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PubMed2003

Laparoscopic omental harvest for flap coverage in complex mediastinitis.

Mediastinitis is one of the most serious complications of cardiac surgery. The standard of care in mediastinitis includes thorough sequential debridement, flap coverage, and culture-directed antibiotics. The most frequently utilized muscles for flap reconstruction include the rectus abdominus and the pectoralis major. However, in some instances these flaps may be inadequate, unavailable, or fail, thus requiring an alternative choice or adjuvant. Most coronary graft procedures utilize the left internal mammary artery, frequently eliminating the left rectus muscles, while prior open cholecystectomy patients frequently lose availability of their right rectus muscle. In addition, radiation therapy or prior flap failure may exclude other muscle transfer procedures. The omentum offers excellent coverage due to mobility and superb arterial and lymphatic flow. Unfortunately, in the past, this has required a celiotomy in an already critically ill patient. We present a series of 5 patients where the omentum was mobilized laparoscopically and passed through an anterior diaphragmatic incision. This option spares a celiotomy, seals the wound, and hastens recovery in very ill patients. We also present a complete review of literature on the topic and provide an algorithm for complex sternal wound reconstruction.

Aged↗
PubMed1992

Coverage by four information services of the core journals of rehabilitation and related topics.

In this study, three serials databases were used to identify core journals in rehabilitation and related areas. Simple strategies were used to search SERLINE (Serials Online, National Library of Medicine), Ulrich's International Periodicals Directory and SACHET (British Library serials database). Coverage of the journals identified by four secondary information services was then studied. These were Medline, Excerpta Medica, CINAHL (Cumulative Index to Nursing and Allied Health) and CATS (Current Awareness Topics Services, British Library). The results confirmed and extended the findings of earlier work: the number of core journals in rehabilitation is very large and their coverage by information services is very selective. Of the services studied here, CATS seemed to be most comprehensive for the journals identified.

Databases, Factual↗
PubMed1992

How well are we protecting our children? An immunisation coverage survey in Hawke's Bay.

AIMS: In July 1991, an immunisation coverage survey was conducted to assess the proportion of two year old children who have been vaccinated in the Hawke's Bay. METHODS: Parents from a representative sample of 100 households with children between the ages of two and four years of age were interviewed regarding household characteristics and parental attitudes towards immunisation. Immunisation histories were abstracted from each child's Health and Development Record Book or, if this was not available or was incomplete, from records retained by the general practitioner(s) responsible for administering immunisations to the child. RESULTS: Coverage levels among two year olds exceeded 85% for all postneonatal vaccinations scheduled for the first year of life; however, levels among two year olds were lower than 85% for all vaccinations scheduled to be received after the first birthday. Overall, only 61% (95% confidence interval (CI) = 50.7, 70.6) of the children were fully vaccinated by the age of two years. Children living in a household where the principal source of income was from benefits were almost 60% less likely to have been fully immunised at two years of age (odds ratio (OR) = 0.42, 95% CI = 0.18, 0.97), as were Maori children (OR = 0.43, 95% CI = 0.18, 1.06). CONCLUSIONS: These results emphasise the need for enhanced education about the importance of completing the full series of recommended vaccinations and of on-time vaccination, as well as for checking childrens' vaccination histories at every contact with the healthcare system and, where necessary, administering past-due immunisations.

Adult↗
PubMed2003

Coverage and costs of mass immunization of an oral cholera vaccine in Vietnam.

The objective of this study was to describe a mass-immunization campaign of a locally-produced oral, killed whole-cell cholera vaccine in Hue city, Vietnam. Mass immunization with a 2-dose regimen of the vaccine was conducted in 13 communes in early 1998. The total, age- and sex-specific vaccine coverage was calculated using data from the vaccination records and the government census. The number of vaccine doses procured, administered, wasted, and left over, and the human and other resources required to prepare and conduct the vaccination campaign were systematically recorded. Government expenditure for planning, procurement, and delivery of the vaccine were documented. In total, 118,555 (79%) of the 49,557 targeted population were fully vaccinated during the mass-vaccination campaign. The total expenditure for the project was US dollar 105,447, resulting in a cost per fully-vaccinated person of US dollar 0.89. Mass immunization with this locally-produced oral, killed cholera vaccine was found to be feasible and affordable with attainment of high vaccination coverage.

Administration, Oral↗
PubMed2003

Influenza vaccination--knowledge, attitudes, coverage--can they be improved?

The reasons for low rate of influenza vaccination in Slovakia have been analyzed in selected target groups. In our questionnaire study we focused on the level of knowledge about this vaccination and the attitudes towards it. We selected three target groups: medical students, nurses and printing company workers. The authors as well tried to identify the ways how the flu vaccination coverage could be increased in the future. The questionnaire survey revealed several surprising facts. Though almost all the respondents knew about the existence of influenza vaccine, less than one quarter of them have ever received influenza shot. Despite our expectations that the main source of information about influenza prevention in medical students and nurses would be from their medical and nursing studies, it was shown to be from mass media instead. Even more staggering was the distrust towards the vaccination as a reason for not being vaccinated in a high proportion of both the medical students and the nurses. The majority of medical students would not even want to get a vaccination, even if it were to be provided for free. These results suggest that if we want to improve the low influenza vaccination coverage within the general population of our country, we will have to focus our attention primarily on the professional groups of medical workers and medical and nursing students who should be able to provide the public with the competent advice. Therefore, changing the current negative approach and improving the deficit in knowledge concerning vaccination are the key tasks for all under- as well as postgraduate teachers of medicine and nursing in Slovakia, especially, but not exclusively, of those specialised in public health.(Tab. 3, Fig. 2, Ref. 8).

Adult↗
PubMed2004

Oral polio vaccines have not yet covered West Africa: survey of immunization coverage conducted in Niger.

Following the re-emergence of polio in West Africa, an investigation was conducted on the occasion when transients gather for the festival in Niger, where the oral polio vaccine (OPV) and BCG coverage among children under the age of 5 years can be evaluated. A total of 259 children were investigated, including 186 from settled families and 73 from unsettled families. OPV coverage was found to be as low as 32.4%, and 61.8% of all participants in the study had not received both OPV and BCG. There were more children who had not received the OPV in unsettled families than in settled families. As there are still unvaccinated children in Niger, polio continues to occur among them. Moreover, outbreaks can transfer to more densely-populated areas, causing much larger outbreaks. To stop the chain of transmission, it is essential to reconsider the strategy of mass vaccination in order to cover all children thoroughly, including transients.

Africa, Western↗
PubMed2004

Fouling coverage of a green tide alga, Ulva pertusa on some antifouling test surfaces exposed to Ayagin harbor waters, east coast of South Korea.

Toxic antifouling chemicals released into the seawaters leads to marine environmental degradation. In order to identify a nontoxic antifoulant, an assessment of antifouling (AF) efficacy of some AF candidates was made at Ayagin harbor, east coast of South Korea. In this static panel study conducted during October 2000-March 2001, some commercial antifoulants, seaweed and seagrass extracts were screened. On panel surfaces coated with a seaweed extract, Ishige okamurae exhibited effective AF activity. Ulva pertusa was encountered as a 'monospecific' fouler with fairly high fouling coverage on many of the test panel surfaces. In recent years the increased influx of inorganic pollutants in the coastal waters causes exorbitant growth of fouling marine algae found all along the Korean peninsula. Especially, a cosmopolitan ship fouling alga U. pertusa occur with high abundance. It was largely suggested that the proposed international ban on the toxic antifoulant tributyltin (TBT) had significant effect on the 'green tide' phenomenon occurring in different parts of the world. However, it appears that Korean scenario of 'green tide' is a localized. Antifouling efficacy of some AF coatings and fouling coverage of a green tide alga, U. pertusa are discussed.

Animals↗
PubMed2004

Child coverage with mosquito nets and malaria treatment from population-based surveys in african countries: a baseline for monitoring progress in roll back malaria.

We assessed the proportion of febrile children less than five years old with prompt effective antimalarial treatment and the proportion of those less than five years old sleeping under insecticide-treated nets (ITNs) or any mosquito net the preceding night in African malarious countries. Data were reviewed from 23 Multiple Indicator Cluster Surveys and 13 Demographic and Health Surveys conducted between 1998 and 2002. A median of 53% of febrile children received antimalarial treatment. A median of 84% of these treatments, however, involved chloroquine, and the proportion of treatments given within two days of onset of symptoms was unknown in most surveys. Median coverages of those less than five years old with any net and ITNs were 15% and 2%, respectively. Use of nets, and especially ITNs, was consistently lower in rural than in urban areas. At the outset of intensified malaria control under Roll Back Malaria, coverage with principal interventions was far below the target of 60% set for Africa in 2005.

Africa South of the Sahara↗
PubMed2004

VA National Drug File Reference Terminology: a cross-institutional content coverage study.

BACKGROUND: Content coverage studies provide valuable information to potential users of terminologies. We detail the VA National Drug File Reference Terminology's (NDF-RT) ability to represent dictated medication list phrases from the Mayo Clinic. NDF-RT is a description logic-based resource created to support clinical operations at one of the largest healthcare providers in the US. METHODS: Medication list phrases were extracted from dictated patient notes from the Mayo Clinic. Algorithmic mappings to NDF-RT using the SmartAccess Vocabulary Server (SAVS) were presented to two non-VA physicians. The physicians used a terminology browser to determine the accuracy of the algorithmic mapping and the content coverage of NDF-RT. RESULTS: The 509 extracted documents on 300 patients contained 847 medication concepts in medication lists. NDF-RT covered 97.8% of concepts. Of the 18 phrases that NDF-RT did not represent, 10 were for OTC's and food supplements, 5 were for prescription medications, and 3 were missing synonyms. The SAVS engine properly mapped 773 of 810 phrases with an overall sensitivity (precision) was 95.4% and positive predictive value (recall) of 99.9%. CONCLUSIONS: This study demonstrates that NDF-RT has more general utility than its initial design parameters dictated

Abstracting and Indexing↗
PubMed2004

Evaluation of SNOMED coverage of Veterans Health Administration terms.

Veterans Health Administration (VHA) is now evaluating use of SNOMED-CT. This paper reports the first phase of this evaluation, which examines the coverage of SNOMED-CT for problem list entries. Clinician expressions in VA problem lists are quite diverse compared to the content of the current VA terminology Lexicon. We selected a random set of 5054 narratives that were previously "unresolved" against the Lexicon. These narratives were mapped to SNOMED-CT using two automated tools. Experts reviewed a subset of the tools' matched, partly matched, and un-matched narratives. The automated tools produced exact or partial matches for over 90% of the 5054 unresolved narratives. SNOMED-CT has promise as a coding system for clinical problems. In subsequent studies, VA will examine the coverage of SNOMED for other clinical domains, such as drugs, allergies, and physician orders.

Forms and Records Control↗
PubMed2004

[General practitioners and vaccination coverage of the population].

Adults have insufficient vaccination coverage in Belgium today. It is up to the general practitioner, who is a key player in the Belgian health system, to ensure that this coverage is improved. The most efficient measures are: systematic patient notification, population and practitioner instruction, reduced cost for the patient, improved access to vaccination services and vaccination reminders to practitioners. These measures will be made easier by the development of the Global Medical Record and the Computerised Medical Record.

Belgium↗
PubMed2004

Is Oklahoma the weak link? The decline in vaccine coverage levels in Oklahoma.

Oklahoma has demonstrated a decline in vaccine coverage levels in children over the past two years, moving from a national ranking of 31st in 2000 to 48th in 2002. This decline has prompted a review of available evidence to identify approaches to move the state toward national averages and ultimately to the Healthy People 2010 Objectives. Oklahoma is one of nine states that are well below the established goal of 80% vaccine coverage for children. Oklahoma is near the bottom of this group with an estimated level of only 65%, placing not only Oklahomans at risk but the nation as well. The following is a plan aimed at both the health department and all health care professionals. Indeed, without physician involvement, the situation will not improve.

Child, Preschool↗
PubMed2005

Reduction of autogenous bone graft resorption by means of bio-oss coverage: a prospective study.

Bone grafting may be required prior to implant placement, at the time of implant placement, or subsequent to it. The aim of this study was to compare the healing of onlay block grafts when deproteinized bovine bone coverage was used with the healing of the grafts without such coverage. The purpose was a clinical evaluation of deproteinized bovine bone's ability to reduce grafted bone resorption. The results indicated that bovine bone can be placed over grafted areas, taking advantage of its osteoconductive properties and compensating for the natural bone resorption caused by remodeling.

Adolescent↗
PubMed2005

Vaccination coverage among callers to a state influenza hotline--Connecticut, 2004-05 influenza season.

In response to the influenza vaccine shortage in the United States, the Connecticut Department of Public Health (DPH) operated a telephone hotline during October 22, 2004-January 15, 2005. The purpose of the hotline was to address questions from the public regarding the availability of influenza vaccine, reduce the number of telephone inquiries to physicians and local health departments (LHDs), and advise callers regarding which groups were most at risk and in need of influenza vaccination. Caller information was collected and shared daily with LHDs, which were encouraged to follow up with callers as their resources allowed. This report summarizes results of a retrospective survey of callers to the DPH influenza vaccine hotline during November 2004. The results indicated that vaccination coverage varied by age group and that persons receiving follow-up calls from LHDs were more likely to receive vaccination. State health departments might consider a hotline as a method for educating the public regarding influenza vaccination and a follow-up system as a means to improve vaccination coverage, especially among those at greatest risk.

Connecticut↗
PubMed2005

The subepithelial connective tissue graft: part II. Histologic healing and clinical root coverage.

Periodontal plastic surgical techniques have evolved to meet the demands of today's dental patient. Free gingival grafts (FGGs), pedicle flaps, subepithelial connective tissue grafts (SCTGs), acellular dermal matrix (ADM) grafts, and guided tissue regeneration (GTR) have all been used to cover denuded root surfaces. FGGs have demonstrated inconsistent results. Pedicle flaps have provided consistent results, but adequate tissue must be present initially. ADM grafts have also demonstrated success, but long-term stability may be a problem. Presently, SCTGs and GTR should be considered the treatment of choice for root coverage. They are the most predictable with average root coverage as high as 98.9% and 92.3%, respectively.

Connective Tissue↗
PubMed2005

Rapid assessment of influenza vaccination coverage among HMO members--northern California influenza seasons, 2001-02 through 2004-05.

The Vaccine Safety Datalink (VSD) is a collaborative project involving CDC and eight health maintenance organizations (HMOs) in the United States. Computerized data on vaccination, medical outcomes, and patient demographics are collected and linked under a standard protocol at multiple HMOs. Beginning with the 2003-04 influenza season, the VSD team and one of the HMOs, Kaiser Permanente Northern California (KPNC), established an automated system for rapid detection of potentially adverse events after vaccinations among its members. During the 2004-05 influenza season, in response to the influenza vaccine shortfall and resulting prioritization of vaccine distribution, this rapid analysis system also was used to assess influenza vaccination coverage weekly among KPNC members. The results indicated that KPNC followed Advisory Committee on Immunization Practices (ACIP) prioritization guidelines by targeting influenza vaccination to children aged 6-23 months and adults aged >/=65 years. For the 2005-06 influenza season, the rapid analysis system should be expanded to include data from additional HMOs and more detailed information on vaccinees (e.g., high risk for influenza complications) to better characterize influenza vaccination coverage during the 2005-06 influenza season on a weekly basis.

California↗
PubMedDate not supplied

[Coverage rates of influenza vaccine in Italy during the 2002/3 and 2003/04 seasons: a cross-sectional study].

The objective of this survey was to assess the level of influenza vaccination coverage in the season 2002/ 2003 compared with the season 2003/2004 in Italy, to understand the drivers and barriers to vaccination and to determine the intention for vaccination for the following winter. We conducted a random-sampling, telephone-based household survey among non-institutionalised individuals representative of the population aged 14 years and above. The surveys for 2002/2003 and 2003/2004 used the same questionnaire and were subsequently pooled. Four target groups were determined for analysis: (1) persons aged 65 years and above; (2) people working in the medical field; (3) persons suffering from a chronic illness and (4) all other groups. The overall sample consisted of 4010 people. The influenza vaccination coverage rate in Italy increased from 19.6% in season 2002/2003 to 22.2% in season 2003/2004. The most frequent reasons mentioned by vaccinees to get vaccinated were advice received from the family doctor or nurse (48.9%), influenza being considered a serious illness which people did not want to contract (38.5%) and not wanting to pass the influenza bug to family and friends (29.2%). Reasons mentioned by never vaccinated people for not getting vaccinated were the fact that people did not consider it before (34.9%), the opinion that one was not very likely to catch influenza (32.2%) and influenza not being a serious illness (23.4%). Options encouraging an influenza vaccination are a recommendation by the family doctor or nurse (58.4%), more available information on the vaccine regarding efficacy and tolerance (34.4%) and more available information on the disease (24.3%). We therefore suggest that family doctors be better informed on influenza vaccine and the disease itself in order to enable them to actively inform their patients on these topics accordingly.

Adult↗
PubMed2005

Predictability of connective tissue grafts for root coverage: clinical perspectives and a review of the literature.

Several techniques using subepithelial connective tissue for root coverage have recently been described in the periodontal literature. The predictability of such procedures, however, varies among the different reports. The factors responsible for these differences are not fully understood. The purpose of this article is to review and comment on factors that may enhance the predictability of root coverage.

Connective Tissue↗

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