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Biomedical subjects

B Pollak

Publications and source records attributed to B Pollak.

13 recordsLinked to original sources
PubMed1989

Primary health care and the addictions: where to start and where to go.

The development of community services for problem drinkers is briefly traced over the last 40 years. The numbers of drinkers in need of advice and treatment far exceeds the available resources. Family practice would be an ideal place in which to further primary care and prevention but lack of time, knowledge and motivation for probing into patients' drinking habits detract from the potential. A pilot study of opportunistic screening in general practice is described whereby a yellow label affixed to a patient's medical record card registers the average weekly alcohol intake. In a sample of 400 patients, 16% were high or intermediate risk drinkers. Each high risk drinker presented with a medical condition which could, in either aetiology or management, be related to high consumption. By discussing this, patients were often motivated to drink less or abstain. Various suggestions are made how better medical training and education could improve the diagnosis and treatment of drinking problems.

Adult↗
PubMed1986

Mycobacterium kansasii: colonization and disease.

Mycobacterium kansasii has a wide range of virulence from fatal disease to infection and colonization. The laboratory report of growth of M. kansasii is often a problem for the clinician and an encumberance for the patient. To determine the difference between patients who had disease from M. kansasii and those from whom it was isolated without causing disease, we compared the records of 70 patients from whom this mycobacterium was isolated. The group with disease was defined as those patients with more than one culture with luxuriant growth and new, compatible symptoms, signs or radiographic changes. Age, sex, occupation, place of birth and residence, past medical history, skin testing, radiographic changes, in vitro antibiotic sensitivities, and the time and source of the isolation were tabulated. The group without compatible disease had only a single isolate and almost never had any new symptom or sign. Patients with disease from M. kansasii were more often male (P less than 0.02) and had more chronic obstructive lung disease (P less than 0.001). Patients without disease more frequently had isolations from laryngeal swabs (P less than 0.001). The cultures of these swabs had less stringent laboratory decontamination. M. kansasii may be a more frequent colonizer of the upper airway than previously thought. Clinicians should use the same rigorous definition of disease caused by M. kansasii as clinical investigators, namely repeated isolations with luxuriant growth in an appropriate host. The laboratory, instead of the clinician, should investigate positive cultures in patients without disease.

Female↗
PubMed1984

Short-course chemotherapy for mycobacteriosis kansasii?

The success of short-course chemotherapy for tuberculosis, the similarity between Mycobacterium tuberculosis and M. kansasii and the effectiveness of rifampin against the latter organism prompted a comparison of the diseases due to these organisms to assess the feasibility of a prospective trial of short-course chemotherapy in patients with mycobacteriosis kansasii. The two groups of patients were matched for age, sex and time of diagnosis. The patients with mycobacteriosis kansasii more frequently had underlying obstructive pulmonary disease. The clinical course of mycobacteriosis kansasii was more indolent, with a slower rate of improvement according to the chest x-ray films and a longer time before sputum smears and cultures became negative. M. kansasii was significantly more resistant to all the antibiotics, including rifampin. Although these differences from tuberculosis suggest that an equally short course of therapy may not be effective for patients with mycobacteriosis kansasii, the outcome was good in compliant patients who were given the three most effective major drugs for 12 months after the sputum smears and cultures had become negative. Therefore, a trial of modified short-course chemotherapy is recommended for patients with mycobacteriosis kansasii.

Clinical Trials as Topic↗