PubMed Health⌕ Search

Biomedical subjects

R K Zimmerman

Publications and source records attributed to R K Zimmerman.

At least 55 records · Page 3Linked to original sources
PubMed1996

An update on vaccine safety.

Vaccination has dramatically reduced the number of annual cases of pertussis, diphtheria, measles and congenital rubella syndrome. Although side effects of immunizations can occur, serious adverse events are rare for all vaccines commonly used in the United States. Infantile spasms and sudden infant death syndrome are not associated with childhood vaccines. Compared with whole-cell pertussis vaccine, acellular pertussis vaccines are significantly less likely to produce moderate reactions such as fever, fussiness, pain, drowsiness, anorexia and local redness or swelling. Despite the documented safety and efficacy of childhood vaccines, concerns about vaccine safety increase when diseases such as measles, pertussis and rubella are no longer common. Parents need to be reminded that their child is susceptible to these diseases, that these diseases are preventable by reasonably safe and effective immunizations and that their child needs a series of vaccines at regular intervals by the age of two years. Since 1994, all physicians have been required by law to use the Vaccine information Statements for measles-mumps-rubella vaccine, diphtheria and tetanus toxoids and pertussis vaccine, poliovirus vaccines and tetanus and diphtheria toxoids for adults.

Child, Preschool↗
PubMed1995

Adult immunizations--a practical approach for clinicians: Part II.

Occupational indications for hepatitis B vaccine include employment in health care services, public safety organizations (e.g., police force) and institutions for the developmentally disabled. Hepatitis B vaccine should also be given to persons having multiple sexual partners, persons abusing injectable drugs, persons receiving hemodialysis and persons recently found to have a sexually transmitted disease. Unimmunized adults should receive enhanced inactivated polio vaccine, not oral polio vaccine. Office procedures that facilitate immunizations include the provision of educational information to patients, standing orders to allow nursing personnel to administer vaccines and feedback to physicians about immunization status and rates.

Adult↗
PubMed1995

Adult immunizations--a practical approach for clinicians: Part I.

Vaccine-preventable diseases cause needless sickness and death in adult Americans. Most adults 65 years of age or older have not been immunized against influenza or pneumococcal disease. In addition to an age of 65 years or older, indications for influenza and pneumococcal vaccines include chronic obstructive pulmonary disease, hemodynamically significant cardiac disease and infection with the human immunodeficiency virus. Many adults in the United States also are not sufficiently protected against tetanus, diphtheria, measles, mumps and rubella.

Adult↗
PubMed1994

Childhood immunization guidelines: current and future.

Recent additions to the immunization schedule include acellular pertussis vaccine, and hepatitis B vaccine for all infants and selected adolescents. The third dose of OPV is recommended at 6 months of age and the first dose of MMR vaccine at 12 to 15 months. A new vaccine against Haemophilus influenzae type b has been licensed. Children aged 6 months and older with asthma, diabetes, or heart disease should receive influenza vaccine. Children aged 2 years and older with asplenia, immunosuppression, and nephrotic syndrome may be candidates for pneumococcal immunization.

Bacterial Capsules↗
PubMed1994

Inadvertent administration of DTP and DT after age six as recorded in the Vaccine Adverse Event Reporting System.

OBJECTIVE: Diphtheria and tetanus toxoids and whole-cell pertussis vaccine (DTP) and pediatric diphtheria and tetanus toxoids (DT) are not recommended for individuals > or = 7 years of age due to increased adverse reactions and the low pertussis case-fatality rate. Our objective was to determine if reactions to DTP and DT in individuals > or = 7 years of age were due to administration of pediatric DTP or DT instead of adult tetanus and diphtheria toxoids (Td), after adjusting for database inaccuracies. METHODS: We analyzed data from the Vaccine Adverse Event Reporting System (VAERS) reported from July 1, 1990 through March 31, 1992. Vaccine manufacturers were contacted to verify whether lot numbers indicated DTP or DT. RESULTS: According to VAERS's data, among individuals 7 years of age or older, 26 received DTP and 77 received DT. When lot numbers were compared with manufacturers' records, 8 of the 77 DT doses were confirmed; 11 had incorrect or missing lot numbers; one was a duplicate; 56 were Td; and one was neither DT nor Td. Alleged adverse reactions included fever, headache, and convulsions. CONCLUSION: Individuals > or = 7 years of age are inadvertently receiving DTP or DT and may be unnecessarily experiencing adverse reactions. The 1992 VAERS database offers opportunities to investigate hypotheses but should be interpreted with caution due to inaccuracies in reporting and duplicate entries.

Adolescent↗
PubMed1993

Immunization barriers in Minnesota private practices: the influence of economics and training on vaccine timing.

OBJECTIVE: Identify barriers to immunization and evaluate the timing of immunization in private practice settings. METHODS: Design was a comparison of childhood immunization data with a survey of physicians who administered the vaccines. Setting was primary care offices in rural and urban/suburban Minnesota. Subjects were children under 7 years old who were receiving either Diphtheria, Tetanus, and Pertussis vaccine, Diphtheria and Tetanus vaccine, or the first Measles, Mumps and Rubella vaccine and their primary care physicians. Main outcome measures were time from birth to the third Diphtheria, Tetanus, and Pertussis vaccine (DTP) and from birth to the first Measles, Mumps, and Rubella vaccine (MMR) and their determinants. RESULTS: The third Diphtheria, Tetanus, and Pertussis vaccine and first Measles, Mumps, and Rubella vaccine were late in 32% and 41% of children, respectively. We observed a significant difference, based upon insurance status, in Diphtheria, Tetanus, and Pertussis vaccine timing (p = 0.0001) but not in Measles, Mumps, and Rubella vaccine timing. Significant correlates of earlier Diphtheria, Tetanus, and Pertussis immunization include physician residency training, suburban/urban practice locale, and the likelihood that the physician would refer children based upon insurance coverage to health departments for immunization. CONCLUSIONS: Important determinants of immunization in the private sector include reimbursement and physician training about prevention.

Child↗
PubMed1992

Childhood immunizations: a practical approach for clinicians.

Family physicians can play a key role in reversing the resurgence of vaccine-preventable illnesses by making sure that patients are fully immunized. Childhood immunization schedules have recently changed. A second dose of measles, mumps and rubella (MMR) vaccine should be given at age four to six years. It has been recommended that hepatitis B vaccine be administered routinely to all infants in the United States. Both hepatitis B vaccine and hepatitis B immunoglobulin should be given to offspring of hepatitis B carriers. Haemophilus b conjugate vaccine (HbCV) should be administered to all infants, beginning at two months of age. Vaccines can be safely administered to patients with mild illnesses, allergic rhinitis, low-grade fever or penicillin allergy, as well as to those taking antibiotics. If indicated, several vaccines, such as diphtheria, tetanus and pertussis, oral poliovirus, HbCV and MMR, can be given simultaneously.

Child↗
PubMed1991

Risk factors for Clostridium difficile cytotoxin-positive diarrhea after control for horizontal transmission.

OBJECTIVE: This study identifies risk factors that predispose hospitalized patients to diarrhea caused by Clostridium difficile. DESIGN: Unlike most previous studies, this case-control study accounts for horizontal (person-to-person) transmission of this infectious organism by matching on location. SETTING: An urban community hospital of 600 beds with both primary care and referred patients. PATIENTS: Both the 36 cases and the 36 controls came from billing printouts for C difficile cytotoxin assays. Exclusion criteria included out-patient specimens and stays of 38 days or more. Controls had negative assays and were individually matched on the basis of the floor and by the general date of specimen collection. RESULTS: Cases had a longer mean duration of antibiotic use (6.7 versus 4.1 days, p = .006). Of the other 22 factors that were evaluated for their risk of predisposing to C difficile, only clindamycin (OR = 3.50, p = .09) and third-generation cephalosporins (OR = 3.00, p = .04) showed any association. The odds ratio for third-generation cephalosporins in the absence of clindamycin was 3.50 (p = .09). Data were collected by physicians who were not blinded. CONCLUSIONS: This study found that the clindamycin and third-generation cephalosporins were risk factors for C difficile-associated diarrhea after controlling for horizontal transmission. First-generation cephalosporins were not risk factors (OR = 0.86), while sample size considerations prevented firm conclusions about second-generation cephalosporins (OR = 1.67, p = .23). Many of the previously alleged risk factors might be explained by the horizontal transmission of an infectious disease; for instance, this seems a better explanation for an outbreak on a surgery ward than does surgery itself.

Bacterial Proteins↗
PubMedDate not supplied

27-gauge short.

Explore the source record for details and available documents.

Anesthesia, Conduction↗