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Biomedical subjects

J M Neff

Publications and source records attributed to J M Neff.

At least 19 recordsLinked to original sources

Protecting children with chronic illness in a competitive marketplace.

Health care for children with chronic illnesses is significantly more expensive than for the average child. Children with chronic illnesses are especially vulnerable in a competitive health care environment because of the higher ongoing cost associated with treating their illnesses and the inherent pressures to reduce services to manage within the capitated rate. To minimize the adverse impact a competitive market could have on these children, a "carve-out" for specific medical conditions is discussed. A capitation pricing system that reflects their higher costs is proposed, as well as a delivery system that is focused on their needs.

Capitation Fee

Quantitative semi-automated enzymatic assay for tissue glycogen.

A simple, rapid, specific and reproducible assay for tissue glycogen is described. The method involves the incubation of a denatured tissue homogenate with amyloglucosidase resulting in the complete hydrolysis of glycogen to glucose. The glucose content of the homogenate supernatant is then determined with the aid of a glucose analyzer. The method has been used to measure the glycogen content of a variety of discrete and complex animal tissues and is particularly convenient for microdeterminations.

Animals

Primary care of previously institutionalized retarded children.

Medical care of retarded children is a responsibility of pediatricians that is seldom discussed. Past practices of isolating these children in institutions and caring for them in special multidisciplinary clinics are fading. The medical experience with 48 retarded children, the problems that they present, and the system of care that was developed to meet their special needs are described. Previous medical care was often found to be lacking or inappropriate. The spectrum of morbidity resembles that of a general pediatric population although chronic conditions are much more prevalent. Utilization of primary care and consultative services is much higher than for a nonretarded population. Much time is required for their care; a great deal of time is devoted to advising caretakers and schools and to coordinating health services. A prepaid system of care using a health associate as the primary provider was developed, and has been an effective means of providing health care to these children.

Acne Vulgaris

Absence of increasing incidence of meningitis caused by Haemophilus influenza type b.

An epidemiologic survey of meningitis caused by Haemophilus influenzae type b in children aged zero to four years during an 11-year period (January 1965-December 1975) was conducted in the Baltimore, Maryland, metropolitan area to examine recent trends in the incidence of this disease. Cases of H. influenzae meningitis were identified at all 19 hospitals in the city and county of Baltimore and all 41 hospitals in the surrounding area. The population at risk (age, zero to four years) was estimated using yearly birth rates provided by the state of Maryland and U.S. Census information for 1960 and 1970. Yearly age-adjusted incidence was calculated; in contrast to previous studies, there was no significant increase in the annual incidence (range, 12-27; mean, 19.3/100,000 population at risk). Previous reports of recent increases in the incidence of meningitis caused by H. influenzae type b may be due to differences in study techniques.

Black People

Toxicity and sublethal effects of No. 2 fuel oil on the supralittoral isopod Lygia exotica.

1. No. 2 fuel oil was of relatively low toxicity to the intertidal isopod Lygia exotica as indicated by the TLm values of over 100% for the WSF and 73 ppm at 24 and 48 hours and 36.5 ppm at 96 hours for the OWD. 2. Respiration was not significantly affected by short term exposure to several concentrations of No. 2 fuel oil prepared as either a WSF or OWD. 3. Lygia contamined by a spill of No. 2 fuel oil and Bunker C residual oil contained high concentrations of dibenzothiophenes. It is not known whether the dibenzothiophenes were accumulated by the Lygia tissues or absorbed to the exoskeleton. Therefore, the high mortality of Lygia following the spill cannot yet be attributed to the dibenzothiophenes.

Animals

Evaluation of two kinds of smallpox vaccine: CVI-78 and calf lymph vaccine. I. Clinical and serologic response to primary vaccination.

A comparative study of two smallpox vaccines, standard calf lymph vaccine, and an attenuated vaccine, CVI-78, was performed in 95 children. Primary vaccination with CVI-78 resulted in a more attenuated response than primary vaccination with standard vaccine. Sixty-one percent of those vaccinated with CVI-78 and 96 percent of those vaccinated with standard vaccine developed a major dermal reaction; 16 percent of those vaccinated with CVI-78 and 89 percent of those vaccinated with standard vaccine developed post-vaccination neutralizing antibodies. Twenty-seven percent of the children vaccinated with CVI-78 demonstrated neither a dermal nor serologic postvaccination response, whereas only 2 percent of those vaccinated with standard vaccination demonstrated no postvaccination response.

Allantois

Evaluation of two kinds of smallpox vaccine: CVI-78 and calf lymph vaccine. II. Clinical and serologic observations of response to revaccination with calf lymph vaccine.

Revaccination with standard calf lymph vaccine was performed on 26 children who had received a primary vaccination with an attenuated smallpox vaccine, CVI-78, and 22 children who had received primary vaccination with standard calf lymph. Revaccination resulted in a vesicular reaction in 96 percent of those who had been vaccinated previously with CVI-78 and 73 percent of those vaccinated previously with standard calf lymph. All children had a positive hemagglutination-inhibition (HI) antibody titer either after primary vaccination or revaccination. Only 65 percent of those initially vaccinated with CVI-78 vaccine had positive neutralizing antibodies after revaccination. All children who received primary vaccination with standard calf lymph had postrevaccination neutralizing antibodies. The children who had neither a dermal nor a serologic response after primary vaccination responded as primary vaccinees on challenge with standard calf lymph.

Animals

Smallpox vaccination reactions, prophylaxis, and therapy of complications.

Smallpox vaccination in the United States is a routine public health measure which has been under intensive review during the last decade. The most frequently occurring adverse reactions to vaccination are benign and require little or no systemic therapy. These reactions include accidental infection, erythematous and urticarial rash, and generalized vaccinia. Chickenpox occurring concurrently with vaccination presents no problem unless vaccinia has widely superinfected the chickenpox lesions. There is no risk to the pregnant woman who is vaccinated, but there is a slight risk that the fetus will develop fetal vaccinia. The vaccinia does not cause congenital malformations. Vaccinia hyperimmune globulin (VIG) in prophylactic dosage may be given to a pregnant woman who is traveling to a smallpox infected or endemic area in order to prevent fetal vaccinia. Vaccinia necrosum and eczema vaccinatum require vigorous systemic therapy with VIG, and often thiosemicarbazone. Post-vaccinial encephalitis, while frequently serious, has not been shown to be ameliorated by VIG therapy, although there are data which suggest VIG has some value in prophylaxis for encephalitis. Prophylaxis, prompt recognition, and proper therapy may reduce the fatality rates of these complications. Revaccination of patients who have suffered a complication is a frequent clinical problem. Revaccination of an individual who has had post-vaccinial encephalitis or vaccinia necrosum is contraindicated unless the risk of contracting smallpox outweighs the risk of the above two diseases. Revaccination of children who have had eczema vaccinatum is not contraindicated. Revaccination of children with a history of accidental infection or erythematous or urticarial rash presents no known or theoretically increased risk.

Eczema