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Biomedical subjects

J Andrus

Publications and source records attributed to J Andrus.

8 recordsLinked to original sources

Growth of preterm infants with cystic periventricular leukomalacia.

Etiology of the high rates of growth failure in children with cerebral palsy (CP) remains unclear. The purpose of this study was to evaluate the relation between growth failure in preterm infants with cystic periventricular leukomalacia (CPVL) and neonatal health complications. The population consisted of all preterm infants (51) with a gestational age of <33 weeks who were admitted to the Children's Hospital of Buffalo from 1988 to 1993 and who had CPVL. Out of the 41 survivors with CPVL who were followed, 39 developed CP and 18 developed growth failure during infancy. At the time of greatest growth failure, the majority (72%) of infants had signs of undernutrition as defined by the Waterlow (1972) classification. Oral feeding impairment was the sole risk factor for the occurrence of growth failure. Undernutrition appears to be important in the occurrence of growth failure in preterm infants with CPVL and CP.

Anthropometry

Perspectives from the global poliomyelitis eradication initiative.

Ten years after the year 2000 target was set by the World Health Assembly, the global poliomyelitis eradication effort has made significant progress towards that goal. The success of the initiative is built on political commitment within the endemic countries. A partnership of international organizations and donor countries works to support the work of the countries. Interagency coordinating committees are used to ensure that all country needs are met and to avoid duplication of donor effort. Private sector support has greatly expanded the resources available at both the national and international level. At the programmatic level, rapid implementation of surveillance is the key to success, but the difficulty of building effective surveillance programmes is often underestimated. Mass immunization campaigns must be carefully planned with resources mobilized well in advance. Programme strategies should be simple, clear and concise. While improvements in strategy and technology should be continuously sought, changes should be introduced only after careful consideration. Careful consideration should be given in the planning phases of a disease control initiative on how the initiative can be used to support other health initiatives.

Global Health

Economic outcomes associated with the use of risperidone in a naturalistic group practice setting.

The purpose of this cohort pilot study was to compare the resource utilization and economic outcomes associated with the use of risperidone versus haloperidol in a naturalistic setting. Patient charts from a large psychiatric group practice were reviewed, and hospital billing data were obtained. Patients meeting the inclusion criteria were placed into one of two cohorts depending on their medication history. Thirty patients treated with risperidone met the selection criteria, and a random quota sampling technique was used to allow for a matched control cohort of 30 patients treated with haloperidol. In the haloperidol and risperidone cohorts, 24 and 28 patients, respectively, were evaluated statistically. Mean utilization rates and costs per patient per month for each service were estimated by using regression analysis. Patients in the risperidone cohort had significantly fewer hospitalizations than did those in the haloperidol cohort (P = 0.004). Likewise, risperidone patients had significantly lower hospitalization costs than haloperidol patients (P = 0.005). Conversely, patients treated with risperidone visited the physician more frequently than did those treated with haloperidol (P = 0.0005). Estimated mean total monthly costs were $123.34 lower (95% confidence interval = $464, $217) per patient in the risperidone cohort than in the haloperidol cohort ($1,636.11 vs $1759.45; P = 0.4693). Significant reductions in hospital costs in the risperidone cohort offset higher medication and physician costs. Overall, total monthly costs were similar for the two cohorts.

Antipsychotic Agents

Epidemiology and clinical characteristics of acute flaccid paralysis associated with non-polio enterovirus isolation: the experience in the Americas.

The Pan American Health Organization adopted as a goal the interruption of transmission of wild poliovirus from the americas by 1990. Collection and processing of stool specimens from patients with acute flaccid paralysis (AFP) to identify wild poliovirus is critical for monitoring the success of the eradication programme. In the study described, cases of AFP in children less than 15 years of age reported in the Americas from 1989 to 1991 were evaluated to investigate the epidemiology of AFP associated with the isolation of non-polio enterovirus (NPEV), to characterize their clinical presentation, and to compare their clinical characteristics with those of AFP cases associated with the isolation of wild poliovirus (confirmed as poliomyelitis). The results show that the notification pattern for AFP associated with NPEV isolates is similar to that for all AFP cases. While AFP associated with NPEV isolates generally differs clinically from confirmed poliomyelitis, 2-21% of cases met one of three case definitions for poliomyelitis. Following the eradication of poliomyelitis, countries can therefore anticipate the continued reporting of cases of AFP that clinically mimic poliomyelitis but which are associated with NPEV. The study also confirms that NPEV circulation is common and that most isolates were from cases that did not resemble poliomyelitis. It is therefore questionable whether characterization of NPEV isolates is essential for global eradication of poliomyelitis and consequently whether allocation of resources for that purpose can be justified.

Acute Disease