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Biomedical subjects

Paul Gargiullo

Publications and source records attributed to Paul Gargiullo.

6 recordsLinked to original sources
PubMed2006

Influenza vaccine effectiveness among 50-64-year-old persons during a season of poor antigenic match between vaccine and circulating influenza virus strains: Colorado, United States, 2003-2004.

During the 2003-2004 influenza season, we conducted a case-control study of influenza vaccine effectiveness (VE) among Colorado residents aged 50-64 years. Cases (n=330) were identified from laboratory-confirmed influenza reports to the Colorado Department of Public Health and Environment (CDPHE). Controls (n=1055) were recruited by random-digit dial telephone survey. VE was 60% (43-72%) and 48% (21-66%) among those without and with high-risk medical conditions, respectively. VE was 90% (68-97%) and 36% (0-63%) against influenza-related hospitalization for persons without and with high-risk conditions, respectively.

Antigenic Variation↗
PubMed2006

Evaluation of potentially common adverse events associated with the first and second doses of measles-mumps-rubella vaccine.

BACKGROUND/OBJECTIVES: In 1989, the American Academy of Pediatrics and the Advisory Committee on Immunization Practices recommended that school children receive 2 doses of measles-mumps-rubella vaccine. With measles and rubella eliminated from the United States, measles-mumps-rubella vaccine adverse events have come under scrutiny, but no study has compared the reactogenicity of the first (measles-mumps-rubella vaccine dose 1) and second (measles-mumps-rubella vaccine dose 2) doses at the most common ages of administration in the United States. METHODS: From a health maintenance organization, 3 groups of children were recruited: (1) toddlers aged 12 to 24 months receiving measles-mumps-rubella vaccine dose 1; (2) kindergartners aged 4 to 6 years receiving measles-mumps-rubella vaccine dose 2; and (3) middle schoolers aged 10 to 12 years receiving measles-mumps-rubella vaccine dose 2. From 2 weeks before measles-mumps-rubella vaccine administration until 4 weeks afterward, families recorded in diaries the occurrence of potentially common symptoms. Postvaccination symptom rates were compared with the prevaccination baseline, with significance assessed by testing incidence rate ratios estimated by Poisson regression. RESULTS: Of 2173 children enrolled, 373 (17%) were lost to attrition, producing a study population of 1800. Compared with the prevaccination baseline, rates of fever, diarrhea, and rash were significantly elevated postvaccination among 535 toddlers receiving measles-mumps-rubella vaccine dose 1. An estimated net 95 (18%) experienced measles-mumps-rubella vaccine-associated events (median onset 5-10 days postvaccination, duration 2-5 days), with high fever (temperature > or = 39.5 degrees C) occurring in 33 (6%). None required medical attention. For 633 kindergartners and 632 middle schoolers, symptom rates were not significantly elevated after measles-mumps-rubella vaccine dose 2 compared with baseline. CONCLUSIONS: Vaccination-associated adverse events occur in approximately 1 of every 6 toddlers receiving measles-mumps-rubella vaccine dose 1, with high fever occurring in 1 of 20. Adverse events are infrequent for measles-mumps-rubella vaccine dose 2 administered to school-aged children.

Age Factors↗
PubMed2005

Respiratory diphtheria among highly vaccinated military trainees in Latvia: improved protection from DT compared with Td booster vaccination.

An outbreak of respiratory diphtheria occurred among highly-vaccinated trainees at a Latvian military academy in August-September 2000. We reviewed immunization, clinical and laboratory records and administered a questionnaire to obtain data on exposure factors. Among 207 trainees, 45 (22%) diphtheria cases and 79 (38%) carriers of toxigenic Corynebacterium diphtheriae were identified. All patients survived; 1 had severe myocarditis. Sharing cups was a risk factor for infection. Over 85% of trainees had received > or =5 doses of diphtheria toxoid. Neither infection nor disease was associated with the number of doses or interval since last dose. However, the risk of disease was lower and diphtheria antitoxin levels were higher among trainees who received their last booster dose with higher-antigen diphtheria toxoid (DT) instead of lower-antigen Td. Outbreaks of mild diphtheria can occur among highly-vaccinated persons living in crowded conditions with intense exposure; high-antigen diphtheria booster-vaccination might provide better protection under these conditions.

Adolescent↗
PubMed2004

Population-based statistics for women diagnosed with inflammatory breast cancer (United States).

OBJECTIVE: The purpose of this study was to use population-based information to describe the demographic and tumor characteristics of inflammatory breast cancer (IBC) - the most aggressive form of this disease. METHODS: IBC cases diagnosed during 1994 through 1998 were reported to 26 population-based cancer registries covering approximately 40% of the US population. Rates were expressed per 100,000 female population and age-adjusted to the 2000 US population. Ninety-five percent gamma confidence limits were estimated for the rates. RESULTS: Among the 3626 women diagnosed with IBC during 1994-1998, the majority were 40-59 years old. Most tumors were diagnosed at a regional (68.9%) or distant (25.3%) stage and were poorly differentiated (49.4%). The rate of IBC was 1.3 per 100,000 for all races combined. Black women had the highest risk (1.6) and Asian and Pacific Islander women the lowest (0.7). CONCLUSIONS: IBC is an extremely rare form of breast cancer. More precise diagnostic criteria are needed to distinguish it from less aggressive forms of the disease. Future studies should use a population-based design and collect detailed clinical information, including the presence of erythema, edema or peau d'orange appearance of the skin, and other clinical signs of disease.

Adult↗
PubMedDate not supplied

Wheezing lower respiratory disease and vaccination of full-term infants.

PURPOSE: There have been speculations that increases in vaccinations have caused recent increases in wheezing lower respiratory disease during infancy. We assess possible associations between vaccines and incidence of wheezing in full-term infants. METHODS: We conducted a matched case-control study of full-term infants born into the Kaiser Permanente Northwest health plan during 1991-1994 and continuously enrolled for at least 12 months (n = 1366 case-control pairs). Potential cases of wheeze were ascertained from medical care databases and verified by chart review. Vaccinations, demographic factors, and wheeze risk factors were abstracted from charts. Adjusted relative risks of first onset of wheeze during post-vaccination exposure windows were estimated by conditional logistic regression. We also conducted case-series analyses of wheeze onsets. RESULTS: We found no evidence that risk of wheeze during infancy is associated with recency of vaccination with whole-cell pertussis (DTP), hepatitis b (HBV), Haemophilus influenzae type b (HIB), oral polio (OPV), or measles, mumps and rubella (MMR) vaccines. We also found no evidence that risk of first wheeze is associated with exposure to HBV or MMR. CONCLUSIONS: Recent increases in wheezing during infancy do not appear to be related to increases in vaccinations of full-term infants.

Age Factors↗