ABSTRACT
An acellular pertussis vaccine (DTaP) containing pertussis toxoid, filamentous hemagglutinin and the 69-kDa outer membrane protein (pertactin) was compared with United States-licensed whole cell pertussis vaccine (DTwP) as a three dose sequence at 2, 4 and 6 months of age. Eighty infants were enrolled; 62 received DTaP and 18 received DTwP. Sixty-two infants had preimmunization and 1 month postimmunization sera available for pertussis antibodies. No infant experienced a serious adverse reaction. Significantly fewer infants in the DTaP group experienced irritability (P < 0.001) and moderate to severe injection site pain and redness (P < 0.001, and P = 0.03, respectively). The DTaP group also had significantly greater increases in geometric mean titers of antibodies against filamentous hemagglutinin (P < 0.001) and pertactin (P = 0.006). This three-component DTaP vaccine induced an antibody response to pertussis toxin, filamentous hemagglutinin and pertactin but caused fewer adverse reactions than DTwP when administered as a primary series of immunization to 2-month-old infants.
Subject(s)
Antibodies, Bacterial/biosynthesis , Bacterial Outer Membrane Proteins/immunology , Bordetella pertussis/immunology , Hemagglutinins/immunology , Pertussis Vaccine/immunology , Toxoids/immunology , Virulence Factors, Bordetella , Bacterial Outer Membrane Proteins/administration & dosage , Double-Blind Method , Female , Hemagglutinins/administration & dosage , Humans , Infant , Infant, Newborn , Injections, Intramuscular , Male , Pertussis Vaccine/adverse effects , Toxoids/administration & dosageABSTRACT
Dietary restriction in cases of mild infantile diarrhea is often advocated but has not been shown to be effective. We enrolled 176 healthy infants less than 1 year of age in a randomized controlled trial to determine the effects of diet on the course of mild diarrhea. When diarrhea occurred (56 episodes), infants were randomly assigned to a treatment diet (24 hours of electrolyte solution then dilute soy formula, dilute cow's milk formula, or undiluted soy formula) or their usual formula. Parents recorded daily weights, stool losses, and oral intake. The difference in effects of unrestricted and treatment diets was small and not clinically significant. Patients on an unrestricted diet averaged 0.7 fewer days of diarrhea (95% confidence interval [CI], -1.43 to 0.02), 5.0 fewer total stools (95% CI, -10.26 to 0.33), and 1% less weight loss (95% CI, 2% to -1%) compared with those receiving a treatment diet. Treatment failures were similar in both groups. An unrestricted diet does not appear to affect the course or symptoms of mild diarrhea.
Subject(s)
Diarrhea, Infantile/diet therapy , Diet , Infant Food , Female , Humans , Infant , Male , Random Allocation , Weight LossABSTRACT
As competition within the health care field increases, marketing strategies are becoming more important for all members of the health care team, including nurse practitioners. The purpose of this research was to identify marketing strategies being used by nurse practitioners in New York state. A total of 285 practitioners responded to a survey containing questions related to marketing techniques traditionally used in the business world: service differentiation, market segmentation and practice promotion. A majority of respondents did not report using many of the marketing strategies contained in the survey, although most nurse practitioners did report identifying themselves as primary care providers in one-on-one interactions with clients. Significantly higher marketing scores were found for nurse practitioners who attended a workshop or seminar on marketing strategies, had three or more years of experience, or who practiced in private outpatient settings.
