ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Through 1990, 308 cases of AIDS had been reported in female residents of Georgia (aged 13 years and older); 77 (25%) were white and 228 (75%) black. The mean age of the white women (43.8 years) was greater than that of the black women (34.5 years). One hundred sixty-six women were from Atlanta (metro Atl), the major metropolitan center in Georgia, and 142 (46%) from other regions of the state (other areas). Blacks represented 74% and 76% of all cases in women in metro Atl and other areas respectively. Of the 308 cases, 178 (58%) were related to intravenous (IV) drug use (99 metro Atl, 79 other areas), including 104 (58%) women who were IV drug users and 74 who were sexual partners of IV drug users. These proportions were similar in the two regions. Among cases related to IV drug use, 85 (86%) women in metro Atl and 69 (87%) women elsewhere in the state were black. The cumulative rate of AIDS in women in metro Atl (14.4/100 000) was twice that of women in the rest of the state (6.7/100 000). The rate for AIDS cases related to IV drug use in black women (27.8/100 000 population) was 19 times that in white women (1.5/100 000). The median survival of all women was significantly greater in metro Atl than in other areas (400 and 296 days respectively), with a difference also in those reported only withPneumocystis cariniipneumonia (466 and 373 days respectively).

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Respiratory syncytial virus (RSV) is a common serious pathogen known to produce annual winter epidemics in young children. A 2-year study of children with significant respiratory disease during the summer revealed a 21% incidence of RSV infection. Respiratory secretions collected from ill children in the LSUMC outpatient clinics, from children seen by private physicians, and from children hospitalized with respiratory tract disease were assayed for RSV antigens. Approximately 39% of those surveyed in 1987 and 13% of those studied in 1988 were positive. As this prevalence was significant, we compared RSV-induced disease in 20 patients hospitalized in summer and 20 hospitalized in winter (1989). The patients were matched by age, weight, sex, and race. Comparisons included subjective severity of disease, presenting symptoms, physical findings, chest roentgenograms, treatment, and average length of hospital stay. No significant differences in disease severity and/or clinical presentation were found. Our findings show that RSV induces disease in the summertime more frequently than generally recognized, and severe disease requiring hospitalization is not infrequent. Physicians should consider RSV in children with serious respiratory disease throughout the year.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Physicians in the United States must maintain vigilance for the 25 000 annual new cases of tuberculosis, concentrated in the elderly, in immigrants, in migrant and minority populations, and in immunosuppressed patients. Tuberculosis rates in the South remain above the national average. Physicians diagnosing tuberculosis may also treat the disease, working with health departments, which can assist with drugs, follow-up tests, and contact investigation. Powerful short-course regimens have been standard treatments since 1986. The preferred combination is isoniazid, rifampin, and pyrazinamide daily for 2 months, followed by isoniazid and rifampin for 4 more months. A 9-month regimen of isoniazid and rifampin is equally effective. Supplementation or extension of these regimens is mandatory when drug resistance or immunosuppression, respectively, is likely. Isoniazid prophylaxis for 6 to 12 months continues to be a vital but often neglected preventive measure for those infected withMycobacterium tuberculosis, but without active disease.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

From February 1988 to April 1990, we collected blood for hepatitis B surface antigen (HBsAg) from all women coming to the Texas Tech University Health Science Center in Lubbock for prenatal care. These patients were from rural western Texas and eastern New Mexico. They were also screened for hepatitis B risk factors, as outlined by the Centers for Disease Control. We reviewed the prenatal records of all HBsAg-positive women. Six of 4452 women (0.13%) had a positive HBsAg test. Four of the six women had identifiable risk factors and two did not; two were non-Hispanic Caucasian (Anglo), two were Hispanic, and two were black. Anglos comprised 49.5% of the rural population, Hispanics 34.9%, blacks 12.8%, and Asians 2.8%. No Asian women were positive for HBsAg. The prevalence of HBsAg positivity was lower in this rural population than in previously reported urban populations. While the prevalence in the studied blacks and Hispanics was similar to that in previous reports, the prevalence in the rural Anglos was lower.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Maryland has higher mortality rates from heart disease, cancer, and stroke (HCS) than the United States as a whole. More than 50% of deaths from HCS are premature, occurring before age 75. The health care and indirect costs from these three diseases total approximately $4.4 billion annually, placing a major economic burden on the state. A large body of scientific literature has shown the potential for the prevention of HCS. Currently, Maryland, like virtually all states, lacks the type of systematic, well-coordinated, comprehensive intervention campaign needed to lower morbidity, mortality, and health care costs from these three diseases. Such a campaign has now been planned by the University of Maryland at Baltimore. Similar campaigns are needed throughout much of the United States.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In 1986 legislation established the Virginia Congenital Anomalies Reporting and Education System (VaCARES). The system has three goals: to collect data that can be used to evaluate possible causes of congenital anomalies, to improve diagnosis and treatment, and to let parents and physicians know what resources are available to aid children born with anomalies. All children (from birth to age 2) with congenital anomalies admitted to Virginia hospitals after January 1, 1987, are being reported to VaCARES; VaCARES then contacts their families and physicians. Before the system was implemented statewide, its procedures were thoroughly tested through two pilot projects in selected hospitals. During the pilots, it was concluded that birth certificates alone are inadequate for case ascertainment. According to hospital reports, the incidence of all congenital anomalies during Pilot II was 562 out of 10 034 births (5.6%); birth certificates showed an incidence of only 83 out of 10 034 births (0.8%). During Pilot I, 3 466 (73.8%) of the diagnoses reported were perinatal conditions; the list of reportable conditions was accordingly altered, reducing perinatal conditions reported in Pilot II to 5 diagnoses (0.4%). It was estimated that there will be about 5000 to 7000 reports submitted to VaCARES each year. It was also shown that parents should be sent general rather than specific information about their child's birth defect and that quality control and close contact with reporting hospitals are essential to maintain the integrity of the registry data.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Asbestos is a versatile fibrous mineral that can cause lung disease and death. Asbestosis, benign pleural disease, lung cancer, and mesothelioma can all result from inhaling asbestos. The history of disease and exposure risks are discussed. The difficult assessment of risk and the long latency period for development of disease demand evaluation and regular surveillance of asbestos-exposed workers.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Asthma affects people of all ages, and the mortality rate associated with the disease is increasing. The proper understanding of the pathogenic mechanisms, including airway inflammation and bronchoconstriction, can lead to a more logical treatment approach. Recognition of the important role of allergic triggers in influencing the sensitivity of the airways can help direct therapy toward prevention. Avoidance of irritants will help patients maintain normal airway function with fewer medications. Appropriate monitoring by the patient or the parent can help the medical team recognize worsening asthma before emergency treatment or hospitalization is required. The proper management of asthma necessitates understanding of the disease, medications, and goals by both the physician and the patient.

ISSN:0038-4348    

出版商:OVID    

年代:1992

数据来源: OVID