles in the right orbital apex. The patient was given a tetanus toxoid booster and antibiotherapy. After extraction of a wooden foreign body, the patient developed right facial nerve palsy, disorders of swallowing, contralateral III cranial nerve palsy, and trismus. Only one case of cephalic tetanus from penetrating orbital wound has been reported in literature 20 years ago. When a patient presents with an orbital wound with ophthalmoplegia and signs of anaerobic infection, cephalic tetanus should be ruled out.
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Chaudhary, Raina, Binod Karki, Sabita Bhatta, and Manoj Pradhan. "Localized Tetanus: Rare and Elusive." Medical Journal of Shree Birendra Hospital 12, no. 1 (November 4, 2013): 47–49. http://dx.doi.org/10.3126/mjsbh.v12i1.9095.
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Tetanus is acute and fatal infectious disease which is acquired due to contamination of wound with soil or animal feces containing spores of Clostridium tetani. In this case, 24 old male, serving personnel of Nepalese Army, developed localized tetanus, a rare form of tetanus nearly 3 weeks following crocodile bite in his left thigh. It was painful with involvement of only local flexor muscles at the site of injury. The aim is to incite awareness of the rare form of the Tetanus in adult which is often overlooked in clinical practice.Medical Journal of Shree Birendra Hospital; January-June 2013/vol.12/Issue1/47-49DOI: http://dx.doi.org/10.3126/mjsbh.v12i1.9095
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Wulandari, Annisa, Purwaningsih Purwaningsih, and Astuti Rofida. "PENDIDIKAN KESEHATAN PADA IBU HAMIL MELALUI PEMBERIAN IMUNISASI TT (TETANUS TOKSOID) DI WILAYAH KERJA UPT. PUSKESMAS PULO BRAYAN." SENTRI: Jurnal Riset Ilmiah 3, no. 1 (January 15, 2024): 442–54. http://dx.doi.org/10.55681/sentri.v3i1.2198.
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Imunisasi tetanus toksoid merupakan suatu cara untuk menimbulkan/meningkatkan kekebalan seseorang secara aktif terhadap infeksi Tetanus saat atau pasca persalinan. Tetanus yaitu gangguan neurologis yang ditandai dengan meningkatnya tonus otot dan spasme, yang disebabkan oleh Clostridum Tetani. Salah satu pencegahan Tetanus Neonatrum adalah dengan melakukan Imunisasi Tetanus Toksoid pada Ibu Hamil. Tujuan dari penelitian ini adalah memberi gambaran Pendidikan Kesehatan Pada Ibu hamil melalui pemberian imunisasi Tetanus Toksoid (TT). Metodeologi : Penelitian ini menggunakan metode deskriptif melalui pendekatan studi kasus yang difokuskan tentang Pendidikan Kesehatan pada Ibu Hamil melalui pemberian imunisasi Tetanus Toksoid. Subyek pada penelitian ini adalah 2 orang pasien dewasa ibu hamil pada trimester I kehamilan I. Hasil : Peneliti melakukan penelitian terhadap dua partisipan yang sama-sama memiliki keluhan tentang defisit pengetahuan di puskesmas pulo brayan dengan lima tahap sesuai dengan proses keperawatan yang dikembangkan oleh Americane Nurse Association (ANNA) yaitu pengkajian, diagnosa keperawatan, intervensi keperawatan, implementasi keperawatan, dan evaluasi. Dengan pendidikan kesehatan mengenai pentingnya imunisasi tetanus toksoid pada ibu hamil diperoleh hasil yang sama antara kasus I dan II didapatkan data hari ke 3 masalah defisit pengetahuan dapat diatasi. Kesimpulan : Setelah peneliti melakukan asuhan keperawatan dengan menggunakan pendekatan proses keperawatan yang mencakup pengkajian, perumusan diagnosa keperawatan, menetapkan rencana, melakukan implementasi dn evaluasi. Maka peneliti dapat menyimpulkan defisit pengetahuan dapat diatasi.
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He, Qing, Yejian Wu, Shuiping Hou, Lei Luo, and Zhoubin Zhang. "Seroprevalence of Diphtheria and Tetanus Immunoglobulin G among the General Health Population in Guangzhou, China." Vaccines 12, no. 4 (April 4, 2024): 381. http://dx.doi.org/10.3390/vaccines12040381.
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A seroepidemiological study was conducted in 2018 to assess diphtheria and tetanus antibodies in Guangzhou, China. Diphtheria and tetanus antibody concentrations were measured with an enzyme-linked immunosorbent assay. A total of 715 subjects were enrolled in the study. The overall diphtheria and tetanus toxoid IgG-specific antibody levels were 0.126 IU/mL (95% CI: 0.115, 0.137) and 0.210 IU/mL (95% CI: 0.185, 0.240), respectively; the overall positivity rate was 61.82% (95% CI: 58.14, 65.39) and 71.61% (95% CI: 68.3, 74.92), respectively. The diphtheria and tetanus antibody concentration was decreased by age and increased by doses. The geometric mean concentrations and positivity rate of diphtheria and tetanus antibodies were lowest and below the essential protection level in people over 14 years of age. Compared to children and adolescents, middle-aged people and the aged are at much higher risk of infection with Corynebacterium diphtheriae and Clostridium tetani. The current diphtheria and tetanus immunization schedule does not provide persistent protection after childhood. There is an urgent need to adjust the current immunization schedule.
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Mayousse, Vincent, Caroline Soete, and Aurélien Jeandel. "Suspected Generalized Neonatal Tetanus in a Litter of Puppies." Journal of the American Animal Hospital Association 59, no. 1 (December 30, 2022): 51–55. http://dx.doi.org/10.5326/jaaha-ms-7246.
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ABSTRACT Tetanus, caused by Clostridium tetani neurotoxin, is extensively described in adult dogs and is frequently associated with a recent history of wounds. Although this condition is reported in 2–3 mo old puppies, tetanus has not been described in neonates. Herein, we report the clinical signs of 3–5 day old American Bully puppies from the same litter, presenting with an acute onset of marked generalized stiffness of the extensor muscles, trismus, and an inability to suckle. Three puppies died because of tetanus: one died during consultation, one was euthanized owing to respiratory distress, and the third died 1 mo after initial presentation following deterioration. All three of these puppies were clinically affected by omphalitis. Complete bloodwork, toxicological screening (including strychnine assay), serology, and polymerase chain reaction tests for selected infectious diseases were unremarkable. Necropsy of the euthanized puppy confirmed suppurative omphalitis, which may have contributed to C. tetani infection. These are the first cases of suspected neonatal tetanus in puppies, which is a frequent condition in newborn humans and is associated with omphalitis as the route of infection.
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Khadka, Bikash, Kishor Khanal, and Nisha Sharma. "Persistent Pyrexia in Tetanus: A Case Report from Nepal." Birat Journal of Health Sciences 7, no. 3 (December 31, 2022): 1919–20. http://dx.doi.org/10.3126/bjhs.v7i3.52774.
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Tetanus, an infection caused by the gram-positive, obligate anaerobic bacillus Clostridium tetani, is still prevalent in developing countries. Fever is an unusual symptom in tetanus. The disease must be managed by preventing tetanospasmin absorption, treating symptoms, stabilizing autonomic instability, using antibiotics, and controlling the airway with assisted ventilation if necessary. We present a case report of a tetanus patient who had persistent pyrexia despite ruling out all the obvious causes of fever ,that coincide with the persistence of muscle spasms and/or use of prolonged duration of benzodiazepines.
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Rangkuti, Nur Aliyah, Juni Permata Sari, and Delfi Ramadhini. "FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN PEMBERIAN IMUNISASI TETANUS TOKSOID PADA IBU HAMIL." Jurnal Kesehatan Ilmiah Indonesia (Indonesian Health Scientific Journal) 5, no. 2 (December 21, 2020): 54. http://dx.doi.org/10.51933/health.v5i2.250.
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One of causes ofmaternal and infant deaths istetanusinfection caused bythe bacterium clostridium tetani as arsult of unsafe/steril labor. Tetanus toxsoid is the best way to protect the mother and baby from the disease tetanus as a result of not sterile or derived from injuries acquired expectant mothers before giving birth. In Padangsidimpuan at 2017 Tetanus Toksoid immunization reached 41%. This research is to know the factors of the giving Tetanus Toksoid immunization on pregnant women in the health Padangmatinggi at 2019. This research is quantitative research using cross sectional design. Sample research are 91 people of pregnant women at the health Padangmatinggi taken in simple random sampling. By using chi square with 90% significance level α = 0.1. The results of analysis is known the majority of respondents knowledgeable less as much as 86.8%. The majority of respondents being negative as much as 53.8%. There is a relationships between knowledge by administering Tetanus Toksoid immunization in the health Labuhan Rasoki at 2019 with p value = 0.000 (< 0.1), there is a relationship attitude by administering Tetanus Toksoid immunization in health Labuhan Rasoki at 2019 with p value = 0.001 (<0.1). It is recommended to health workers to improve health promotion through public awareness about Tetanus immunization Toksoid to pregnant women.
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Shafi Ullah Khan, Muhammad Kashif Farooq, Ejaz Ahmad, Muhammad Khan, Intekhab Alam, Shah Sawar Khan, and Nibahat Hameed. "In-Hospital Mortality among Patients of Severe Adult Tetanus Presenting with bad Prognostic Factors: A Tertiary Care Hospital Experience." Journal of Saidu Medical College, Swat 13, no. 2 (June 28, 2023): 60–66. http://dx.doi.org/10.52206/jsmc.2023.13.2.769.
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Background: Tetanus caused by clostridium tetani, despite being a preventable disease, is still posing a significant health hazard to developing countries like Pakistan. Objective: To determine in-hospital mortality among patients of severe adult tetanus presenting with bad prognostic factors.Material and Methods: This cross-sectional study was conducted at the Department of Medicine, Medical Teaching Institution Lady Reading Hospital, Peshawar, Pakistan from July 13, 2017, to January 13, 2018, on 176 patients. All severe adult tetanus patients as per Ablett Classification with bad prognostic factors (incubation period <7 days, persistent fever >40o C, persistent tachycardia of >120/min, and no history of post-exposure prophylaxis) were included in the study. Patients with compromised renal functions (urea >108 mg/dl, reduced urine output <50 ml/hr) and already diagnosed neuromuscular junction disorders were excluded from the study. Written informed consent was obtained and patients were enrolled in the study. All patients were immediately worked up with detailed history and clinical examinations and were managed as per ICU protocols and followed within the hospital for mortality.Results: Mean age of study participants was 47±10.27 years. The majority of study subjects were males (n=102, 58%), un-immunized (n=88, 50%) or partially immunized (n=26, 15%), socioeconomically poor (n=84, 48%), illiterate (n=82, 47%) and from urban areas (n=114, 65%). In-hospital mortality was recorded in 109 (62%) of the study subjects. In hospital mortality was recorded highest in patients with an age range of 41-65 years (n=70/109, 64.22%), males (n=63/109, 57.8%), unimmunized (n=55/109, 50.45%), poor (n=52/109, 47.7%), illiterate (n=51/109, 46.78%) and urban (n=71/109, 65.14%). Conclusion: In-hospital mortality was high in patients with severe adult tetanus presenting with bad prognostic factors.Keywords: Clostridium tetani, Hospital Mortality, Severe adult tetanus, Tetanus, Tetanus Antitoxin, Tetanus Toxoid, Trismus, Prognostic Factors.
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Sodha, Vikram Singh, Shalu Gupta, Somendra Bansal, Bhanwar Lal Yadav, Dinesh Bharti, and Bhanu Kaushik. "Study of clinico-epidemiological factors and outcome of tetanus in a tertiary care hospital." International Surgery Journal 5, no. 7 (June 25, 2018): 2518. http://dx.doi.org/10.18203/2349-2902.isj20182765.
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Background: Tetanus is an acute neurological fatal disorder caused by anaerobic spore forming bacillus Clostridium tetani, which produced an exotoxin (Tetanospasmin) in a wound. Purpose of this study was to find out the clinico-epidemiological factors of tetanus and how we can modify or minimize the outcome of this disease.Methods: This prospective, observational study was conducted in isolation ward in department of general surgery, SMS hospital Jaipur (Rajasthan) from 1 March 2016 to October 2017. Two hundred patients with clinical diagnosis of tetanus, who were admitted in single unit of SMS hospital, recruited in this study. Patients with age less than 1 yr were excluded. After admission, patient’s detailed history and thorough clinical examination done. The day to day progress of the cases was followed till the time of their discharge from the hospital. Outcome variables were age, gender, geographical area, causes of tetanus and site of injury, precipitating factors, role of baclofen, morbidity, cured and mortality.Results: In this study, mean age of patients were 17 years and male to female ratio was 2.44:1. Most of patients were from rural backgrounds with rural to urban ratio of 6.14:1. Overall mortality in present study was 16.5%. The severity of disease directly related with mortality. The mortality for mild, moderate and severe tetanus was 0%, 1.9% and 68.1% respectively.Conclusions: Though tetanus is a vaccine preventable illness, its prevalence is high in our country. The incidence of tetanus can be reduced by: strengthening of primary immunization programme; proper wound management and giving prophylactic tetanus immune globulins along with tetanus vaccine.
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Ernst, Michael E., Michael E. Klepser, Michelle Fouts, and Markos N. Marangos. "Tetanus: Pathophysiology and Management." Annals of Pharmacotherapy 31, no. 12 (December 1997): 1507–13. http://dx.doi.org/10.1177/106002809703101211.
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OBJECTIVE: To review the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of tetanus and its complications. DATA SOURCES: MEDLINE and Iowa Drug Information Services databases were searched for literature pertaining to tetanus. Additional literature was obtained from the references of selected articles identified in the search. Information from all articles was considered for inclusion in the manuscript. STUDY SELECTION AND DATA EXTRACTION: Articles selected were those considered by the authors to assist in providing the reader an understanding of the epidemiology, pathophysiology, clinical manifestations, diagnosis, and management of tetanus. DATA SYNTHESIS: While the number of tetanus cases has decreased markedly since data reporting for the disease began in 1947, mortality among those who acquire the disease remains high. Elderly patients are particularly susceptible to tetanus and its complications. Prevention of tetanus focuses on primary immunization and scheduled boosters. Management of tetanus involves initial stabilization of the patient and protection of the airway, prevention of tetanospasmin absorption by administration of human tetanus immune globulin 3000–6000 IU, and eradication of Clostridium tetani with antimicrobial therapy (metronidazole 500 mg q8h). Supportive measures include the administration of neuromuscular blocking agents such as pancuronium in patients requiring artificial ventilation, as well as benzodiazepines (midazolam 5–15 mg/h) for sedation and muscle relaxation. Autonomic dysfunction should be managed with β-adrenergic blockers such as propranolol or labetalol. CONCLUSIONS: Despite the relative inffequency of tetanus cases, mortality among untreated patients remains significantly high. Clinicians should become knowledgeable in the pathophysiology, clinical manifestations, and management of this potentially fatal disease.
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Muthia, Gina, Afrizal Afrizal, Putri Nelly Syofiah, Yulia Fitri, and Laura Maisiska. "TINGKAT PENGETAHUAN CALON PENGANTIN TENTANG IMUNISASI TETANUS DIFTERI DI WILAYAH KERJA PUSKESMAS TARUSAN KABUPATEN PESISIR SELATAN." Jurnal Kesehatan Tambusai 4, no. 4 (December 28, 2023): 6667–73. http://dx.doi.org/10.31004/jkt.v4i4.21919.
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Penyakit tetanus adalah penyakit menular yang tidak ditularkan dari manusia ke manusia secara langsung tetapi penyebabnya adalah kuman clostridium tetani. Kekebalan terhadap tetanus hanya dapat diperoleh melalui imunisasi tetanus difteri (Td) pada wanita usia subur dan ibu hamil. Wanita usia subur dan ibu hamil yang mendapatkan imunisasi tetanus difteri (Td) akan membentuk antibody tetanus seperti difteri, antibody tetanus termasuk golongan Ig G yang mudah melewati sawar plasenta, masuk dan menyebar melalui aliran darah ke seluruh tubuh janin yang akan mencegah terjadinya tetanus neonatorum. Dari 20 Puskesmas yang ada di Kabupaten Pesisir Selatan, Puskesmas Tarusan merupakan salah satu puskesmas dengan cakupan imunisasi Td1 terendah yaitu 0% dengan jumlah sasaran adalah 4786 orang. Tujuan penelitian adalah untuk mengetahui tingkat pengetahuan calon pengantin tentang imunisasi Tetanus Difteri di Wilayah Kerja Puskesmas Tarusan Kabuapten Pesisir Selatan. Metode Penelitian : Desain penelitian ini adalah cross sectional. Penelitian ini telah dilaksanakan di Wilayah Kerja Puskesmas Tarusan Kabupaten Pesisir Selatan pada tanggal 21-25 Juni 2023. Populasi adalah calon pengantin yang sudah menikah pada bulan April 2023, sampel berjumlah sebanyak 30 orang pengantin. Penelitian ini dianalisis dengan distribusi frekuensi. Hasil : 22 orang (73,3%) memiliki pengetahuan yang cukup tentang pengertian imunisasi Td, 16 orang (53,3%) memiliki pengetahuan yang kurang tentang tujuan imunisasi Td, 21 orang (70%) memiliki pengetahuan yang cukup tentang manfaat imunisasi Td, 21 orang (70%) memiliki pengetahuan yang baik tentang efek samping imunisasi Td. Dapat disimpulkan sebagian besar responden memiliki pengetahuan yang cukup tentang imunisasi Td.
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Celichowski, Jan, and Edyta Bichler. "The time course of the last contractions during incompletely fused tetani of motor units in rat skeletal muscle." Acta Neurobiologiae Experimentalis 62, no. 1 (March 31, 2002): 7–17. http://dx.doi.org/10.55782/ane-2002-1413.
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The time course of the contraction and the relaxation of individual contractions during incompletely fused tetani of motor units were analyzed. Investigations were performed on fast fatigable (FF), fast resistant (FR) and slow (S) motor units of the rat medial gastrocnemius muscle. Stimulation of a motor unit with a series of nine trains of stimuli at a frequency from 10 to 150 Hz was used and tetani fused to a variable degree were recorded. For fast motor units the procedure was repeated twice and observations were made on potentiated tetani in the second series of stimulation. For each tetanus, the amplitude of the tension increase, the peak amplitude of the contraction, the contraction time and the half-relaxation time were measured in the last contraction of the tension recording. It was observed in all three types of motor units that the last contraction was prolonged in parallel with the increase of fusion of a tetanus. In this contraction, the contraction time slightly decreased whereas the half-relaxation time strongly prolonged. The prolongation of the half-relaxation time was the strongest in tetani of slow units. Moreover, for the last contraction in a tetanus, the rate of changes in tension were studied. The rate of increase in tension during the contraction decreased in parallel with the increase of fusion of a tetanus, whereas the maximal rate of the tension decrease during the relaxation was found in tetani with fusion indices of 0.79, 0.98 and 0.95 for FF, FR and S motor units, respectively. Changes in the time course of contractions in tetani fused to a variable degree can shed light on processes of summation of contractions in unfused tetani at the level of individual motor units.
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Fusetti, S., C. Ghirotto, and G. Ferronato. "A Case of Cephalic Tetanus in a Developed Country." International Journal of Immunopathology and Pharmacology 26, no. 1 (January 2013): 273–77. http://dx.doi.org/10.1177/039463201302600131.
Full textAbstract:
Tetanus is a potentially life-threatening infection that results from contamination of skin wound by Clostridium Tetani spores. Although, it remains an important health problem in developing countries without strict national immunization programs, this condition is rare in the developed world. The most frequent presenting symptoms are trismus and dysphagia, due to the spasmodic contraction of the masticatory muscles. Then the disease usually diffuses with a descending pattern inducing a generalized contraction of the agonist and antagonistic muscles, which characterize a tetanic spasm. Mortality usually results from respiratory failure, cardiovascular collapse, or autonomic dysfunctions. Treatment usually requires the prompt admission to the intensive care unit to avoid the development of potential life-threatening complications. We report the case of a 78-year-old farmer, who was referred to us with progressive onset of lock-jaw and muscular stiffness of the facial region, that had occurred after he had scratched himself with a rose. The recognition of the presenting signs of cephalic tetanus allowed the prompt management of the infection. However, because of the rarity of this condition, the clinicians may be unfamiliar with the clinical presentation, and be unsuspecting of the diagnosis.
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Pennings, Jeroen L. A., Eric Abachin, Raphaël Esson, Hennie Hodemaekers, Antoine Francotte, Jean-Baptiste Claude, Céline Vanhee, Sylvie Uhlrich, and Rob J. Vandebriel. "Regulation of Clostridium tetani Neurotoxin Expression by Culture Conditions." Toxins 14, no. 1 (January 2, 2022): 31. http://dx.doi.org/10.3390/toxins14010031.
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Background: Ensuring consistency of tetanus neurotoxin (TeNT) production by Clostridium tetani could help to ensure consistent product quality in tetanus vaccine manufacturing, ultimately contributing to reduced animal testing. The aim of this study was to identify RNA signatures related to consistent TeNT production using standard and non-standard culture conditions. Methods: We applied RNA sequencing (RNA-Seq) to study C. tetani gene expression in small-scale batches under several culture conditions. Results: We identified 1381 time-dependent differentially expressed genes (DEGs) reflecting, among others, changes in growth rate and metabolism. Comparing non-standard versus standard culture conditions identified 82 condition-dependent DEGs, most of which were specific for one condition. The tetanus neurotoxin gene (tetX) was highly expressed but showed expression changes over time and between culture conditions. The tetX gene showed significant down-regulation at higher pH levels (pH 7.8), which was confirmed by the quantification data obtained with the recently validated targeted LC-MS/MS approach. Conclusions: Non-standard culture conditions lead to different gene expression responses. The tetX gene appears to be the best transcriptional biomarker for monitoring TeNT production as part of batch-to-batch consistency testing during tetanus vaccine manufacturing.
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Abdullahi Samaila, Bashir Abdulkadir, Kamaladdeen Kabir, Sani Aliyu, and Zubairu Umar. "Pathogenesis and Management of Tetanus." UMYU Journal of Microbiology Research (UJMR) 3, no. 1 (June 30, 2018): 16–23. http://dx.doi.org/10.47430/ujmr.1831.003.
Full textAbstract:
Tetanus is an infectious disease affecting the central nervous system caused by Clostridium tetani. The bacteria is an anaerobic Gram- positive bacilli that forms spores, which germinate in anaerobic condition to produce an exotoxin known as Tetanospasmin, and this is the whole mark of the pathogenesis of this disease. Tetanus remains a great public health problem in developing countries such as Nigeria. It affects all age group and both males and females. In Nigeria, the death rate differs from the range of 38% to 60%, depending on the infrastructural facilities and personnel at the reporting centre. The disease is not very common in developed nations. Mortality rate of 20-60% was reported in Africa. Four clinical types of tetanus were recognized such as generalized, cephalic, localized and neonatal type. Diagnosis is mainly clinical. The management of tetanus include Neutralization of unbound toxins, eliminating the source of the toxin and prevention of its further production, Control of spasm as well as general measures to support the life of the affected patient. It is a fatal disease with poor prognosis especially the cephalic type in adults, and neonatal tetanus. The objective of this work is to present a reviewed update on pathogenesis and management of tetanus. Additionally, to evaluate the contribution of tetanus towards the increased morbidity and mortality in Nigeria.
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Iwamoto, Satori, and Harrison Chu. "Tetanus Presented as Acute Abdomen." Asploro Journal of Biomedical and Clinical Case Reports 5, no. 1 (March 2, 2022): 42–45. http://dx.doi.org/10.36502/2022/asjbccr.6261.
Full textAbstract:
Tetanus is commonly seen in the emergency department with a puncture wound. This is an unusual presentation of tetanus without an open wound. A 59 year old male with a past history of hypertension, hepatitis C, prior injection drug use, and homeless presented to the emergency department with altered mental status and hyperthermia with fever of 105 F on a hot July afternoon. Patient was found in his car sleeping. Initially, the patient declined medical care, but was later found unresponsive with a methadone bottle next to him. Given Narcan on field with improvement of mental status. Patient developed acute ridged abdominal pain. A CT scan raised concern for acute abdomen, with portal venous gas, and intestinal pneumatosis. Surgery consulted and was concerned for ischemic colon with perforation. Vancomycin, ceftriaxone and metronidazole were given. Emergency exploratory laparotomy was performed with a small serosal injury on colon repaired with suture. Blood culture came back positive for Clostridium tetani and Mobiluncus curtisii. Infectious disease consulted. Felt tetanus cannot be ruled out. Patient was given tetanus immune globulin (TIG), metronidazole and later tetanus vaccine. Patient has fully recovered, tolerates oral diets, and has been discharged to a nursing facility without any neurological deficit. Tetanus is a neurological disorder caused by the tetanus toxins produced by clostridium tetani, which is a gram positive obligate anaerobes commonly found in soil. It is relevant to note that this bacterium can also be found inside the gut of animals and humans. The disease is well characterized by ancient Greeks, and common symptoms include trismus (“lockjaw”), opisthotonos, and a board-like rigid abdomen. Incubation is usually 7-21 days and this disease is usually prevented by vaccination. This case is unusual because there is no open wound and PE is limited due to patient’s overdose on opiates (methadone). Possible cause for this particular case may be that since there was no open wound, the blood could have been seeded by the perforated bowel because they may also be found in the gut. The patient was given metronidazole as part of Tx for acute abdomen, which happens to also be a treatment for tetanus. Diseases can be presented atypically. This case illustrates the importance of differential diagnosis when considering treatments in any pathology.
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O’Leary, Deborah D., Karen Hope, and Digby G. Sale. "Posttetanic potentiation of human dorsiflexors." Journal of Applied Physiology 83, no. 6 (December 1, 1997): 2131–38. http://dx.doi.org/10.1152/jappl.1997.83.6.2131.
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O’Leary, Deborah D., Karen Hope, and Digby G. Sale.Posttetanic potentiation of human dorsiflexors. J. Appl. Physiol. 83(6): 2131–2138, 1997.—Twitch contractions of the ankle dorsiflexors were evoked before and after applied 7-s tetanic stimulation at 100 Hz in 20 young adults. Torque decreased 15% during the tetanus. At 5 s after tetanus, twitch peak torque had potentiated 45%. Potentiation declined to 28% after 1 min, rose slightly to 33% at 2 min, and declined slowly with potentiation still 25% after 5 min. There was large intersubject variation in the amount of potentiation (5–140%) and its persistence (5 to ≥20 min). The muscle compound action potential (M wave) did not change significantly (from pretetanic value) at 5 s after tetanus but increased sharply (26%) at 2 min and then subsided. Twitch half relaxation time (23%) decreased significantly more than twitch rise time (13%) 5 s after tetanus and recovered more slowly. Twitch rates of torque development (75%) and relaxation (71%) increased similarly 5 s after tetanus and were still elevated (∼25%) at 5 min. The extent of twitch torque potentiation was significantly inversely correlated with pretetanic twitch rise time ( r = −0.69), half relaxation time ( r = −0.61), and twitch-to-tetanus ratio ( r = −0.66). The data indicate that posttetanic potentiation has a greater effect on twitch half relaxation time than on time to peak torque and is more prominent in muscles with a short twitch time course and small twitch-to-tetanus ratio.
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Westerblad, H., and D. G. Allen. "The influence of intracellular pH on contraction, relaxation and [Ca2+]i in intact single fibres from mouse muscle." Journal of Physiology 466, no. 1 (July 1993): 611–28. http://dx.doi.org/10.1113/jphysiol.1993.sp019737.
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1. The effects of intracellular pH (pHi) on myoplasmic free calcium concentration ([Ca2+]i) and contractile performance were studied in intact single fibres dissected from mouse skeletal muscle. Indo‐1 was used to measure [Ca2+]i and pHi was altered by changing perfusate CO2. 2. Tetanic tension was decreased at acidic pHi and increased at alkaline pHi whereas the rate of mechanical relaxation was showed at both acidic and alkaline pHi. Resting and tetanic [Ca2+]i were increased at acidic pHi and decreased at alkaline pHi while the final rate of decline of [Ca2+]i after a tetanus was markedly slowed at acid pHi but only marginally accelerated at alkaline pHi. 3. Steady‐state [Ca2+]i‐tension curves were constructed from measurements of tetani at different stimulus frequencies. The curves at acid pHi showed a reduced maximum Ca(2+)‐activated tension and a reduced Ca2+ sensitivity, and curves at alkaline pHi showed the opposite changes. 4. Two methods were devised to determine the contribution of [Ca2+]i to the rate of relaxation. In one method the instantaneous tension was plotted as a function of instantaneous [Ca2+]i throughout a tetanus and compared with the steady‐state [Ca2+]i‐tension relation. In a second method the [Ca2+]i signal during a tetanus was converted to a Ca(2+)‐derived tension record by means of the steady‐state [Ca2+]i‐tension relation and this Ca(2+)‐derived tension was then compared to the true tension. 5. The sarcoplasmic reticulum (SR) pump function was analysed by plotting ‐d[Ca2+]i/dt against [Ca2+]i during the final slow decline of [Ca2+]i after a tetanus. This analysis shows that the Ca2+ uptake by the SR is a third‐ or fourth‐power function of [Ca2+]i and that acidosis substantially slows the rate of SR Ca2+ pumping. 6. In conclusion, the slowing of relaxation at acidic pHi could be attributed to a slowing of cross‐bridge detachment rather than the observed slowing of the rate of uptake of Ca2+. Conversely the slowing of relaxation in alkaline pHi could be attributed to the increase of Ca2+ sensitivity of the myofibrillar proteins.