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Biomedical subjects

J Pakter

Publications and source records attributed to J Pakter.

At least 19 recordsLinked to original sources
PubMed1987

Diphtheria-tetanus-pertussis immunization and sudden infant death: results of the National Institute of Child Health and Human Development Cooperative Epidemiological Study of Sudden Infant Death Syndrome risk factors.

The possible association between diphtheria-pertussis-tetanus (DTP) immunization and the subsequent occurrence of sudden infant death has been examined using data from the National Institute of Child Health and Human Development (NICHD) Sudden Infant Death Syndrome (SIDS) Cooperative Epidemiological Study, a large multicenter, population-based, case-control study. In a preliminary report based on the first 400 eligible singleton SIDS victims and 800 matched living control infants, no temporal association between SIDS and DTP immunization was found. From the final sample of 800 eligible singleton SIDS victims, 95% (n = 757) were defined as definitely or probably having died of SIDS on the basis of pathology data. Data from these 757 case infants and their corresponding control infants (n = 1,514) are presented in this report. Two control infants, both living, were randomly selected for each case infant: an age-matched control A and an age-, race-, and low birth weight-matched control B. Overall, case infants were less likely to have received any DTP immunization. Only 39.8% of case infants had received at least one DTP immunization compared to 55.0% of control A infants and 53.2% of control B infants. Based on maternal interviews and postnatal medical records, 1.8% of case infants (five infants) immunized with DTP died within the first 24 hours following immunization. Similarly, 5.0% of control A infants (n = 21) and 2.2% of control B infants (n = 9) had been immunized within 24 hours of the maternal interview, which represents the comparable time frame for the age-matched control infants. These results confirm the earlier preliminary findings from the NICHD SIDS Cooperative Epidemiological Study and suggest that DTP immunization is not a significant factor in the occurrence of SIDS.

Black or African American↗
PubMed1982

Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study.

We examined the neonatal mortality rates of low-birth-weight infants (501 to 2250 g) born between 1976 and 1978 in three kinds of hospitals in New York City: those with newborn-intensive-care units (Level 3), those with capabilities for the care of most premature infants (Level 2), and those without any special facilities for premature newborns (Level 1). Among 13,560 singleton low-birth-weight infants, the adjusted neonatal mortality rate for Level 3 hospitals was 128.5 per thousand live births - significantly lower (P less than 0.001) than the rates for both level 2 (168.1) and Level 1 units (163.0). The association of level of care with mortality could not be accounted for by differences between groups in social or demographic status, in prenatal care, or in medical complication of pregnancy. We infer that birth at a Level 3 center lowers neonatal mortality in low-birth-weight infants. However, only 34 per cent of the patients in this study were born in such units.

Critical Care↗
PubMed1982

Ectopic pregnancy in New York City, 1975-1980.

Seventy-three non-federal acute care New York City hospitals were asked to report the number of ectopic pregnancies. These reports were compared with legally required certificates of termination of pregnancy (fetal death certificates). The number of ectopic pregnancies reported via the questionnaire was six times the number reported on the certificates of termination of pregnancy. Based on the hospital survey, ectopic pregnancies increased from 1,457 in 1975 to 2,080 in 1980. The number of ectopic pregnancies per 1,000 conceptions per year increased 48.5 percent, from 6.48 in 1975 to 9.62 in 1980 (p less than .001). Of the 30 fatalities related to an ectopic pregnancy, 93.4 percent were Black or Hispanic and two-thirds were single. An unexplained finding was that 75 per cent of the fatal tubal pregnancies were right-sided (p less than .01). At least one-half of the deaths were attributable to physician error and one-fifth were attributable to patient neglect. Ectopic pregnancy continues to be overlooked and misdiagnosed. Increased physician suspicion of this complication in the susceptible population is needed to decrease fatalities.

Adult↗
PubMed1979

Family-centered care activities by size of maternity service.

Fifty-four of the 55 New York City maternity services in operation as of January 1, 1978 responded to a questionnaire eliciting information as to the availability of certain family-centered care practices. The larger maternity units, especially those in which more than 2,000 live births occur annually, were noted to have a higher prevalence and greater extent of family-centered care activities than the smaller units. Although size alone cannot be isolated as the critical factor in this analysis, its association with other factors helps explain the differences observed.

Delivery, Obstetric↗