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G F Hayden

Publications and source records attributed to G F Hayden.

At least 73 records · Page 4Linked to original sources
PubMed1982

Methodologic issues in the evaluation of vaccine effectiveness: measles vaccine at 12 vs. 15 months.

Initial studies of vaccine effectiveness are usually controlled clinical trials. Subsequent serologic and epidemiologic investigations cannot be as carefully controlled, and methodologic rigor must be considered when evaluating their results. The authors reviewed the methodologic features of greatest importance in the design of field investigations of vaccine efficacy and examined how different methodologic approaches may have influenced the results of studies of measles vaccine efficacy at 12 vs. 15 months of age. Among the serologic studies, time since vaccination was not controlled, so that children vaccinated several years ago at 12 months of age may have been compared with children vaccinated much more recently at later ages. Most studies included children vaccinated at several years of age as controls rather than children vaccinated only at the pivotal ages of 13-15 months. Finally, studies using a single clinic as their vaccine source found smaller differences in efficacy than studies using multiple vaccine sources, suggesting that variation in handling and storage may affect the results. Among the epidemiologic studies, no single methodologic feature clearly influenced whether there was significantly improved vaccine efficacy with increasing age at vaccination. However, studies differed with respect to intensity of effort to detect cases unreported through the usual channels; definition of what constituted a case of measles; whether the effect of midoutbreak clinics on overall estimates of vaccine efficacy was considered; and inclusion of revaccinated children in the analysis. These methodologic variations can make it extremely difficult to evaluate the size and clinical importance of relatively small differences in vaccine efficacy. Greater attention to the methodologic features discussed here will be needed in future studies of vaccine efficacy.

Epidemiologic Methods↗
PubMed1982

Parents' conception of their use of over-the-counter medicines.

To explore their hypothetical responses to management of fever or nasal congestion in their children, 109 patients were interviewed in a clinic waiting-room area. Most parents said they would medicate their children in these situations without first consulting a health professional. Parents were more willing to administer a drug product for fever than for nasal congestion, especially to children under 2 years of age. Although most parents selected appropriate medications for these situations, many were poorly informed about these drugs and falsely attributed germicidal and decongestant properties to aspirin and Tylenol. Younger, less educated, indigent parents in lower-status occupations were the least well informed. Pediatricians need to prepare parents for their role as health care providers.

Acetaminophen↗
PubMed1981

Three-day therapy of lower urinary tract infections with nitrofurantoin macrocrystals: a randomized clinical trial.

Forty-nine girls between the ages of 2 and 18 years with a symptomatic urinary tract infection documented by two clean-catch urine cultures completed a double-blind study comparing the effectiveness of three days versus ten days of nitrofurantoin macrocrystal therapy. Localization of the infection to the lower urinary tract was presumed on the basis of clinical presentation. All patients had sterile urine on day two or three of therapy. In the ten-day group, two of 23 patients (8.7%) experienced a single relapse, and seven patients (30%) had 12 episodes of reinfection during a six-month follow-up. In the three-day group, two of 26 patients (7.7%) had a single relapse, and six patients (23%) had 12 episodes of reinfection. The rates of relapse and reinfection in the compared groups were not statistically significantly different (P greater than 0.05). Three days of treatment with nitrofurantoin macrocrystals is an effective regimen for symptomatic girls presumed to have uncomplicated lower urinary tract infections.

Adolescent↗
PubMed1981

Prophylaxis of varicella in high-risk children: dose-response effect of zoster immune globulin.

Immunodeficient patients who were presumed to be susceptible received zoster immune globulin prophylaxis after exposure to varicella. The highest clinical attack rate (35.9%) was seen in household contacts; the lowest attack rate (0%) was observed in children exposed at school. Among household contacts, 48 of 100 patients who received high titer ZIG (reciprocal complement fixation titer greater than or equal to 2,560) developed fourfold rises in serum CF antibody between pre- and 48-hour post-treatment specimens, compared to only one of 34 patients treated with lower titer ZIG lots (P less than 0.001). Patients who developed fourfold antibody rises were significantly less likely to contract clinical varicella (P less than 0.01). Patients who received high titer ZIG also had significantly lower risks of death (P = 0.025) and complications (P = 0.006). Among ZIG-treated patients who contracted clinical varicella, 80% developed mild disease (less than 100 pox), and the median incubation period was prolonged. Immunodeficient children exposed to varicella benefit from ZIG prophylaxis and higher titer ZIG is of greatest benefit.

Adolescent↗
PubMed1981

Acute suppurative otitis media in children. Diversity of clinical diagnostic criteria.

Practicing pediatricians were surveyed via mailed questionnaire and a review was made of the pertinent literature in an attempt to identify suitable criteria for making the clinical diagnosis of acute suppurative otitis media (ASOM) in children. Clinical diagnostic criteria were described in only 26 of the 43 studies reviewed; 18 different sets of criteria were used. Use of identical criteria in more than one study was usually the result of multiple publications by particular authors rather than agreement between two investigators. One hundred and sixty-five questionnaire respondents proposed 147 different sets of criteria. Only 11 criteria sets were proposed by more than one respondent, and no single set was listed by more than six respondents. Greater standardization of clinical diagnosis is desirable, but difficult to achieve and will require additional studies to correlate clinical findings with objective measures of diagnosis, such as tympanocentesis.

Acute Disease↗
PubMed1980

Olfactory diagnosis in medicine.

Like the reporter who relies on a nose for news, the physician needs a nose for diseases and intoxications. Characteristic patient odors accompany many diseases and intoxications, and their recognition can provide diagnostic clues, guide the laboratory evaluation, and affect the choice of immediate therapy.

Alcoholism↗
PubMed1979

Nosocomial varicella. Part II: suggested guidelines for management.

Because of the potential severity of varicella among patients with compromised immunity in hospitals, a case of nosocomial varicella demands immediate attention. Patients with varicella should be discharged or placed in strict isolation. Other patients in the hospital should be screened for varicella exposure and susceptibility, and isolated as necessary. Exposed staff members must also be screened for susceptibility. Prompt institution of these measures should prevent or reduce transmission of nosocomial varicella.

Chickenpox↗
PubMed1978

Current status of mumps and mumps vaccine in the United States.

Reported mumps in the United States has declined to all-time low levels following the increasingly widespread use of mumps-virus vaccine. Mumps vaccine has proven safe and effective. Its incorporation into combined live-virus vaccines, especially measles-mumps-rubella, has made mumps vaccination a practical and economically feasible component of routine immunization activities. Because of the favorable experience to date with mumps vaccine and the associated drop in mumps morbidity and mortality, mumps control programs likely will receive increasing public health attention in the coming years.

Adolescent↗
PubMed1977

Immunization.

Explore the source record for details and available documents.

Immunization↗
PubMed1977

Current status of rubella in the United States, 1969-1975.

Implementation of the rubella immunization policy in the United States has resulted in marked decreases in the number of reported cases of both rubella and CRS. Emphasis on immunization of one- to 12-year-old children has resulted in a dramatic reduction in reported rubella in this age group. Accordingly, the proportion of reported cases occurring in adolescents and young adults has increased. Therefore, it seems appropriate to place more emphasis on immunizing susceptible adolescent and adult females as an adjunct to routine immunization in early childhood. This joint strategy should result in a further decrease in the incidence of rubella and CRS.

Adolescent↗
PubMed1976

Risk of congenital abnormality after inadvertent rubella vaccination of pregnant women.

The risk to a fetus after rubella vaccination of its mother is unknown. The Center for Disease Control has compiled information from the pregnancies of 343 women inadvertently given rubella vaccine shortly before or after conception. The pregnancies of 145 women were terminated by therapeutic abortion, and rubella vaccine virus was recovered from the products of conception of nine women, including six of the 28 known to be seronegative to rubella at the time of vaccination. None of the 172 infants carried to term had either clinical or serologic evidence of rubella infection, including 38 infants of women known to be susceptible and 12 additional women estimated to be susceptible at the time of rubella vaccination. On the basis of the binomial distribution, the maximum risk of fetal infection after maternal rubella vaccination is between 5 and 10 per cent. The actual risk is probably less.

Abortion, Therapeutic↗