ID

33348

Descripción

Study ID: 104065 Clinical Study ID: 104065 Study Title: Immune memory of GSK's DTPw-HBV/Hib vaccine by giving Plain PRP polysaccharide at 10 mths. Immuno & reacto of a booster dose of DTPw-HBV/Hib or DTPw-HBV or DTPw-HBV+Hib at 15-18 mths in infants previously primed with DTPw-HBV/Hib Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00169442  Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 3 Study Recruitment Status: Completet Generic Name: Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine (KFT) Trade Name: Zilbrix/Hib Study Indication: Diphtheria; Haemophilus influenzae type b; Hepatitis B; Tetanus; Whole Cell Pertussis

Palabras clave

  1. 6/12/18 6/12/18 -
Titular de derechos de autor

GSK group of companies

Subido en

6 de diciembre de 2018

DOI

Para solicitar uno, por favor iniciar sesión.

Licencia

Creative Commons BY-NC 3.0

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Immune memory of Combined Diphtheria, Tetanus, Whole Cell Pertussis, Hepatitis B, Haemophilus influenzae Type b Vaccine at infants (15 to 18 mths) - 104065

Large Swelling Reaction

Administrative data
Descripción

Administrative data

Subject Number
Descripción

Subject Number

Tipo de datos

integer

Protocol Number
Descripción

Protocol Number

Tipo de datos

integer

Date of Birth
Descripción

Date of Birth

Tipo de datos

date

Vaccine - possible cause of swelling reaction
Descripción

Vaccine - possible cause of swelling reaction

Tipo de datos

text

Report of Physical Examination
Descripción

Report of Physical Examination

Date of physical examination
Descripción

Please complete this section for: any local swelling with diameter >50mm, any noticeable diffuse injection site swelling (diameter not measurable), any noticeable increased circumference of the injected limb.

Tipo de datos

date

Was the examination performed by a member of study personnel during the large swelling reaction period?
Descripción

Was the examination performed by a member of study personnel during the large swelling reaction period?

Tipo de datos

boolean

Date when the swelling was first considered to be a large swelling reaction
Descripción

Date when the swelling was first considered to be a large swelling reaction

Tipo de datos

date

If occurring within 24 hrs after vaccination, please specify how long after vaccination
Descripción

If occurring within 24 hrs after vaccination, please specify how long after vaccination

Tipo de datos

integer

Unidades de medida
  • hrs
hrs
Size of swelling
Descripción

measurement of the greatest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Type of swelling
Descripción

please specify in section "clinical case description"

Tipo de datos

text

Circumference of swollen limb (at the site of maximum swelling)
Descripción

Circumference of swollen limb (at the site of maximum swelling)

Tipo de datos

integer

Unidades de medida
  • mm
mm
Circumference of the opposite limb (at the same level)
Descripción

Circumference of the opposite limb (at the same level)

Tipo de datos

integer

Unidades de medida
  • mm
mm
Associated signs
Descripción

Associated signs

Temperature
Descripción

Please report t°; if the t° has been taken more than once a day, please report the highest value.

Tipo de datos

integer

Unidades de medida
  • °C
°C
Route
Descripción

Route

Tipo de datos

text

Redness
Descripción

Redness

Tipo de datos

boolean

Redness - largest diameter
Descripción

Redness - largest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Induration
Descripción

Induration

Tipo de datos

boolean

Induration - largest diameter
Descripción

Induration - largest diameter

Tipo de datos

integer

Unidades de medida
  • mm
mm
Pain
Descripción

at administration site

Tipo de datos

boolean

Pain intensity
Descripción

Pain intensity

Tipo de datos

text

Functional impairment
Descripción

Functional impairment

Tipo de datos

boolean

Functional impairment intensity
Descripción

Functional impairment intensity

Tipo de datos

text

If hospitalisation is required, please also complete a Serious Adverse Event Form
Descripción

If hospitalisation is required, please also complete a Serious Adverse Event Form

Clinical Case Description
Descripción

Clinical Case Description

Please give a clinical description of the observed large swelling reaction.
Descripción

Includes a description of the joint involved and specific associated symptoms. Please mention also eventual diagnostic(s) procedures and therapeutic interventions.

Tipo de datos

text

Last date when the swelling was still considered to be a large swelling reaction
Descripción

Last date when the swelling was still considered to be a large swelling reaction

Tipo de datos

date

Outcome of the large swelling reaction
Descripción

Outcome of the large swelling reaction

Tipo de datos

text

Follow-up information
Descripción

Follow-up information

Tipo de datos

text

Is there an alternative explanation for the swelling?
Descripción

e.g., allergy, infection, trauma, underlying conditions

Tipo de datos

boolean

If Yes, please specify below
Descripción

If Yes, please specify below

Tipo de datos

text

Similar models

Large Swelling Reaction

Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de datos
Alias
Item Group
Administrative data
Subject Number
Item
Subject Number
integer
Protocol Number
Item
Protocol Number
integer
Date of Birth
Item
Date of Birth
date
Item
Vaccine - possible cause of swelling reaction
text
Code List
Vaccine - possible cause of swelling reaction
CL Item
Plain PRP Vaccine (1)
CL Item
DTPw-HBV Kft Vaccine (2)
Item Group
Report of Physical Examination
Date of physical examination
Item
Date of physical examination
date
Was the examination performed by a member of study personnel during the large swelling reaction period?
Item
Was the examination performed by a member of study personnel during the large swelling reaction period?
boolean
Date when the swelling was first considered to be a large swelling reaction
Item
Date when the swelling was first considered to be a large swelling reaction
date
If occurring within 24 hrs after vaccination, please specify how long after vaccination
Item
If occurring within 24 hrs after vaccination, please specify how long after vaccination
integer
Size of swelling
Item
Size of swelling
integer
Item
Type of swelling
text
Code List
Type of swelling
CL Item
Local swelling around injection site, not involving adjacent joint (1)
CL Item
Diffuse swelling, not involving adjacent joint (2)
CL Item
Swelling, involving adjacent joint (3)
Circumference of swollen limb (at the site of maximum swelling)
Item
Circumference of swollen limb (at the site of maximum swelling)
integer
Circumference of the opposite limb (at the same level)
Item
Circumference of the opposite limb (at the same level)
integer
Item Group
Associated signs
Temperature
Item
Temperature
integer
Item
Route
text
Code List
Route
CL Item
Axillary (1)
CL Item
Oral (2)
CL Item
Tympanic oral (3)
CL Item
Tympanic rectal (4)
CL Item
Rectal (5)
Redness
Item
Redness
boolean
Redness - largest diameter
Item
Redness - largest diameter
integer
Induration
Item
Induration
boolean
Induration - largest diameter
Item
Induration - largest diameter
integer
Pain
Item
Pain
boolean
Item
Pain intensity
text
Code List
Pain intensity
CL Item
Minor reaction to touch (1)
CL Item
Cries/protest on touch (2)
CL Item
Cries when limb is moved/spontaneously painful (3)
Functional impairment
Item
Functional impairment
boolean
Item
Functional impairment intensity
text
Code List
Functional impairment intensity
CL Item
grade 1 (easily tolerated, causing minimal discomfort and not interfering with everyday activities) (1)
CL Item
grade 2 (sufficiently discomforting to interfere with normal everyday activities) (2)
CL Item
grade 3 (prevents normal everyday activities) (3)
Item Group
If hospitalisation is required, please also complete a Serious Adverse Event Form
Item Group
Clinical Case Description
Please give a clinical description of the observed large swelling reaction.
Item
Please give a clinical description of the observed large swelling reaction.
text
Last date when the swelling was still considered to be a large swelling reaction
Item
Last date when the swelling was still considered to be a large swelling reaction
date
Item
Outcome of the large swelling reaction
text
Code List
Outcome of the large swelling reaction
CL Item
Recovered/resolved (1)
CL Item
Recovering/resolving (2)
CL Item
Not recovered/not resolved (please provide further follow-up data) (3)
CL Item
Recovered with sequelae/resolved with sequelae (please specify under section "clinical case description") (4)
Follow-up information
Item
Follow-up information
text
Is there an alternative explanation for the swelling?
Item
Is there an alternative explanation for the swelling?
boolean
If Yes, please specify below
Item
If Yes, please specify below
text

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