BCG VACCINATION AGAINST TUBERCULOSIS IN CHICAGO

PEDIATRICS ◽  
1961 ◽  
Vol 28 (4) ◽  
pp. 622-641
Author(s):  
Sol Roy Rosenthal ◽  
Erhard Loewinsohn ◽  
Mary L. Graham ◽  
Dorothy Liveright ◽  
Margaret G. Thorne ◽  
...  

A series of 1,716 BCG-vaccinated and 1,665 nonvaccinated infants, all born at the Cook County Hospital in Chicago between February, 1937, and February, 1948, were followed until February, 1960 (23 years). Among the vaccinated there was a total of 17 cases of tuberculosis (0.43/1,000/yr) and 65 cases in the nonvaccinated 1.7/1,000/yr), a reduction of 75%, statistically highly significant (p 0.001). The morbidity was 0.41/1,000/yr (16 cases in 1,716) in the vaccinated subjects and 1.5/1000/yr (59 cases in 1,665) in the controls, or a reduction of 74% (p 0.001). There was one death from tuberculosis in the vaccinated subjects and six in the controls, or a reduction of 83%. The number of deaths is too small for meaningful statistical analysis. Comparisons of the control and vaccinated groups were made for subsequent contact to tuberculosis in the home and environment, sex, race, birth weight, observation years, follow-up care, general health and reasons for loss from study. The over-all comparability of the two groups was adequate in most respects. Statistically significant differences were assessed for medical importance. In 639 families in which there were both vaccinated and control siblings, 8 of the 790 vaccinated subjects developed tuberculosis as compared with 30 of the 845 control individuals. The difference is highly significant (p 0.001). Thirteen cases of nonfatal tuberculosis developed in the controls 2 years of age and under and none in the vaccinated. There were three deaths from tuberculosis in the controls under 2½ years of age (miliary tuberculosis plus meningitis in all) and one death in the vaccinated group (meningitis). The latter was an infant who had not converted at 6 months of age and was not revaccinated. Following vaccination, 99.3% became tuberculin positive and 82.4% were still positive, after 8 years, to a single vaccination.

2021 ◽  
pp. 66-67
Author(s):  
Vijay Pratap Singh ◽  
Akash Singh ◽  
Pranab Kumar Verma ◽  
Vishal Mohan Singh ◽  
Arun Kumar Jha

Background: Early breast cancer patients admitted in the surgical oncology department of Savera Cancer and Multispeciality Hospital. Patients were divided in two treatment arms; Arm A and Arm B. Arm A patient went through MRM and Arm B patients went through BCS. This study included prospective cases of 1 year from June 2019 to June 2020. Method: In all MRM group patients all breast tissue, skin, nipple areola complex and level 1, 2, 3 lymph nodes removed. In all BCS group patients lump was removed with an envelope of normal appearing breast tissue. In all resected specimens free surgical margin was ensured via histopathology reports (HPR). Patients were reviewed in early post operative period for complications and follow up done at the end of 1st, 3rd, 6th and 12th month for recurrence. In treatment Arm A (MRM) 08 patients developed arm ede Result: ma; 05 patients developed shoulder dysfunction; 07 patients developed ap necrosis; 07 patients developed arm dysesthesia. Whether in treatment ARM B (BCT) 04 patient had Seroma formation; 13 patients developed wound infection & wound contracture. Complications were reported in 35% of MRM group (35 out of 100 cases), while they were absent in 65% (65 out of 100). However, in the BCS group, complications were reported in 6.66% cases only (15 out of 100 cases), while were absent in 93.33% (75 out of 100). P value by statistical analysis being 0.283, the difference being statistically insignicant. Recurrence were present in 6.66% of MRM group (8/100) while they were absent in 92.34 % (92/100). However in BCS group recurrences were present in 3.33 % (3/100) and were absent in 97.67% (97/100). P value by statistical analysis being 1, the difference being statistically insignicant. Grading of complications has been captured from CTCAE Version 5.0 (Common Terminology Criteria for Adverse Events). Conclusion: There is slight signicant difference in the recurrence rate, whether the patient had undergone BCS or MRM based on our short term follow-up. However a long term follow-up is required.


2020 ◽  
Vol 10 (1) ◽  
pp. 56
Author(s):  
Uğur Gürgan

The aim of this study is to determine the effect of Psycho-drama Integrated Psycho-Education Program (PIPP) on divorce adaptation and resilience scores of children of divorced families. In this study, a 2x3 design with experimental and control groups and having pre-test, post-test and follow-up measurements was used. Nonparametric statistics were used in the analysis of the obtained data. Mann Whitney U test was adopted to determine the significance of the difference between the groups and Wilcoxon Signed-Ranks Test was utilized to find the significance of the difference between the measurements. The Child’s Divorce Adjustment Inventory, Child and Youth Resilience Measure and Personal Information Form were used as data collection tools. Based on the results, it was seen that the PIPP had a highly significant effect on the increase in adaptation and resilience scores of children of divorced families and this effect was long-lasting.


2019 ◽  
Vol 98 (11) ◽  
pp. 2533-2539
Author(s):  
Shreekant Parasuraman ◽  
Jingbo Yu ◽  
Dilan Paranagama ◽  
Sulena Shrestha ◽  
Li Wang ◽  
...  

Abstract Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fatemeh Javidi ◽  
Parsa Yousefichaijan ◽  
Fatemeh Dorreh ◽  
Ali Arjmand ◽  
Masoud Rezagholizamenjany

Background: Montelukast, as a non-steroidal anti-inflammatory drug, could reduce inflammation in nephrotic syndrome (NS). This study aimed to evaluate the therapeutic effect of montelukast as adjunctive therapy in pediatric NS. Methods: This clinical trial study was conducted on patients with NS. The patients were assigned into two equal groups (N = 25 in each) of intervention (steroid + montelukast) and control and treated for one month. One month later, in the follow-up stage, their proteinuria was measured. The results before and after treatment were statistically analyzed by SPSS software version 21, and the final report of the project was presented. Results: The age of participants in the intervention and control groups was 7.26 ± 4.23 and 6.79 ± 3.91 years, respectively (P = 0.68), and there were 10 female participants in both groups (P = 1.0). Albumin levels in 96% of the control group and 76% of the intervention group were 1.5 - 2.5 μg/dL (P = 0.037). Also, 48% of participants in the control group were corticosteroid dependent, and 60% of participants in the intervention group responded to corticosteroids (P = 0.194). The severity of nephrotic syndrome was moderate in 60% of participants in the control group and mild in 60% of participants in the intervention group (P = 0.138). Conclusions: The results of this study showed that recovery rate was higher in the intervention group, but the difference was not statistically significant.


1984 ◽  
Vol 5 (10) ◽  
pp. 478-481 ◽  
Author(s):  
G. Srinivasan ◽  
E. Azarcon ◽  
M.R.L. Muldoon ◽  
G. Jenkins ◽  
S. Polavarapu ◽  
...  

AbstractHuman rotavirus (HRV) epidemics have not been reported in normal full-term newborn nurseries in the US. This report describes an epidemic from April 27 to May 6, 1982 in which 23 infants were infected. Diagnosis was confirmed with Rotazyme (Abbott) in 82% (23/28 ) of the neonates screened. Five were asymptomatic; in the remaining 18 cases, the symptoms were usually mild and self-limited. Transient shedding of the virus was found in 8% (4/52) of personnel screened, and only one of them was symptomatic. Control measures included the following: strict cohorting, closure of transitional nursery, enteric precautions and wiping of horizontal surfaces with 95% ethyl alcohol which has been shown to be an effective virucidal agent for rotavirus in laboratories. Follow-up in 80 of 108 contact neonates born during the epidemic showed only two mildly symptomatic cases after discharge. During an 11-month period of surveillance, 33% of neonates (1,688/5,054) born at Cook County Hospital were screened for excretion of virus in stools; only 3.6% of infants (61/1,688) were positive by Rotazyme and none were symptomatic. This report suggests that strict measures are helpful in control of HRV epidemic gastroenteritis and asymptomatic shedding need not be as high as the previously reported incidence of 40% to 50%.


2011 ◽  
Vol 24 (1) ◽  
pp. 43-47
Author(s):  
NS Afsar ◽  
MMN Khan ◽  
MMH Chowdhury ◽  
SA Haq ◽  
M Khalilur Rahman ◽  
...  

Background: Spondyloarthropathies include a wide spectrum of disease. The study was conducted with the aim of observing the efficacy of SSZ and MTX in different subclasses of spondyloarthropathies and to compare the treatment response of the two drugs. Methods: This study was conducted in the Department of Medicine and Rheurnatology clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU) between January 1999 and July 2001.A total number of one hundred twenty five patients was included in the study. Patients with active disease more than three months, regularly taking NSAIDs and not on DMARD in the last three months were included in the study. Monthly follow up of the patients was done for 6 months. Result: One hundred twenty five patients were included in this study. Male female ratio was 11.5:1. Mean age of patients was 24.17±7.15 years. The mean disease duration was 47.8±32.8 months. The present study categorized the patients into responder and non responder. Among the 78 patients in AS subclass, after completion of 6 month trial 55.6% patients in SSZ group and 39.4% patients in MTX group were categorized responder. The difference of response between drug groups was not significant (p=0.158). In the JCA subclass 81.82% in SSZ and 50% in MTX group were responder. The numbers of patient in Reiter's/Reactive Arthritis in our study were too small to make a definite comment. Conclusion: It can be concluded from this study that both the SSZ and MTX are effective DMARDs for spondyloarthropathies. Statistical analysis did not prove superiority of one drug over another, though the response rates were numerically higher in SSZ group. TAJ 2011; 24(1): 43-47


2021 ◽  
Vol 6 (2) ◽  
pp. 159-165
Author(s):  
Subhash Chand Bairwa ◽  
Ravinder Singh Gothwal ◽  
Badri Ram ◽  
Shivani Gupta ◽  
Chetna Meena

Aim: To compare the effect of two RT schedules for thoracic palliation in advanced NSCLC patients (30 Gy in 10 fractions over two weeks and 27 Gy in 6 fractions over three weeks, 2 fractions per week) on pulmonary symptoms, radiological response of the primary thoracic tumour, pulmonary functions and acute toxicities. Material and method: A hospital based quantitative prospective follow-up study. Total 104 advanced NSCLC patients were randomized into two fractionation arms. Evaluation was done pretreatment and 4 weeks after end of RT. Symptoms palliation and radiological response to RT & radiation pneumonitis were assessed by using RTOG 4-point scale and Revised (RECIST) guideline version 1.1 respectively. Radiotherapy was given by Cobalt-60 teletherapy machine. Results: Total 96 patients were evaluated for symptom palliation, radiological response and acute toxicities. The percentage of patients achieving symptom palliation was slightly higher in the control arm. At 1st month of follow-up, 16.67% & 18.75% patients in Study & control arm showed PR. Post-RT mean FVC and FEV1 showed a tendency for improvement in both mean FVC and FEV1 in compare to baseline. Treatment was well tolerated both arms. Grade I nausea and vomiting developed in 43% and 37.5% patients in Study and Control Arm respectively. 58% & 39% patients developed Grade 1 radiation pneumonitis as cough & dyspnea in study and control arms respectively. Grade 2 radiation pneumonitis was developed in 2 patient of study arm at 3rd week of follow-up but they lost follow up. Around 31% patients developed Grade1 esophagitis as dysphagia in both arms at 1 week of follow-up which was reduced up to 7% by 2nd week. A very few patients developed grade1 skin reaction as dermatitis in 1st week of treatment. The difference in symptom palliation, radiological response, pulmonary functions and acute toxicities in both arms was not statistically significant. Conclusion: The two RT fractionation schedules showed equal efficacy in terms of symptoms palliation, radiological response of the primary thoracic tumor, pulmonary functions and acute toxicities. Thus the 27 Gy/6 fractionation arm appears preferable compared to 30 Gy/10 arm to minimize the patients’ visits and load on the machines.


Author(s):  
Cecília T. BARROS ◽  
Vanessa G. MIRANDA ◽  
Karine L. CORTELLAZZI ◽  
Luciane C. LOPES ◽  
Sílvio BARBERATO-FILHO ◽  
...  

Objective: To evaluate the efficacy of pharmaceutical care in improving outcomes of Brazilian outpatients with type 2 diabetes mellitus. Methods: In this single-blind, controlled trial, 71 outpatients were randomized into two groups: pharmaceutical care intervention (managed using pharmacotherapy follow-up protocol); and control (managed using standard dispensing procedures). Outcomes included hospitalization, severe complication (retinopathy, renal insufficiency, hypoglycemia, coronaropathy or foot lesion), and the values of A1c hemoglobin (HbA1c), capillary glycaemia (CG), blood pressure (BP), total cholesterol (TC) and body mass index (BMI). All patients were followed for 12 months and drug-related problems (DRP) were described in intervention group. The groups were compared using the Student´s t-test, Tukey-Kramer, Chi-square and Fisher exact tests. Results: No significant difference in baseline clinical characteristics of the intervention (n= 36) and control groups (n= 35) (p>0.05). The groups did not differ for the outcome hypoglycemia, CG, BP, HbA1c, TC and BMI (p>0.05), but CG and HbA1c levels decreased at 3, 6 and 12 months, in both groups (p≤0.05). A total of 56 DRP were observed in intervention group and the pharmacist resolved approximately 60% of these. Conclusion: Improvements in the glycemic parameters of outpatients with type 2 diabetes mellitus attended within a community pharmacy were observed. Studies involving larger samples are needed to confirm the benefits of pharmacotherapy follow-up care for key clinical outcomes in these patients. The trial was registered in Clinicaltrials.gov: Record NCT03196336.


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