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Hernia: del griego ERNOS, dislocación, quebradura. Se designa con el nombre de hernia, a un tumor formado por un órgano o una parte de órgano salido de la cavidad que normalmente lo contiene, por un orificio natural o accidental. Antiguamente se empleaba el sufijo "Cele", que es la palabra griega latinizada "Kele" que significa tumor y que se posponía al nombre de la víscera que estaba encerrado en la hernia, por ejemplo: enterocele - hernia intestinal-, cistocele - hernia vesical-, rectocele hernia rectal-, etc.

This study is the third in a series on virus-neutralizing antibody response to different schedules of antirabies serum and vaccines in previously non-exposed persons. Three types of vaccine were studied-phenolized (Semple), duck embryo and high-egg-passage (HEP) chicken embryo. Reduced schedules of vaccine, consisting of 2-7 inoculations given at various intervals, did not give results comparable in efficacy (time of appearance, level and persistence of antibody) with schedules comprising at least 14 daily inoculations of vaccine as determined in previous trials. The effectiveness of a booster dose in previously sensitized individuals was confirmed with a demonstration that a rise in serum antibody appears between 4 and 8 days after the booster inoculation. Effective sensitization appears to be as much a function of spacing of inoculations as of total dosage of vaccine antigen. Interference by immune serum with the antigenicity of subsequently administered vaccine, noted previously by the present authors and by other workers, was again confirmed. This interference could be overcome by the administration of a sufficient amount of vaccine.

Groups of adult humans, previously unexposed to rabies and with no history of rabies vaccination, were inoculated with different schedules of phenolized inactivated vaccine and Flury strain chicken-embryo vaccine, with or without one inoculation of hyperimmune serum. Serum specimens of the inoculated individuals were studied for antibody up to the 28th day following the first inoculation of the vaccines and serum. The results can be summarized as follows:1. Passive antibody appeared in the blood-stream within one day following inoculation of hyperimmune serum. The antibody persisted at a good level for at least 10 days, but dropped slightly by the 14th day and was present in most individuals at the 21st day.2. There was a tendency for the antibody levels at 21 and 28 days to be lower in the phenolized vaccine plus antiserum groups than in those groups which received phenolized vaccine alone.3. Seven or 12 daily inoculations of phenolized vaccine alone produced antibody in most instances by the 10th day and persisted generally through the 28th day.4. Daily inoculations of phenolized vaccine produced a superior antibody response to that derived from the same total amount of vaccine given as a single inoculation.5. A single inoculation intramuscularly of Flury strain chicken-embryo vaccine of high egg-passage did not produce detectable antibody.6. The group which received hyperimmune serum followed by 12 daily inoculations of phenolized vaccine showed early and persistent antibody throughout the entire period of test. The antibody levels were comparable to those recently observed in man treated effectively with antiserum-vaccine combination after severe exposure to rabies.(9)

Further studies were made on groups of adult humans, previously unexposed to rabies and with no history of rabies vaccination, who were inoculated with different schedules of phenolized inactivated vaccine given subcutaneously and high egg passage (HEP) Flury strain vaccine given intradermally, with and without inoculation of antirabies serum. Serum specimens of the inoculated individuals were studied for antibody up to the 60th day after the first inoculation of the vaccines and serum. Studies were also made on the effect of "booster" doses of HEP Flury strain vaccine given 6 months after preparatory inoculations. The results can be summarized as follows:1. Fourteen daily inoculations of phenolized vaccine produced a superior antibody response to that obtained with 3 inoculations given 5 days apart.2. Three intradermal inoculations of HEP Flury vaccine given 5 days apart gave a low level of antibody response, but these individuals responded efficiently by producing antibody to a "booster" dose of the same vaccine given 6 months later.3. Administration of phenolized vaccine or of HEP Flury vaccine alone did not produce detectable antibody in most individuals until between the 10th and the 15th day after the first inoculation of the vaccine.4. Passive antibody following inoculation of antirabies serum persisted in some individuals for as long as 42 days. Two inoculations of serum administered 5 days apart did not give levels of antibody higher than those obtained with one inoculation.5. One inoculation of serum completely suppressed antibody response to 3 inoculations of Flury vaccine given intradermally 5 days apart, and also prevented the preparation of the individuals to respond to a later "booster" dose of this vaccine.6. Three inoculation of phenolized vaccine given 5 days apart acted efficiently in producing antibody by the 60th day. However, the interfering action of one and two inoculations of serum was clearly defined in this schedule.7. One inoculation of serum had no suppressive effect on the active antibody response to 14 daily doses of phenolized vaccine; two doses of serum given in the same combination definitely interfered with the production of an active antibody response.

Epidemiological patterns of rubella transmission were studied by performing haemagglutination-inhibition (HI) tests on 1 132 sera collected from urban and rural areas of Spain in the period 1969-71. Different epidemiological values were ascribed to 3 levels of HI titre in order to analyse current prevalence and past incidence independently. Titres below 8 were considered negative, while low titres (8-32) were taken to indicate old immunity, medium titres (64-512) to indicate well-established immunity, and high titres (>/=1 024) to indicate recent infection. The method appears to be of value for the surveillance of rubella. The findings confirmed that transmission takes place mainly among children of school age and continues at a substantial level up to about 30 years of age. The pattern of transmission differed markedly between city and rural populations.

This article reports experiments with guinea-pigs on methods of producing wounds and infecting them with street virus, and on the use of nitric acid, detergent solution and antirabies serum in the local treatment of these wounds for the prevention of rabies. Despite certain limitations in the experimental arrangement, the authors consider that these findings are valuable in verifying some of the similar experiments performed by other workers.The addition of hyaluronidase to the virus challenge suspension did not increase the infectivity of the suspension when applied to wounds, but there was a trend towards increased pathogenicity of the hyaluronidase-virus mixture over virus suspension alone when inoculated intramuscularly.In the local treatment of wounds the protective action which resulted when nitric acid was applied within 4 hours, but not after a 24-hour interval, after infection, confirmed the results of other workers.Antirabies serum also proved effective both when infiltrated under the wound and when inoculated systemically up to 24 hours after infection, this being the longest interval tested. The results suggested that the serum exerted a specific local action.While some protective action was apparently achieved with the detergent Terjolate when applied by gentle swabbing, or by infiltration of saline solution under the wound, up to 3 hours after infection, this protection was distinctly inferior to that obtained with nitric acid or serum. The authors point out the excellent results reported by other workers with a different detergent, Zephiran chloride, and recommend further studies on this and other similar substances less corrosive than nitric acid.These experiments, considered together with those reported by other workers, indicate the value of simple washing, flushing or irrigation of wounds as a means of reducing virus levels below the infective dose.The authors cite the need for further research on local treatment of wounds in order to clarify mechanisms of action of various procedures and agents now used, and to improve the methods for handling the worrisome situation presented by a bite wound from an animal suspected of having rabies.