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Biomedical subjects

D B Nelson

Publications and source records attributed to D B Nelson.

At least 91 records · Page 5Linked to original sources
PubMed1985

Increased risk of gastrointestinal perforations in neonates mechanically ventilated with either face mask or nasal prongs.

Twenty cases of gastrointestinal perforations not associated with necrotizing enterocolitis or a bowel obstruction (GPNN) were reviewed. Fifteen infants suffered perforations during cycle ventilation. Perforations were localized in the stomach, duodenum, ileum, and jejunum. To determine if the type of mechanical ventilation used (ie, face mask, nasal prongs, or endotracheal tube) was associated with GPNN, a matched case-control analysis was performed. Case and control infants were matched by means of Apgar scores, gestational age, and length of time on ventilatory support. The Mantel-Haenszel estimate for estimating odds-ratios was used to determine that infants ventilated with nasal prongs or face mask were more likely to develop a gastrointestinal perforation than control infants ventilated with endotracheal tubes (odds-ratio greater than or equal to 29.6). This risk was associated with both upper gastrointestinal perforations (odds-ratio greater than or equal to 21.0) and lower gastrointestinal perforations (odds-ratio greater than or equal to 15.3). Routine use of mechanical ventilation with either nasal prongs or face mask appears to be associated with an unacceptable risk of gastrointestinal perforations in sick neonates.

Duodenal Diseases↗
PubMed1984

The effect of immune globulin on the response to trivalent oral poliovirus and yellow fever vaccinations.

To assess whether immune globulin may be administered concurrently with trivalent oral poliovirus vaccine (OPV) or yellow fever vaccine, antibody responses were studied in Peace Corps volunteers embarking for overseas duty in 1978. Of 200 volunteers who received OPV, 192 (96%) had pre-existing neutralizing antibody to at least 2 poliovirus types; of 160 yellow fever vaccinees, 24 (15%) had pre-existing 17D yellow fever antibody. Each volunteer received 5 ml of immune globulin, 0-7 days before, 3-5 days after, or 28-32 days after vaccination. This last group was designated the control group. Of the volunteers who received immune globulin 0-7 days before vaccination, 71% 72%, 49%, and 82% responded to poliovirus types 1, 2, and 3, and yellow fever, respectively (response was defined as a 4-fold or greater rise in serum neutralizing antibody titre between baseline (0-7 days before vaccination) and follow-up (15-40 days after vaccination)). These rates did not differ significantly from those in persons who received immune globulin 28-32 days after vaccination (61%, 60%, 51%, and 83%, respectively). Thus, among individuals who, for the most part, were immune to poliomyelitis but not to yellow fever, immune globulin did not decrease the antibody response to OPV or to yellow fever vaccine when given 0-7 days before vaccination.

Administration, Oral↗
PubMed1984

A new method for inferior capsulotomy in the face of ruptured zonules.

During routine planned extracapsular cataract extraction, rupture of the inferior zonules was noted while performing the superior portion of the anterior capsulotomy. After the nucleus expression and cortical aspiration, a Sheets glide was placed in the anterior chamber between the anterior and posterior capsule, deep into the capsular bag. This provided a platform for the performance of a controlled inferior capsulotomy in the face of weakened zonular support.

Cataract Extraction↗
PubMed1983

Prevalence of serum antibody to staphylococcal enterotoxin F among Wisconsin residents: implications for toxic-shock syndrome.

Staphylococcal enterotoxin F (SEF) has previously been shown to be a marker for toxic-shock syndrome (TSS)-associated strains of Staphylococcus aureus, whereas the serologic absence of antibody to SEF (anti-SEF) has been shown to be a marker for susceptibility of persons to TSS. In this study, anti-SEF was measured by radioimmunoassay in 689 banked sera obtained from Wisconsin residents during 1960, 1970, and 1980. The prevalence of anti-SEF as estimated by logistic regression analysis was 47%, 58%, 70%, 88%, 96%, and 99% at ages one, five, 10, 20, 30, and 50 years, respectively. Evidence for the transplacental transfer of anti-SEF is also presented. Despite the reported increased incidence of TSS occurring during the past five years, with a preponderance of cases occurring among women, no significant differences in the prevalence of anti-SEF were noted between sexes or longitudinally between the years 1960, 1970, and 1980. These data enhance our understanding of the epidemiology of TSS and further identify the population that may be susceptible to TSS.

Adolescent↗
PubMed1983

National surveillance for Guillain-Barré syndrome: January 1978-March 1979.

Between January 1, 1978, and March 31, 1979, 1,034 cases of Guillain-Barré syndrome (GBS) were reported to the Centers for Disease Control by the 1,813 American Academy of Neurology sentinel physicians who participated in the national GBS surveillance program. A direct correlation was observed between increasing age and the age-specific attack (incidence) rates. Based on the cases observed and the total US population, age-adjusted attack rates were statistically higher in males (0.52 per 100,000) than in females (0.40). Rates for whites were 0.44 and those for blacks 0.28 per 100,000; although the difference is statistically significant, uncertainties as to the true denominators by race preclude acceptance of these differences as valid. Sixty-seven percent, or 682 of the patients, reported that they had had an antecedent illness within 8 weeks before onset of GBS, and among them the peak period of onset of GBS was in the second week after the onset of the prior illness. There were also 52 patients (5%) who had undergone surgery and 45 (4.5%) who had received vaccinations, both within the 8 weeks before onset of GBS. However, the high proportions of antecedent illness in these groups (45% of those operated and 53% of those vaccinated) made attribution of GBS to the procedures tenuous. Risk of GBS in patients who reported receiving a swine influenza vaccination in 1976 was no greater than in those who reported that they did not receive this vaccine.

Adolescent↗
PubMed1983

St. Louis encephalitis--Florida 1977. Patterns of a widespread outbreak.

From 8 August through 5 December 1977, 110 laboratory-documented cases (78 confirmed, 32 presumptive) of St. Louis encephalitis (SLE) occurred in 20 counties throughout central-south Florida. Most cases were initially identified through an active surveillance system involving repeated contact of hospital infection control officers. This outbreak had three characteristics that are unusual for SLE epidemics in the eastern United States: it lacked an urban focus, a disproportionate number of cases affected young males, and the epidemic period extended into December. There was no significant difference between attack rates for blacks and whites. Males were significantly more often affected than females. Because of the time required for laboratory confirmation of cases, most outbreak control measures were initiated after the outbreak was declining. Reporting of clinically suspected SLE cases to initiate epidemic mosquito control should improve the timeliness of control measures in future outbreaks.

Adolescent↗
PubMed1982

Rubella susceptibility in inner-city adolescents: the effect of a school immunization law.

In order to improve the immune status of girls in our medical clinic, we conducted a prospective sero-survey to identify susceptibles and developed a system for vaccinating non-immune girls. Over an 18-month period, 481 inner-city adolescents were screened. Susceptibility rate defined by a titer less than 1:8 was 12 per cent and did not differ significantly with regard to age or race. Nine months into the study period, the State of Wisconsin enacted a "no immunization-no school" law. The susceptibility rate dropped from 22 per cent prior to the enactment of the law, to 5 per cent after. Of the 60 girls identified as susceptible, 54 (90 per cent) kept their follow up appointments for vaccinations. Enforced state immunization laws appear to be effective in lowering rubella susceptibility.

Adolescent↗
PubMed1982

National surveillance for Reye syndrome: a five-year review.

National surveillance for Reye syndrome conducted during five years, including the period 1973-1974 and December 1976 through November 1980, has resulted in the reporting of more than 2,000 cases of Reye syndrome. The highest reported incidence of Reye syndrome occurred during years of primary influenza B and A (H1N1) activity; the reported incidence during one period of influenza A (H3N2) activity was somewhat lower. Regional outbreaks of Reye syndrome have been associated with influenza A (H1N1) and B but now with influenza A (H3N2). Cases of Reye syndrome in whites tend to be distributed throughout all age groups whereas a large percentage of cases in blacks have been reported in infants less than 1 year of age in three of the past four years. Nationally, there has been a decline in the case-fatality ratio in recent years.

Adolescent↗
PubMed1981

Guillain-Barré syndrome and the 1978-1979 influenza vaccine.

An ongoing surveillance program was intensified to determine whether an increased risk of acquiring vaccine-related Guillain-Barré syndrome (GBS) (similar to that observed after vaccination with the A/New Jersey swine-influenza vaccine in 1976) existed for the approximately 12.5 million adults (greater than or equal to 18 years old) vaccinated in the 1978-1979 influenza campaign. In the contiguous United States (excluding Maryland) 544 cases of GBS with onset between September 1, 1978, and March 31, 1979, were reported, including 12 adults who had been vaccinated within eight weeks before the onset of GBS and 393 who had not. The relative risk of vaccine-associated GBS for adults reported in this surveillance was 1.4 (95% confidence limits, 0.7 to 2.7)--significantly below the risk (6.2) associated with A/New Jersey vaccine for the equivalent eight-week period. In contrast to the A/New Jersey vaccine, the 1978-1979 influenza vaccine was not associated with a statistically significant excess risk of GBS.

Adolescent↗
PubMed1981

A study of the proportions of swimmers among well controls and children with enterovirus-like illness shedding or not shedding an enterovirus.

CHildren between the ages of less than 1 year and 15 years who visited a pediatric clinic in Madison, Wisconsin, from June 13 through September 1, 1977, were surveyed for the frequency and location of swimming they had done in the two weeks prior to the clinic visit. The study population consisted of 679 well controls, and 296 children with enteroviral-like syndromes. Throat and rectal swab specimens were collected from 241 of the ill patients and from 27 well children. Non-polio enteroviruses were recovered from 119 ill and two well individuals. Other viruses were recovered from an additional 13 ill patients. The majority of viral-like syndromes were respiratory, with or without fever and gastrointestinal symptoms. Exclusive beach swimmers had significantly (p less than 0.0005) increased relative risk (odds ratio estimate 3.41) of enterovirus illness. The highest relative risk (10.63) of enterovirus illness occurred in children less than 4 years old who were exclusive beach swimmers. Swimming in pools exclusively carried no significantly increased risk of enterovirus illness. Children with apparent viral illnesses based on clinical findings, who had no virus isolated, did not differ from well controls in the type of swimming exposure (either beaches or pools) in the two weeks prior to their clinic visit.

Adolescent↗
PubMed1981

Surveillance of Reye syndrome in the United States, 1977.

Between December 1, 1976, and November 30, 1977, 454 cases of Reye syndrome were reported to the Centers for Disease Control by 43 states. Analysis of data about these cases revealed that Reye syndrome primarily affected white children under age 18 years, with a mean age of 7.7 years and bimodal incidence peaks in infancy and at age 6-7 years, was temporally and geographically associated with influenza B for about 75% of cases, but also occurred sporadically and not in association with influenza B activity. Although Reye syndrome was reported infrequently for non-white children aged one year or older, there was a high incidence in minority infants, and the case-fatality ratio in infants of all races was significantly higher than that of the older children. Favorable outcome was associated with prolonged interval between onset of prodromal illness and hospitalization, admission to hospital at a milder stage of illness, and treatment in hospitals with established pediatric training programs.

Adolescent↗
PubMed1980

Further evaluation of the circular sequential vein graft technique of coronary artery bypass.

Our study reports a series of circular sequential vein grafts in 21 patients with highly symptomatic triple-vessel coronary artery disease. Four or more distal anastomoses were done in each patient. Thirteen of the patients were restudied, and the results revealed a 97% patency rate for distal anastomoses (58 out of 60) at 4 to 13 months after operation. One patient died 2 months after operation. Postmortem examination revealed a desmoplastic, fibrotic reaction at the proximal anastomosis of the circular graft, with 3 of 4 distal anastomoses patent. Twenty of the 21 patients in this series are now alive with asymptomatic cardiac status 14 to 22 months after operation. The finding by Grondin and associates [1] of increased patency rate with this technique for distal anastomoses is confirmed. The circular sequential vein graft represents a particularly advantageous technique for patients in whom 4 to 6 distal anastomoses are needed for complete revascularization and in whom one or more vessels have limited runoff. The obvious disadvantage of this technique is that all distal anastomoses depend on a single proximal anastomosis.

Adult↗
PubMed1980

Reye syndrome in Ohio, 1973-1977.

Some major epidemiologic features of Reye syndrome have been elucidated since the first description of this clinical entity. Multiple studies have shown an association with epidemic influenza B and endemic varicella. Little population data are available on age, sex, race, geographic distribution, and secular trends. A five-year retrospective population-based study of 190 Ohio residents diagnosed with Reye syndrome from January 1, 1973-December 31, 1977, is reported here. The temporal relationships between the occurrence of Reye syndrome and influenza B and varicella were confirmed; however, a high number of blacks and city dwellers with Reye syndrome were found in this study.

Adolescent↗
PubMed1980

Family-acquired respiratory disease in high-risk infants.

Five infants who had been patients in the same Neonatal Intensive Care Unit (NICU) were readmitted with respiratory illness. The illness was characterized by cough, congestion, apnea, and infiltration of the lungs revealed by radiographic examination. Only one infant was febrile. All five patients recovered; however, one infant required prolonged intubation and mechanically assisted ventilation. Investigation revealed that the illness was associated with prematurity and contact with ill family members. Illness was not associated with exposure to ill personnel in the NICU, low birth weight, or previous lung disease. This outbreak demonstrates the dangers involved in sending premature infants home when respiratory illness is prevalent in the family.

Cross Infection↗
PubMed1980

Aflatoxin and Reye's syndrome: a case control study.

Aflatoxin levels were determined in serum and urine of 17 patients with Reye's syndrome and in control subjects. No significant difference in aflatoxin levels was found for the two groups. However, 23% of all persons studied had levels of aflatoxin indicative of recent exposure. Aflatoxin levels were associated with ingestion of cornmeal and corn bread but not peanut-containing products. This prevalence of aflatoxin may be of public health importance.

Adolescent↗