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Biomedical subjects

S Sepkowitz

Publications and source records attributed to S Sepkowitz.

At least 19 recordsLinked to original sources
PubMed1996

Perverse reactions to pertussis vaccine by government medical agencies.

Pertussis vaccine has not been shown to cause permanent neurologic damage in children, according to the American Academy of Pediatrics and others. However, the federal government continues to maintain that, on rare occasions, permanent brain damage does occur. The report of a single case-control study in support of this position prompted the establishment of a special committee under the sponsorship of the United States Public Health Service, the Institute of Medicine, and the National Research Council to determine the validity of the report. The special committee concurred that pertussis vaccine does produce permanent brain damage in rare instances. Physicians are required to warn all responsible parties of vaccine recipients that pertussis vaccine may cause "lasting brain damage." This requirement has been authorized by Congress and the National Childhood Injury Act of 1986.

Case-Control Studies↗
PubMed1995

International rankings of infant mortality and the United States' vital statistics natality data collecting system--failure and success.

BACKGROUND: International rankings of infant mortality rates have been consistently lower for the US than other industrialized countries, and this ranking has been falling. This study examines the influence of birth registrations among very low birthweight infants on these international rankings. METHODS: Birth rates of infants weighing < 1500 g (VLBW) reported by Japan, Sweden, the Netherlands, France, the UK and Canada were compared to the rates of infants of this weight born in the US, and these rates were correlated with the infant mortality rates reported by these countries. Also, deaths in the first 24 hours after birth were correlated with the reported mortality rates. RESULTS: Countries with the lowest infant mortality rates tended to have the lowest incidence of births < 500 g (correlation coefficient, r = 0.73) and of births 500-999 g (correlation coefficient, r = 0.81). When white and black newborns in the US were reported separately, the correlation coefficients were 0.96 and 0.97 for these weights. Furthermore, the countries with the lowest infant mortality rates registered the fewest number of deaths in the first 24 hours after birth, correlation coefficient, r = 0.78; when white and black newborns were reported separately, r = 0.95. In addition, the international rankings of the US, 1969-1988, when correlated with the annual birth rate of white infants < 500 g registered in this country was r = 0.78. CONCLUSION: Differences in birth registration practices for infants weighing < 1500 g are primarily responsible for the poor, deteriorating performance by the US in the international rankings of neonatal mortality rates.

Birth Rate↗
PubMed1994

Why infant very low birthweight rates have failed to decline in the United States vital statistics.

BACKGROUND: Very low birthweight (VLBW) rates, i.e. births of < 1500 g, have been long established as the major determinant of outcome for infants. Nevertheless, despite much medical, political and social effort, these rates have not declined during the past 40 years in the US Vital Statistics. To explore the causes of this disturbing finding, trends in low birthweight distribution at a community hospital and the Vital Statistics data were investigated. METHODS: The weights of livebirths and foetal deaths (27,944 births) at a community hospital during three 5-year periods, 1973-1987, were examined for trends in low birthweight (LBW) distribution, and they were contrasted with the US Vital Statistics. RESULTS: For white infants weighing 500-999 g the livebirth rates declined from 3.7 per 1000 births in period one to 1.1 per 1000 in period three (70.2%); for white infants 1000-1499 g, livebirths declined from 4.2 to 3.2 per 1000. Hospital white livebirths < 2500 g declined 18.7% from the first to the third period. Among black livebirths the LBW rate also declined from 126.4 per 1000 in period one to 85.4 per 1000 in the third period. Foetal deaths declined from 8.2 per 1000 births to 6.2 per 1000 in period three, a 24.4% decline. However, foetal deaths < 500 g increased 411%, from 3.6% of the total foetal deaths in period one to 18.4% in the third period. CONCLUSION: Increasing registration of births in the US may have hidden a marked improvement in the VLBW problem. More complete registration of births and changes in the perception of viability appear responsible for the artefact.

Bias↗
PubMed1993

The CRIB score.

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Hospital Mortality↗