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G P Schmid

Publications and source records attributed to G P Schmid.

At least 19 recordsLinked to original sources
PubMed2001

Evaluation of a mass influenza vaccination campaign.

Kawaura, a rural town in Kumamoto Prefecture, Japan, population approximately 6,800, started a mass influenza vaccination campaign in the 1999-2000 season for all residents > or = 3 years of age. The town provided free vaccinations to children < or = 13 years and the elderly > or = 65 years. Only 900 yen (US$8.80) was charged to the other residents for two vaccinations. In the 1999-2000 season, a total of 5,563 doses of vaccine were administered to 2,952 residents. Over 90% of the vaccinees received two doses. The program resulted in a vaccination rate of 43% of all residents. The vaccination rates for females and males were 40.7% and 36.8%, and for those of 3-14 years, 15-64 years, and > or = 65 years population were 75%, 31%, and 55%, respectively. The town spent a total of 5.78 million yen (US$56,700) for the campaign. The per-shot cost was estimated as 1,683 yen (US$16.50). From December 1999 through March 2000, a total of 233 town residents (15-101 years old, median 72) were admitted to the town hospital. Of the 233 inpatients, 22 (66-98 years old, median 78) developed respiratory illness, with 4 fatal outcomes. Of these 22 cases, 3 had been vaccinated twice, while 19 had not been vaccinated at all. The relative risk of vaccinees' hospitalization due to respiratory illness decreased to 0.13 compared with that of non-vaccinees (3/1,203 versus 19/1,003, vaccine efficacy = 0.87). Likewise, the relative risk of vaccinees death due to respiratory illness decreased to 0.28 compared with that of non-vaccinees (1/1,203 versus 3/1,003). The results of the Kawaura town's initiative should be helpful for better modeling of mass influenza vaccination campaigns.

Adolescent↗
PubMed1999

Bacterial vaginosis: review of treatment options and potential clinical indications for therapy.

We reviewed data on the treatment of bacterial vaginosis published from 1993 through 1996. For nonpregnant women, we recommend use of metronidazole (500 mg orally twice daily for 7 days), clindamycin vaginal cream (2%, once daily for 7 days), or metronidazole vaginal gel (0.75%, twice daily for 5 days) as the preferred treatment for bacterial vaginosis. For pregnant high-risk women (women with a prior preterm birth), the objective of the treatment is to prevent adverse outcomes of pregnancy, in addition to relief of symptoms. Thus, systemic therapy for possible subclinical upper tract infection as well as medication that has been studied in pregnant women are preferable. Therefore, we recommend metronidazole (250 mg orally three times a day for 7 days). For pregnant low-risk women (women without a prior preterm birth) with symptomatic disease, the main objective of the treatment is to relieve symptoms. We recommend metronidazole (250 mg orally three times a day for 7 days). Data do not support routine treatment of male sex partners.

Female↗
PubMed1999

Treatment of chancroid, 1997.

Since the 1993 treatment guidelines for sexually transmitted diseases were published by the Centers for Disease Control and Prevention, experience has indicated that the regimens recommended then remain largely effective. The recommended therapies--with azithromycin (1 g orally, once), ceftriaxone (250 mg intramuscularly, once), or erythromycin (500 mg orally, four times a day for 7 days)--appear highly effective in the United States; limited data from Kenya suggest that the ceftriaxone regimen may not be as effective there as it once was. The alternative regimen of ciprofloxacin proposed in 1993 (500 mg orally, twice a day for 3 days) is as effective as the recommended therapies, but new information indicates that single-dose therapy with 500 mg orally is not as effective as the use of either larger single doses or more prolonged therapy. Persons who are infected with human immunodeficiency virus (HIV) do not respond as well as those who are not HIV-infected, and males who are uncircumcised appear not to respond as well as those who are circumcised.

Chancroid↗
PubMed1998

Congenital syphilis after treatment of maternal syphilis with a penicillin regimen exceeding CDC guidelines.

BACKGROUND: Although congenital syphilis usually occurs as a result of a failure to detect and treat syphilis in pregnant women, failures of the currently recommended regimen to prevent congenital syphilis have been reported. CASE: This report describes an infant with congenital syphilis despite maternal treatment with a regimen exceeding current CDC guidelines. CONCLUSION: Regardless of the regimen used to treat syphilis during pregnancy, clinicians should recognize the possibility of occasional treatment failures and the importance of adequate follow-up of infants at risk for congenital syphilis.

Adult↗
PubMed1995

Recommendations for treatment of chancroid, 1993.

Since the 1989 Sexually Transmitted Diseases Treatment Guidelines were published by the Centers for Disease Control and Prevention, changes in the efficacy of the recommended and alternative regimens for the treatment of Haemophilus ducreyi infections have been described. Among recommended agents, erythromycin remains effective, and although a single dose of ceftriaxone appears to remain effective in the United States, limited data from Kenya have shown that this regimen has been associated with treatment failures. Of alternative treatment regimens, trimethoprim-sulfamethoxazole has been associated with widespread failure, but little work has been done to further evaluate the efficacy of the amoxicillin/clavulanic acid and ciprofloxacin regimens. Of the new antimicrobials, azithromycin has been very effective in the United States, but the efficacy of this drug elsewhere has not been thoroughly evaluated. Fleroxacin has been very effective in Kenya. Data from Africa indicate that patients who are infected with the human immunodeficiency virus do not respond to therapy as well as patients who are not, and patients who are uncircumcised may not respond as well to therapy as do patients who are circumcised.

Anti-Bacterial Agents↗
PubMed1995

Bacterial vaginosis: review of treatment options and potential clinical indications for therapy.

We reviewed data on the treatment of bacterial vaginosis published from 1989 through 1992 (articles published after the 1989 publication of the Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines). This review suggests that oral metronidazole (500 mg twice daily for 7 days) is the preferred treatment for bacterial vaginosis. Other effective (but alternative) treatment regimens include single-dose metronidazole (2 g orally), 2% clindamycin vaginal cream (once daily for 7 days), 0.75% metronidazole vaginal gel (twice daily for 5 days), and oral clindamycin (300 mg twice daily for 7 days). Data do not support the practice of routine treatment of male sex partners of infected females. Treatment of bacterial vaginosis during pregnancy should focus on the elimination of symptoms; data on adverse pregnancy outcomes for women with bacterial vaginosis remain insufficient to recommend treatment of asymptomatic patients. Before performing surgical abortion, treatment of bacterial vaginosis (symptomatic or asymptomatic) should be considered to prevent pelvic inflammatory disease.

Administration, Topical↗
PubMed1995

Enhanced recovery of Haemophilus ducreyi from clinical specimens by incubation at 33 versus 35 degrees C.

Isolation rates of Haemophilus ducreyi from cases of chancroid are low. Experts recommend that isolation media be incubated at 33 to 35 degrees C, but the possible effect of this temperature range on the recovery of H. ducreyi has not been evaluated. We inoculated two sets of agar plates with material from genital ulcers and incubated one set at 33 degrees C and one at 35 degrees C; incubation at 33 degrees C identified 21% more cases than did incubation at 35 degrees C (109 versus 85 cases, respectively, of the 116 cases from which an isolation was made; P < 0.01).

Agar↗
PubMed1995

Understanding the essentials of economic evaluation.

Economic evaluation (EE) answers the following simple question: "From which course of action do we get the most value for our money?" We ask this question because resources are always limited, i.e., we never have enough money to do all the things we would like to do. Three types of economic evaluations are used: cost-effectiveness analysis, cost-utility analysis, and cost-benefit analysis. Although all involve a monetary and outcome comparison of two or more courses of action, the methodologies and outcomes of each type vary, making each one particularly suited for specific and different indications. Although the performance of an EE may be complex, its concept is intuitively simple. Understanding the basic elements of economic analysis is more and more important to all health-care providers because health-care policy makers at all levels are increasingly using EE for allocating resources.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Prevalence of self-medication with antibiotics among patients attending a clinic for treatment of sexually transmitted diseases.

To ascertain the prevalence of self-medication with antimicrobial agents among patients attending a clinic for treatment of sexually transmitted diseases (STDs), we administered a questionnaire to and collected a urine specimen for antimicrobial testing from 551 patients before treatment. We defined self-medication as an antimicrobial agent taken on the patient's own initiative by self-report during the week before the visit to the clinic or a positive urine assay for antimicrobial agents at the time of the clinic visit. We tested urine for the presence of antimicrobial agents by a disk diffusion method using Sarcina lutea as the test organism. A total of 75 (14%) of the 551 participants were self-medicators: 19 reported antimicrobial use and had a positive urine test, 27 reported antimicrobial use but had a negative urine test, and 29 denied antimicrobial use but had a positive urine test. Thus, 29 (60%) of the 48 patients with antimicrobial agents detected in their urine at the time of the clinic visit denied self-medication. Self-medicators acquired their antibiotics either from their medicine cabinet (44%) or from a family member or friend (56%). Self-medication was associated with self-report of prior use of unprescribed antimicrobial agents (P < .0001). We concluded that use of unprescribed antimicrobial agents (usually beta-lactam agents or tetracyclines) among STD clinic attendees in our study was common and that self-reporting was not a reliable method of screening for self-medicators.

Adult↗
PubMed1992

Chancroid in the United States, 1981-1990: evidence for underreporting of cases.

Chancroid, a bacterial sexually transmitted disease (STD) characterized by genital ulceration, has reemerged in the United States during the last decade. From 1950 to 1980, cases were infrequently reported. After an epidemic in California in 1981, however, the numbers of cases increased, peaking in 1987 at 5,035. Despite a subsequent decline in numbers of reported cases to 4,223 in 1990, new areas continue to report outbreaks. Interpreting chancroid surveillance data is difficult because confirmatory culture media are not commercially available. In addition, states may not require that unconfirmed or even confirmed cases be reported. To determine if chancroid is more widely distributed than surveillance figures indicate, CDC contacted STD clinics in 115 health departments, located in 32 states, the District of Columbia, and Puerto Rico--areas chosen because they had reported five or more cases of chancroid in any single year during 1986-1990--to determine if cases might be occurring but not reported. Only 16 of the 115 clinics had culture media available for Haemophilus ducreyi, and only nine had laboratory facilities complete enough to definitively diagnose chancroid, syphilis, or genital herpes, the most common STDs characterized by genital ulcers. Five or more clinically likely cases occurring in 1990 were identified in 24 states, seven more than surveillance figures indicated. Surveillance can be improved if a) states utilize the definitions for chancroid cases adopted for use in 1990 and b) microbiology laboratories utilize enhanced diagnostic methods.

Chancroid↗
PubMed1991

Syphilis treatment update.

Explore the source record for details and available documents.

Centers for Disease Control and Prevention, U.S.↗
PubMed1990

Approach to the patient with genital ulcer disease.

The three major diseases characterized by genital ulcers--genital herpes, syphilis, and chancroid--are common, with genital herpes being most common in industrialized countries and chancroid being most common in developing countries. One fourth to one half of patients with genital ulcers have no diagnosed cause for their illness despite diagnostic efforts. The bulk of these cases is probably constituted by one of the three diseases for which diagnostic tests are falsely negative. There is accumulating evidence that genital ulcers facilitate the transmission of human immunodeficiency virus (HIV), and they may also be markers of high-risk behavior for acquisition of HIV. Appropriate therapy of patients with genital ulcers (as well as their sexual partners) depends on accurate diagnosis. Patients with genital ulcers, particularly those with syphilis or chancroid, should be encouraged to undergo testing for HIV infection.

Diagnosis, Differential↗
PubMed1989

Evaluation of six media for the growth of Trichomonas vaginalis from vaginal secretions.

Many media have been formulated for the growth of Trichomonas vaginalis, but the relative sensitivities of these media have not been determined. We evaluated the ability of six media, including all five media commercially available in the United States, to grow Trichomonas vaginalis from vaginal secretions. In a first experiment, we evaluated the ability of five media to grow T. vaginalis from vaginal secretions of 375 women and determined the optimal days on which to read culture tubes, by inoculating aliquots of secretions into each medium and reading the tubes 1, 2, 3, 4, and 7 days later. Sixty-five patients (17%) had a positive wet-mount examination for T. vaginalis, and all the positive results were confirmed by growth in at least one medium. Of 310 wet-mount-negative specimens, 37 (12%) grew T. vaginalis; overall, 102 women (27%) had a positive culture. Diamond and modified Diamond media (the latter being the only medium not commercially available) detected 99 (97%) and 92 (90%) isolates, respectively, compared with three formulations of Kupferberg medium, which detected 77 (75%), 50 (49%), and 43 (42%) isolates. The optimal single day to read wet-mount-negative cultures was day 7, but 4 (11%) of the 37 positive specimens were positive only before day 7. In a second study, we compared the ability of modified Diamond medium with that of a sixth medium, Lash medium, to grow T. vaginalis from 48 wet-mount-positive specimens; modified Diamond medium supported growth in all cases, whereas Lash medium supported growth in only 26 (54%) cases. We conclude that formulations of Diamond medium are superior to formulations of Kupferberg or Lash medium for growth of t. vaginalis.

Animals↗
PubMed1987

Chancroid in the United States. Reestablishment of an old disease.

For 30 years, chancroid has been an uncommon and geographically localized disease in the United States; a mean of 878 cases were reported annually between 1971 and 1980. Since 1981, however, numerous outbreaks have established chancroid as an endemic disease in many additional areas and, in 1986, 3418 cases, the largest number since 1952, were reported. Cases are occurring preponderantly among men who patronize prostitutes, and infected individuals who have traveled from outbreak areas or from outside the United States are suspected of having contributed to the spread of disease. Efforts to eradicate disease in outbreak areas have been only occasionally effective and have been hampered by difficulty in locating potentially infected individuals and by travel by infected individuals. The failure to eradicate outbreaks leaves residual sources for new disease transmission into yet additional areas.

Black or African American↗