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Biomedical subjects

R W Demmler

Publications and source records attributed to R W Demmler.

5 recordsLinked to original sources
PubMed1992

Improving measles vaccination rates in previously vaccinated adults.

BACKGROUND: During the 1988 measles epidemic in Houston, Texas, the Harris County Medical Society made each of its members aware of the Centers for Disease Control recommendations concerning revaccination of persons born between 1957 and 1971. A review of records in a family practice residency clinic found a revaccination rate of only 11% among this population. Previous studies of increasing influenza vaccine administration suggest that enlisting the assistance of office personnel can improve the vaccination rate. METHODS: A study was conducted that compared two methods of administering measles vaccine to those born between 1956 and 1967 who had received the killed measles vaccine. Standard ambulatory care (control group) was compared with a proactive system in which front desk personnel and nursing staff identified and vaccinated appropriate patients (study group). RESULTS: Sixty-one percent of the study group were vaccinated after identification by office personnel, compared with 5% of the control group (P less than .001). CONCLUSIONS: Standard ambulatory care protocols, which rely heavily on the patient's chief complaint to determine the patient's medical needs, interfere with the rate of revaccination. The measles vaccination rate can be significantly improved by a simple modification of practice routine, eg, using support personnel.

Adult↗
PubMed1990

Live attenuated and inactivated influenza vaccine in school-age children.

In 1985, we enrolled 189 school-age children by family in a double-blind study to determine protection against influenza by a single dose of cold-recombinant bivalent A vaccine or commercial trivalent inactivated vaccine compared with placebo. All children in school or day care, 3 to 18 years of age, in an enrolled family received the same preparation. Following vaccination, 60% and 21% of cold-recombinant bivalent A vaccine recipients and 73% and 83% of trivalent inactivated vaccine recipients demonstrated fourfold or greater response in hemagglutination-inhibition antibody titer to A/H1N1 and A/H3N2, respectively. Sixty-seven percent of all trivalent inactivated vaccine recipients demonstrated a fourfold or greater serologic response to H1N1, H3N2, and influenza B following a single dose of vaccine. During the 1985-1986 influenza B/Ann Arbor epidemic, heterotypic protection afforded by the influenza B/USSR component of trivalent inactivated vaccine was 62% compared with placebo. A single dose of trivalent inactivated vaccine protected school-age children, 6 to 19 years of age, from influenza B infection; the rate of protection was 64% against infection and 73% against febrile illness.

Adolescent↗
PubMed1990

Estrogen therapy during menopause and the treatment of osteoporosis.

Estrogen remains the single most effective agent in the treatment of menopausal symptoms and prevention of bone loss. This article focuses on the use of estrogen therapy during menopause and the pharmacotherapy of osteoporosis. Risks and benefits of hormonal therapy and regimen selection for menopausal women are discussed. The second section of the article focuses on current treatment strategies for osteoporosis.

Age Factors↗
PubMedDate not supplied

Differences in serum concentrations of and responses to generic verapamil in the elderly.

STUDY OBJECTIVE: To determine if there are greater differences in bioavailability of generic verapamil at steady state in elderly patients than in healthy young subjects. DESIGN: Double-blind, randomized, three-way crossover study. SETTING: Clinical research center at a general teaching hospital. SUBJECTS: Eight young, healthy subjects between ages 18 and 45 years, and eight elderly, hypertensive patients over 65 years of age. INTERVENTIONS: Each participant was randomly assigned to receive brand-name verapamil or one of two generic preparations. Young subjects received each of the three preparations 80 mg twice/day for 7 days separated by a 1-week washout. Elderly patients took the three preparations for 21 days. Serum drug levels and blood pressure were measured and electrocardiograms performed 13 times after the last dose of drug. MAIN RESULTS: In young subjects, the pharmacokinetics and pharmacodynamics of the three preparations were nearly identical. There was, however, a great deal of variability in the bioavailability of the generic products. In the elderly patients, one generic product had a maximum serum concentration and area under the curve that were 77% and 43% greater, respectively, than the brand-name product (p < 0.02). Assessments of bioequivalency (based on confidence intervals) demonstrated that this generic drug's bioavailability was from 4-118% and peak serum concentration from 10-139% greater than the brand-name drug. This was associated with greater prolongation of the PR intervals. CONCLUSIONS: A generic verapamil product that is bioequivalent in young subjects may not be bioequivalent in elderly subjects. Testing of drugs with complex pharmacokinetics in young subjects may not reliably predict the clinical outcomes in elderly hypertensive patients.

Adult↗