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Biomedical subjects

M Castiglia

Publications and source records attributed to M Castiglia.

7 recordsLinked to original sources
PubMed1999

Predictors of childhood immunization completion in a rural population.

Despite the availability of effective vaccines, immunization rates among two-year old children continue to be low in many areas of the United States including rural West Virginia. The goal of this study was to identify barriers to childhood immunization in rural West Virginia and determine factors that were important in the completion of the childhood immunization schedule. A telephone survey was used to collect data from a randomly selected sample of 316 mothers, of two-year olds, from 18 rural counties of West Virginia. Results indicated that two-thirds or 65% of the children in the study sample had completed their recommended immunizations by two years of age. Immunization barriers identified in this study include: living in health professional shortage areas, lack of health insurance, negative beliefs and attitudes regarding childhood immunizations, problems accessing the immunization clinic, and a perception of inadequate support from the immunization clinic. Results of the structural equation modeling, using LISREL-8, indicated that 20% of the variation in immunization completion (R2 = 0.197) was explained by attitude towards immunization and perceived support received from the immunization clinic. Furthermore, 42% of the variation in attitude towards immunization (R2 = 0.419) was explained by immunization-related beliefs, and 28% of the variation in immunization-related beliefs (the R2 = 0.277) was explained by general problems faced during immunization and perceived clinic support. The study concluded that positive immunization-related beliefs and attitudes, support from the immunization clinic, and ease of the immunization seeking process are important factors in the timely completion of the childhood immunization schedule.

Child↗
PubMed1999

Lymphocutaneous syndrome. A review of non-sporothrix causes.

The lymphocutaneous syndrome can be caused by a number of diverse microorganisms requiring very different antimicrobial therapy for resolution. The epidemiology and geographic occurrence of the infection often can provide important first clues to the microbiologic etiology. Accurate diagnosis can be accomplished usually by punch or wedge biopsy of a primary lesion or proximal subcutaneous nodule submitted for histopathologic examination and culture. The microbiology laboratory staff should be alerted to the diagnostic possibilities so that appropriate cultural and incubation techniques, procedures, and precautions can be initiated. Provision of a correct microbiologic diagnosis and institution of appropriate antimicrobial therapy will result in a complete cure in almost all instances. Adjunctive surgical debridement may be required for certain organisms such as Nocardia or Mycobacterium chelonae.

Dermatomycoses↗
PubMed1998

Persuasive messages. Development of persuasive messages may help increase mothers' compliance of their children's immunization schedule.

Effective immunization campaigns can be designed by determining which persuasion strategy is most effective in attracting the attention of mothers of preschoolers. The authors assess the impact of three persuasional strategies: fear-arousal, motherhood-arousal, and rational messages, on mothers of preschoolers who are late for their immunizations. The fear-arousal message was found to be most effective, followed by the motherhood-arousal, and then the rational message, in attracting mothers' attention to their child's immunization status.

Child↗
PubMed1995

Pharmacokinetic optimisation of vancomycin therapy.

Renewed interest in vancomycin over the past decade has led to an abundance of data concerning the pharmacokinetics of vancomycin, and its dosage selection and concentration-response relationships. No definitive data exist that correlate vancomycin serum concentrations with clinical outcomes. However, inconsistencies in sampling times for peak serum concentrations and differences in infusion times make interpreting vancomycin serum concentrations difficult. Furthermore, the evidence implicating vancomycin as a cause of oto- or nephrotoxicity is circumstantial, and these adverse effects may occur only in high-risk populations. Owing to the variability in its dose-serum concentration relationship and multicompartmental pharmacokinetics, several methodologies have been developed for instituting and adjusting vancomycin dosages. Nomograms rely on a fixed volume of distribution and the relationship between vancomycin clearance and creatinine clearance. Since both of these factors may be altered in certain populations, dosage methodologies (both traditional and Bayesian) that use population- or patient-specific pharmacokinetic data perform better than standard nomograms for initiating vancomycin therapy. Controversy still exists as to whether a 1- or a 2-compartment model is more appropriate for making dosage adjustments; however, steady-state rather than non-steady-state vancomycin serum concentrations should be used for dosage adjustments. Certain pathophysiological states such as age, bodyweight and renal function contribute to altered pharmacokinetics and may alter the design of the dosage regimen. Since no definitive relationship exists between vancomycin serum concentrations and either clinical outcome or adverse effects, considerable controversy surrounds the utility of monitoring serum vancomycin concentrations. Therefore, routine vancomycin serum concentration monitoring may be warranted only in specific populations, such as patients receiving concurrent aminoglycoside therapy or those receiving higher than usual dosages of vancomycin, patients undergoing haemodialysis and patients with rapidly changing renal function.

Dose-Response Relationship, Drug↗
PubMed1993

Prosthetic hip infection and bacteremia due to Campylobacter jejuni in a patient with AIDS.

Campylobacter jejuni is a common enteric pathogen in healthy individuals and in patients with AIDS. It usually causes a self-limited diarrheal illness with fever and abdominal pain. We report what we believe is a unique case of C. jejuni osteomyelitis in a 60-year-old man who had hemophilia A, AIDS, and a hip prosthesis. He presented to the hospital with a 4-day history of fever and diarrhea and a 1-day history of hip pain. Findings on plain films and a bone scan were suggestive of osteomyelitis in the proximal femur. Cultures of blood and a hip aspirate yielded C. jejuni.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

The global problem of antimicrobial resistance.

Along with other multidrug-resistant pathogens previously identified, Streptococcus pneumoniae is becoming a serious concern in hospital and ambulatory care settings. The AIDS pandemic has increased the threat of resistance in Mycobacterium tuberculosis. Antimicrobial drug resistance involves three molecular mechanisms drug inactivation, altered cell permeability, and alteration of target sites. Surveillance and multidisciplinary approaches will be key to containing the threat of global antimicrobial resistance.

Attitude of Health Personnel↗