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A Flower

Publications and source records attributed to A Flower.

7 recordsLinked to original sources
PubMed1995

A new method for active surveillance of adverse events from diphtheria/tetanus/pertussis and measles/mumps/rubella vaccines.

We describe a new method for active post-marketing surveillance of vaccine safety based on patient records. We studied the association between diphtheria/tetanus/pertussis (DTP) vaccination and febrile convulsion, and between measles/mumps/rubella (MMR) vaccination and febrile convulsion and idiopathic thrombocytopenic purpura (ITP) in five district health authorities in England by linking vaccination records with computerised hospital admission records. We found an increased relative incidence for convulsions 0-3 days after DTP vaccination. The effect was limited to the third dose of vaccine for which the attributable risk (all ages) was 1 in 12,500 doses. Completion of vaccination by 4 months instead of 10 months after the change in the UK to an accelerated immunisation schedule may have resulted in a 4-fold decrease in febrile convulsions attributable to DTP vaccine. 67% of admissions for a convulsion 6-11 days after MMR vaccination were attributable to the measles component of the vaccine (risk 1 in 3000 doses). An excess of admissions for a convulsion 15-35 days after MMR vaccination was found only for vaccines containing the Urabe mumps strain (1 in 2600 Urabe doses). There was a causal association between MMR vaccination and ITP resulting in admission 15-35 days subsequently; there was no evidence of a mumps strain-specific effect. The estimated absolute risk of 1 in 24,000 doses was 5 times that calculated from cases passively reported by clinicians. This finding emphasises the need for active surveillance of adverse events. The record linkage method that we used is an effective way to identify vaccine-attributable adverse events.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed1993

Risk of aseptic meningitis after measles, mumps, and rubella vaccine in UK children.

Cases of aseptic meningitis associated with measles/mumps/rubella vaccine were sought in thirteen UK health districts following a reported cluster in Nottingham which suggested a risk of 1 in 4000 doses, substantially higher than previous estimates based on cases reported by paediatricians (4 per million). Cases were ascertained by obtaining vaccination records of children with aseptic meningitis diagnosed from cerebrospinal fluid samples submitted to Public Health Laboratories or discharged from hospital with a diagnosis of viral meningitis. Both methods identified vaccination 15-35 days before onset as a significant risk factor and therefore indicative of a causal association. With both, half the aseptic meningitis cases identified in children aged 12-24 months were vaccine-associated with onset 15-35 days after vaccine. The study confirmed that the true risk was substantially higher than suggested by case reports from paediatricians, probably about 1 in 11,000 doses. However, the possibility that the aseptic meningitis induced by vaccination was largely asymptomatic and a chance laboratory finding in children investigated for other clinical conditions, particularly febrile convulsions, could not be excluded. Comparison of national reports of virus-positive mumps meningitis cases before and after the introduction of this vaccine indicated that the risk from wild mumps was about 4-fold higher than from vaccine. Altogether, 28 vaccine-associated cases were identified, all in recipients of vaccines containing the Urabe mumps strain. The absence of cases in recipients of vaccine containing the Jeryl Lynn strain, despite its 14% market share, suggested a higher risk from Urabe vaccine. A prospective adverse event surveillance system using the study methods is currently being established to assess the risk, if any, from the Jeryl Lynn strain which is now the only mumps vaccine used in the UK.

Child, Preschool↗
PubMed1981

An occupational therapy program for chronic back pain.

This paper describes a multidisciplinary approach to the evaluation and treatment of the patient with chronic spinal pain with particular emphasis on the cooperative roles of the physical disabilities occupational therapist and the psychosocial occupational therapist. The goal of the total program is to help patients progress from a sick role of dependent, painful behavior to a less pain-centered, more productive role--one in which they have begun to assume control over the way they feel and function. The success of the program is measured by the patient's increased activity level and improved ability to cope with the demands of home and job. A review of patient records after one year of operation showed that only 4 of 54 patients who completed both phases of the program were returning to the orthopedic back clinic as outpatients.

Back Pain↗
PubMedDate not supplied

[Use of discourse analysis for evaluation of the condition of patients with dementia of the Alzheimer type].

The study was concerned with the ability to discourse in a group of 10 patients with minor or moderately severe disturbances in Alzheimer disease and in a control group of healthy subjects. The aim the study was to answer the question whether patients with this disease have language deficits, and if they have, then at what level they appear and what is their influence on the communication ability. The experimental task included production of a narrative and a procedural discourse. The results were analysed from the standpoint of grammar of clauses and their informative contents. The analysis showed that the patients had no deficit in respect to the extent of the discourse, its complexity and grammar correctness. However, errors were found in the contents of the discourse. In particular, the discourse of the patients had a greater number of irrelevant and incorrect propositions. The possible explanation of the demonstrated deficit pattern is discussed stressing the importance of progmatic and cognitive factors. The conclusion is that language disorders in these patients should not be regarded as a type of aphasia.

Aged↗