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181.
To ascertain whether live attenuated or inactivated vaccines can be considered equivalent, we examined the primary antibody response of children following vaccination with influenza virus antigens in three different formulations. Nine children received cold recombinant vaccine (CRV) containing A/Korea/82 (H3N2) and A/Dunedin/83 (H1N1) variants. Eight of these children responded to HA of the H3N2 subtype and the major portion of the elicited antibody was in the IgG1 subclass. Antibody of low titer in the IgG2 and IgG3 subclasses was detected in two and six serum specimens, respectively. Six of the nine children administered with CRV responded to the H1 antigen and only IgG1 antibody was detected. Serum specimens from eight children less than one year of age (5 less than 6 months of age) who had developed an antibody response to trivalent inactivated vaccine (TIV) vaccination were examined. High levels of IgG1 antibody to purified H3 were detected in all eight children. Low titers of antibody in IgG2 and IgG3 subclasses were detected in two and five children, respectively. Antibody responses to purified H1 showed a similar subclass distribution. In order to examine secondary response, eight children primed by immunization with TIV vaccine were subsequently given a single booster dose of purified hemagglutinin (HA) conjugated to diphtheria toxoid (HA-D). In 6/8 specimens antibody rises were detected to purified H3 and H1 antigens. Prior to the HA-D immunization, low levels of HA specific IgG1 antibody were detected in all serum specimens and vaccine induced responses were primarily of the IgG1 subclass.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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Background and Purpose . The National Health and Nutrition Examination Surveys (NHANES) activity of daily living (ADL) instrument is a 16‐item questionnaire designed to represent the internal latent construct of activities of daily living. The purpose of the present study was to measure selected psychometric properties (dimensionality, internal consistency and individual item response) of the NHANES ADL instrument on a population of patients who reported frequent severe headaches. Method . The study group consisted of 672 attendees of a traditional medical appointment with a report of severe headaches. Data analyses included exploratory factor analysis, internal consistency measures and graded item response theory. Results . The NHANES ADL instrument is a uni‐dimensional and internally consistent measure of activities of daily living. Graded item response theory analyses indicated that all 16 single items were sensitive measures of the latent construct of activities and daily living. Selected items demonstrated high discrimination while others demonstrated moderate discrimination among responses. Conclusion . Individual use of selected items of the NHANES ADL instrument may further improve the capacity of the healthcare provider in measuring and recording dysfunction associated with headaches. Copyright © 2006 John Wiley & Sons, Ltd. 相似文献
184.
Scarborough JE Tuttle-Newhall JE Pietrobon R Marroquin CE Collins BH Desai DM Kuo PC Pappas TN 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2008,10(1):25-29
The purpose of our study is to determine whether the current level of transplant fellow training is sufficient to meet the future demand for liver transplantation in the United States. Historical data from the Nationwide Inpatient Samples (NIS) for the years 1998 through 2003 were used to construct an estimate of the annual number of liver transplant procedures currently being performed in the United States, and the number projected for each year through 2020. Estimates for the current and future number of surgeons performing liver transplant procedures were also constructed using the same database. The NIS database was used because current national transplant registries do not include information on the number of surgeons performing liver transplant procedures. Using historical data derived from the NIS database, we project that the estimated number of liver transplant procedures per surgeon will remain relatively stable through 2020, with each surgeon performing an average of 12.9 procedures in 2020 compared to 12.9 currently. We conclude that the relationship between demand for liver transplantation in the United States and the supply of liver transplant surgeons will remain stable over the next 15 years. 相似文献
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Soh CR Pietrobon R Freiberger JJ Chew ST Rajgor D Gandhi M Shah J Moon RE 《Intensive care medicine》2012,38(7):1143-1151
Purpose
Necrotising soft tissue infection (NSTI) is a deadly disease associated with a significant risk of mortality and long-term disability from limb and tissue loss. The aim of this study was to determine the effect of hyperbaric oxygen (HBO2) therapy on mortality, complication rate, discharge status/location, hospital length of stay and inflation-adjusted hospitalisation cost in patients with NSTI.Methods
This was a retrospective study of 45,913 patients in the Nationwide Inpatient Sample (NIS) from 1988 to 2009.Results
A total of 405 patients received HBO2 therapy. The patients with NSTI who received HBO2 therapy had a lower mortality (4.5 vs. 9.4 %, p?=?0.001). After adjusting for predictors and confounders, patients who received HBO2 therapy had a statistically significantly lower risk of dying (odds ratio (OR) 0.49, 95 % confidence interval (CI) 0.29–0.83), higher hospitalisation cost (US$52,205 vs. US$45,464, p?=?0.02) and longer length of stay (LOS) (14.3?days vs. 10.7?days, p?0.001).Conclusions
This retrospective analysis of HBO2 therapy in NSTI showed that despite the higher hospitalisation cost and longer length of stay, the statistically significant reduction in mortality supports the use of HBO2 therapy in NSTI. 相似文献187.
Little science, big science: strategies for research portfolio selection in academic surgery departments 下载免费PDF全文
Shah A Pietrobon R Cook C Sheth NP Nguyen L Guo L Jacobs DO Kuo PC 《Annals of surgery》2007,246(6):1110-1115
OBJECTIVE: To evaluate National Institutes of Health (NIH) funding for academic surgery departments and to determine whether optimal portfolio strategies exist to maximize this funding. SUMMARY BACKGROUND DATA: The NIH budget is expected to be relatively stable in the foreseeable future, with a modest 0.7% increase from 2005 to 2006. Funding for basic and clinical science research in surgery is also not expected to increase. METHODS: NIH funding award data for US surgery departments from 2002 to 2004 was collected using publicly available data abstracted from the NIH Information for Management, Planning, Analysis, and Coordination (IMPAC) II database. Additional information was collected from the Computer Retrieval of Information on Scientific Projects (CRISP) database regarding research area (basic vs. clinical, animal vs. human, classification of clinical and basic sciences). The primary outcome measures were total NIH award amount, number of awards, and type of grant. Statistical analysis was based on binomial proportional tests and multiple linear regression models. RESULTS: The smallest total NIH funding award in 2004 to an individual surgery department was a single $26,970 grant, whereas the largest was more than $35 million comprising 68 grants. From 2002 to 2004, one department experienced a 336% increase (greatest increase) in funding, whereas another experienced a 73% decrease (greatest decrease). No statistically significant differences were found between departments with decreasing or increasing funding and the subspecialty of basic science or clinical research funded. Departments (n = 5) experiencing the most drastic decrease (total dollars) in funding had a significantly higher proportion of type K (P = 0.03) grants compared with departments (n = 5) with the largest increases in total funding; the latter group had a significantly increased proportion of type U grants (P = 0.01). A linear association between amount of decrease/increase was found with the average amount of funding per grant and per investigator (P < 0.01), suggesting that departments that increased their total funding relied on investigators with large amounts of funding per grant. CONCLUSIONS: Although incentives to junior investigators and clinicians with secondary participation in research are important, our findings suggest that the best strategy for increasing NIH funding for surgery departments is to invest in individuals with focused research commitments and established track records of garnering large and multiple research grants. 相似文献
188.
Anand Shah Karen C Nielsen Larissa Braga Ricardo Pietrobon Stephen M Klein Susan M Steele 《Indian Journal of Orthopaedics》2007,41(3):230-236