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Biomedical subjects

W A Todd

Publications and source records attributed to W A Todd.

13 recordsLinked to original sources

Unintentional injury depictions in popular children's television programs.

OBJECTIVES: The frequency and magnitude of depictions of risky events and unintentional injuries in top ranked children's animated and live action television programs was assessed. METHODS: Qualitative and quantitative media content analysis were used. Scenes from television episodes were examined for the depiction of risky events and unintentional injuries. RESULTS: A total of 201 actual and potential injury related events were tabulated in 99 episodes aired in 2003 and 2004. Only 26% of the risky events depicted led to an injury or physical consequence. More than 80% of the events involved behavioral or environmental risk factors. Safety factors were not present in over 90% of risky events depicted. The general tone and context of events was humor or indifference rather than concern or action, with little or no relevance to the plot. CONCLUSION: Unintentional injuries are the leading cause of death and disability for children, yet animated and live action television programs marketed to children continue to portray injury risk inaccurately. Working with the children's television production industry to improve injury depiction is a much needed advocacy activity.

Child↗

An epidemic of Reye syndrome associated with influenza A (H1N1) in Colorado.

An unusual cluster of Reye syndrome was associated with an outbreak of influenza A (H1N1) infections in the state of Colorado. Two of the 16 affected children had had prior episodes of Reye syndrome following respiratory infections, and one had had transverse myelitis following varicella. A serologic study of patients treated at a children's hospital and serum specimens submitted to the state health department revealed that approximately 59% of children in Colorado had been infected with the H1N1 strain of influenza A over a two-year period. Based upon this serologic survey, the minimum and maximum rates of Reye syndrome associated with H1N1 infections were calculated to be 2.5 and 4.3 cases per 100,000 H1N1 infections, respectively. A retrospective analysis of admissions to four referral hospitals in Denver failed to reveal any unusual clustering of Reye syndrome with outbreaks of influenza A H3N2 infections during 1975-1978. The reason for an association between Reye syndrome and the H1N1 strain but not the H3N2 strains of influenza A remains unclear.

Adolescent↗

Group B beta-hemolytic streptococcus: randomized controlled treatment study at term.

A randomized controlled investigation was undertaken to evaluate the role of maternal oral antibiotic therapy in decreasing the incidence of maternal and neonatal colonization at term with group B beta-hemolytic streptococcus (GB-BHS). Data were collected to determine the optimum transfer media and the colonization rate in the study population. At delivery 1441 maternal-infant pairs were evaluated. One hundred sixty-eight women (11.6%) and 55 infants (3.8%) were colonized. Forty-four women colonized with GB-BHS at 38 weeks' gestation were randomly assigned to a treatment (500 mg potassium penicillin or erythromycin ethylsuccinate q.i.d.) or a control group to determine the value of antepartum oral antibiotic therapy in preventing infant colonization. There was a significant reduction in maternal (P = 0.008) and infant (P = 0.004) colonization rates in the treatment group. There were no observed complications of antibiotic therapy in mothers or infants. This study suggests that routine cultures for GB-BHS should be done at 38 weeks' gestation. Mothers colonized at this time may be considered candidates for prophylactic antibiotic treatment.

Carrier State↗

Clinical and serologic study of four smallpox vaccines comparing variations of dose and route of administration. Basic study and laboratory standardization.

The present four-center collaborative study was undertaken in an attempt to define the best vaccine and/or vaccination procedure for use in areas of the world that are free of smallpox. The study was designed to compare the effect of different vaccinial strains, viral concentrations, and routes of administration on the morbidity and antibody response associated with primary vaccination and standard challenge revaccination. Primary vaccinations were performed on 1,585 children; 49.6% of the children were vaccinated by the percutaneous route, and 50.4% received vaccine subcutaneously. The overall age and sex distributions of percutaneous and subcutaneous vaccinees were comparable, but there were marked differences in participants among the four study centers. Vaccines in Kentucky had a greater mean age; the greatest number of Negroid children were enrolled in St. Louis, and more of them were vaccinated by the subcutaneous route; and the dropout rate was much greater in San Diego and Colorado. An analysis of comparative interlaboratory serologic procedures with the use of 20 coded duplicate samples of serum revealed good agreement in the hemagglutination-inhibition test; results of neutralization tests had greater variability of mean titers. On duplicate samples of serum from study participants there was generally good correlation between each of the four study centers and the Center for Disease Control's reference laboratory in titers of hemagglutination-inhibiting antibody. In contrast, 38% of the neutralization titers determined at the four study centers were greater than or equal to 0.67 log10 higher than the respective titers noted at the Center for Disease Control.

Black or African American↗

Clinical and serologic study of four smallpox vaccines comparing variations of dose and route of administration. Primary percutaneous vaccination.

In an investigation of the antigenicity and reactogenicity of four smallpox vaccines, 786 children received primary percutaneous vaccination with vaccine in one of three concentrations, 10(6), 10(7), or10(8) pock-forming units/ml. Dose-response curves indicated that the three licensed vaccines (New York City Board of Health strains grown in calf lymph or chorioallantoic membrane, and the Lister vaccine) had similar potencies, but the CV-1 strain was about 10-fold less infectious. CV-1 also produced smaller skin lesions than the other three vaccines, and the incidence of fever in CV-1 vaccines who developed either "major reactions" or serum antibody was not significantly different from that in children in all vaccine groups with no evidence of "take." Hemmagglutination-inhibiting antibody was consistently seen in individuals who received potent New York City and Lister vaccines, and neutralizing antibody was induced in 82%-85% of children in this group who had some evidence of take (production of hemagglutination-inhibiting antibody or or major reaction). Only 30% of CV-1 vaccines with takes produced neutralizing antibody. Minor complications occurred in all groups, but most often in children who received the New York City strains."

Animals↗

Clinical and serologic study of four smallpox vaccines comparing variations of dose and route of administration. Standard percutaneous revaccination of children who receive primary percutaneous vaccination.

A standard challenge with percutaneous smallpox vaccine was administered to 629 children six to 12 months after percutaneous primary inoculation with one of four vaccines (New York City Board of Health strains grown in calf lymph or chorioallantoic membranes, the Lister vaccine, or the CV-1 strain). Of those who had had major reactions on primary vaccination, 8%-21% responded to revasccination with a typical primary-type skin response. In contrast, such a primary-type response occurred in 50% of those who on primary vaccination had developed serum antibody in the absence of major reactions and in 83% of those who had had no serologic or clinical evidence of primary "take." Skin lesions on revaccination tended to be largest in thosewhose primary vaccination was with CV-1, although fever and minor complications were not more frequent. Moreover, even in children who had received CV-1 vaccine, skin responses to challenge vaccine were clearly attenuated when compared with responses of children who had not had takes on primary vaccination. Sizes of lesions and acceleration of skin erytherma after challenge were related in most children to titers of both hemagglutination-inhibiting and neutralizing antibody at the time of revaccination. One month after revaccination, neutralizing antibody was present in 93%-96% of those with takes onprimary vaccination with New York City or Lister vaccines, but only 75% of CV-1 vaccines.

Antibody Formation↗

Mucocutaneous lymph node syndrome in Denver.

Four children with acute febrile mucocutaneous lymph node syndrome (MLNS) were hospitalized in Denver over a two-year period. The children had most of the principle features of this recently described syndrome, including prolonged fever unresponsive to antibiotics, an erythematous rash, conjunctivitis, pharyngitis, and nonsuppurative cervical lymphadenitis. Three of the children exhibited characteristic desquamation from the fingertips or toes during convalescence. None developed clinical or electrocardiographic evidence of coronary thromboarteritis, the most serious complication of the disease. Additional cases undoubtedly will be reported in the United States as physicians become famililar with this new syndrome and learn to distinguish it from the other acute febrile exanthems.

Bacterial Infections↗

Bacteriology and treatment of purulent nasopharyngitis: a double blind, placebo-controlled evaluation.

One hundred forty-two children with purulent nasopharyngitis were randomized to four treatment groups with an antibiotic (cephalexin) alone or combined with a decongestant/antihistamine (pseudoephedrine/triprolidine) or their corresponding placebo equivalents. Follow-up evaluations by parents and physicians and bacteriologic evaluations were performed after 5 to 6 days of therapy. Groups were comparable with regard to age, sex, race, number of patients withdrawn from the study, fever greater than 38.0 degrees C, appearance of nasal discharge, nasal crusting and number of days until follow-up. Initial cultures from patients grew: Streptococcus pneumoniae, 46%; Haemophilus influenzae type b, 21%; and Streptococcus pyogenes, 8%. Nasal crusting was significantly associated with the growth of S. pneumoniae or H. influenzae type b. There were no significant differences between active drug and placebo treatment groups for change in nasal discharge, complications or apparent drug benefit. Cephalexin therapy did not result in a decrease in cultivation of pathogenic organisms from the nasopharynx. Significantly more side effects were attributed to pseudoephedrine/triprolidine treatment than to placebo. Routine culture or treatment of purulent nasopharyngitis should not be considered unless future controlled clinical trials demonstrate some therapeutic benefit.

Bacterial Infections↗

Bacteriuria and autonomic nerve function in diabetic women.

Significant bacteriuria (viable count greater than or equal to 10(5)/ml) was found on single testing in 10% of 400 consecutive diabetic women aged 15-65 yr routinely attending a diabetic clinic. Twenty patients with and 21 without significant bacteriuria were then randomly selected for measurement of cardiovascular autonomic reflexes, bladder ultrasound, and mictiography. There were no significant differences between these two groups in age, duration and type of diabetes, glycosylated hemoglobin, blood urea, and creatinine. Abnormalities of cardiovascular autonomic function were more common in the bacteriuric group (P less than .01). Although the bacteriuric group voided a smaller volume of urine, none had evidence of increased residual bladder volume of urine on ultrasound. Diabetic women with cardiovascular autonomic neuropathy appear to be at increased risk of developing bacteriuria. However, age is probably the most important factor influencing the prevalence of bacteriuria in diabetic and in nondiabetic women.

Adolescent↗