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Petersen J, Freedman J, Ford L, Gawthrop M, Simons H, Edelstein M, Plunkett J, Balogun K, Mandal S, Patel D. Changes to country-specific hepatitis A travel vaccination recommendation for UK travellers in 2017-responding to a vaccine shortage in the national context. Public Health 2018; 168:150-156. [PMID: 30442468 DOI: 10.1016/j.puhe.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 08/29/2018] [Accepted: 09/06/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES A routine review of hepatitis A travel vaccination recommendations was brought forward in June 2017 due to hepatitis A vaccine shortages and a concurrent outbreak in men who have sex with men (MSM). There were three objectives: first, to document the review process for changing the recommendations for the UK travellers in June 2017. Second, to study the impact of these changes on prescribing in general practice in 2017 compared with the previous 5 years. Third, to study any changes in hepatitis A notifications in June-October 2017 compared with the previous 5 years. STUDY DESIGN This is an observational study. METHODS Travel vaccination recommendations for countries with either low-risk (<20%) or high-risk (>90%) status according to child hepatitis A seroprevalence were not changed. A total of 67 intermediate-risk countries with existing recommendations for most travellers and with new data on rural sanitation levels were shortlisted for the analysis. Data on child hepatitis A seroprevalence, country income status, access to sanitation in rural areas and traveller volumes were obtained. Information about the vaccine supply was obtained from Public Health England. Changes to the existing classification were made through expert consensus, based on countries' hepatitis A seroprevalence, sanitation levels, level of income, volume of travel and hepatitis A traveller cases. Data on the number of combined and monovalent hepatitis A-containing vaccines prescribed in England, 2012-2017, were obtained from the National Health Service Business Service Authorities. The number of monthly prescriptions for January-September 2017 was compared with the mean number of prescriptions for the same month in the previous 5 years (t-test, α = 5%, df = 4). The number of hepatitis A cases notified in June-October 2017 not related to the MSM outbreak was compared with the number of notifications in the same months in previous years. RESULTS A total of 36 countries were downgraded based on good access (80+% of population) to sanitation in rural areas and the intermediate-risk status in terms of child hepatitis A seroprevalence. For these countries, vaccination would only be recommended to travellers staying long term, visiting friends and relatives or staying in areas without good sanitation. There was a significant decline in hepatitis A vaccine prescriptions in June-September 2017, and there was no increase in the number of notifications. CONCLUSIONS Hepatitis A vaccination recommendations for travel were revised in 2017 following a systematic approach to maintain continuity of supply after a hepatitis A vaccine shortage and increased hepatitis A vaccine demand related to a large outbreak. Improved access to good sanitation in rural areas and low seroprevalence estimates among children have led to 36 countries to no longer require vaccination for most travellers. These changes do not seem to have impacted on hepatitis A notifications in England, although further research will be needed to quantify the impact more precisely.
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Affiliation(s)
- J Petersen
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK.
| | - J Freedman
- Travel and Migrant Health, Public Health England, London, UK
| | - L Ford
- National Travel Health Network and Centre (NaTHNaC), Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Gawthrop
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK
| | - H Simons
- National Travel Health Network and Centre (NaTHNaC), Liverpool School of Tropical Medicine, Liverpool, UK
| | - M Edelstein
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - J Plunkett
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - K Balogun
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - S Mandal
- Immunisation, Hepatitis and Blood Safety Department, National Infection Service, Public Health England, London, UK
| | - D Patel
- National Travel Health Network and Centre (NaTHNaC), University College London Hospital NHS Foundation Trust, London, UK
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DeFranco E, Jacobs T, Plunkett J, Chaudhari B, Huettner P, Muglia L. Placental pathologic aberrations in cases of familial idiopathic spontaneous preterm birth. Placenta 2011; 32:386-90. [DOI: 10.1016/j.placenta.2011.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/01/2011] [Accepted: 02/28/2011] [Indexed: 11/26/2022]
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Chaudhari BP, Plunkett J, Ratajczak CK, Shen TT, DeFranco EA, Muglia LJ. The genetics of birth timing: insights into a fundamental component of human development. Clin Genet 2009; 74:493-501. [PMID: 19037974 DOI: 10.1111/j.1399-0004.2008.01124.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The timing of birth necessitates the coupling of fetal maturation with the onset of parturition, and occurs at characteristic, but divergent gestations between mammals. Preterm birth in humans is an important but poorly understood outcome of pregnancy that uncouples fetal maturation and birth timing. The etiology of preterm birth is complex, involving environmental and genetic factors whose underlying molecular and cellular pathogenic mechanisms remain poorly understood. Animal models, although limited by differences with human physiology, have been crucial in exploring the role of various genetic pathways in mammalian birth timing. Studies in humans of both familial aggregation and racial disparities in preterm birth have contributed to the understanding that preterm birth is heritable. A significant portion of this heritability is due to polygenic causes with few true Mendelian disorders contributing to preterm birth. Thus far, studies of the human genetics of preterm birth using a candidate gene approach have met with limited success. Emerging research efforts using unbiased methods may yield promising results if concerns about study design can be adequately addressed. The findings from this frontier of research may have direct implications for the allocation of public health and clinical resources as well as spur the development of more effective therapeutics.
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Affiliation(s)
- B P Chaudhari
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri 63110, USA
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Geddes JF, Plunkett J. The evidence base for shaken baby syndrome. West J Med 2004. [DOI: 10.1136/bmj.328.7451.1317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Physicians disagree on several issues regarding head injury in infants and children, including the potential lethality of a short-distance fall, a lucid interval in an ultimately fatal head injury, and the specificity of retinal hemorrhage for inflicted trauma. There is scant objective evidence to resolve these questions, and more information is needed. The objective of this study was to determine whether there are witnessed or investigated fatal short-distance falls that were concluded to be accidental. The author reviewed the January 1, 1988 through June 30, 1999 United States Consumer Product Safety Commission database for head injury associated with the use of playground equipment. The author obtained and reviewed the primary source data (hospital and emergency medical services' records, law enforcement reports, and coroner or medical examiner records) for all fatalities involving a fall. The results revealed 18 fall-related head injury fatalities in the database. The youngest child was 12 months old, the oldest 13 years. The falls were from 0.6 to 3 meters (2-10 feet). A noncaretaker witnessed 12 of the 18, and 12 had a lucid interval. Four of the six children in whom funduscopic examination was documented in the medical record had bilateral retinal hemorrhage. The author concludes that an infant or child may suffer a fatal head injury from a fall of less than 3 meters (10 feet). The injury may be associated with a lucid interval and bilateral retinal hemorrhage.
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Affiliation(s)
- J Plunkett
- Department of Pathology, Regina Medical Center, Hastings, MN 55033, USA.
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Abstract
Surface modulation is part of normal bone growth. However, the radiologic appearance of physiologically growing bone in infancy may resemble changes secondary to trauma. This case report reviews bone remodeling in the postnatal infant and describes its unique radiologic and pathologic characteristics, allowing normal to be differentiated from healing and repair.
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Affiliation(s)
- J Plunkett
- Department of Pathology, Regina Medical Center, Hastings, Minnesota 55033, USA
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Plunkett J. Clarity on the diagnosis line. Ann Diagn Pathol 2000; 4:134. [PMID: 10841632 DOI: 10.1016/s1092-9134(00)90022-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Plunkett J. Recognizing abusive head trauma in children. JAMA 1999; 282:1421-2. [PMID: 10535427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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Abstract
Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, Hastings, Minnesota 55033, USA
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Abstract
Ruptured aneurysms of the cerebrovasculature in infancy and early childhood, except for "giant" aneurysms and arteriovenous malformations, are rare. Seizures, loss of consciousness, and apnea are the usual presenting signs in infancy; symptoms such as headache or visual disturbances and signs such as cranial nerve compression or meningeal irritation commonly found in older children or adults are absent in infants. However, the morphologic findings (i.e., subarachnoid and retinal hemorrhage, and occasionally subdural hemorrhage) may be mistaken for inflicted trauma, especially if the aneurysm is not identified. Sudden death caused by rupture of a cerebral aneurysm has not been previously described in an infant. This report outlines the investigation and autopsy findings in a 7-month-old infant who died unexpectedly as a result of rupture of a complex basilar artery aneurysm.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, Hastings, Minnesota 55033, USA
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Abstract
Subdural hemorrhage, retinal hemorrhage, and cerebral edema have been considered diagnostic for a "shaken infant" since the syndrome was described almost 30 years ago. However, the specificity of these findings has been disputed by defense witnesses in recent U.S. criminal prosecutions. This review examines the scientific basis for the shaken baby syndrome.
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Affiliation(s)
- J Plunkett
- Regina Medical Center, and Minnesota Regional Coroner's Office, Hastings 55033, USA
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Plunkett J, Thomas LC. Coroner and medical examiner systems. JAMA 1998; 280:325. [PMID: 9686545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Plunkett J. Serum tests for diagnosis of iron deficiency. Am J Clin Pathol 1990; 94:524-5. [PMID: 2220678 DOI: 10.1093/ajcp/94.4.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Plunkett J. Sudden death and myocardial infarction in Minnesota. N Engl J Med 1984; 310:1187-8. [PMID: 6709015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Dwyer AJ, Prewitt JM, Ecker JG, Plunkett J. Use of the hazard rate to schedule follow-up exams efficiently. An optimization approach to patient management. Med Decis Making 1983; 3:229-44. [PMID: 6633190 DOI: 10.1177/0272989x8300300211] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The problem of surveillance for metastasis in a cancer patient is modeled as an allocation problem. The hazard rate of metastasis appearing determines the efficient scheduling of follow-up exams. An optimal schedule of follow-up exams is shown to be dependent on the hazard rate, K, and D. K relates the cost of testing to the benefit of early detection. It diminishes as benefit increases or cost diminishes. D is the time by which a metastasis' detection by testing precedes its clinical presentation. Hence it is a direct measure of the effectiveness of testing. The optimal testing frequency = (hazard rate/2K)1/2. Testing may be stopped when the hazard rate drops below 2K/D2. Tests need never be routinely scheduled if the intervals between tests exceed D in length.
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Dwyer AJ, Glaubiger DL, Ecker JG, Doppman JL, Prewitt JM, Plunkett J. The radiographic follow-up of patients with Ewing sarcoma: a demonstration of a general method. Radiology 1982; 145:327-31. [PMID: 7134429 DOI: 10.1148/radiology.145.2.7134429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
An analysis of the patterns of detectable tumor recurrence using the concepts of hazard rate, predictive value, and cumulative probability was undertaken to assess the appearance of metastases in Ewing sarcoma. This study comprises 107 patients who were seen between 1964 and 1977. The distribution of the sites of metastases indicates that repeated examinations of both lungs and bones are necessary for the effective surveillance of both truncal and extremity primary lesions. The hazard rates for metastases suggest that these serial examinations should be concentrated early in the follow-up period for truncal primaries and more uniformly distributed for extremity primaries. The method used is general and is applicable to any disease for which the surveillance for recurrence or a complication is of major concern. The results of the analysis may be used in the selection and scheduling of follow-up examinations for patients with Ewing sarcoma, and in advising the patient of the prognosis for continued remission.
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Stein IM, Plunkett J, Troy M. Comparison of techniques for examining long-term ECG recordings. Med Instrum 1980; 14:69-72. [PMID: 6153451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The Holter superimposition method was compared with the Argus/H computer system and the Stein/Peterson frozen display technique in the analysis of 94 long-term ambulatory ECG recordings using technical staff experienced with each analysis procedure. The use of the Holter superimposition method resulted in a failure of detection of 33-66 percent of ventricular and supraventricular arrhythmias as compared to the two other computer-based playback systems. The Argus/H system and the frozen display method of Stein and Peterson were comparable with respect to ventricular arrhythmia detection, but the frozen display method was superior to the Argus/H system with respect to the detection of supraventricular arrhythmias.
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