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Biomedical subjects

C G Helmick

Publications and source records attributed to C G Helmick.

35 records · Page 2Linked to original sources
PubMed1989

Multiple sclerosis in Key West, Florida.

In 1984, a press release by a Miami, Florida, neurologist described a possible cluster of persons with multiple sclerosis in Key West, Florida. The authors examined the cluster using prevalence rates, which are recognized as having a latitudinal gradient for multiple sclerosis, being generally high at high latitudes and low at low latitudes. Case ascertainment showed 32 definite or probable cases among residents of the study area (latitude, 24.5 degrees N) on September 1, 1985, a prevalence rate of 70.1/100,000 population--14 times the rate estimated for this latitude by modeling techniques based on US and international data, 7-44 times the rate for areas at similar latitudes (Mexico City, Mexico; Hawaii; New Orleans, Louisiana; and Charles County, South Carolina), and 2.5 times the expected rate for all US latitudes below 37 degrees N. This finding could not be explained by changes in diagnostic criteria, case ascertainment bias, immigration of people from high-risk areas, an unusual population structure, a large percentage of related cases, or better survival. Prevalent cases (n = 22) were more likely than general population controls (n = 76), matched by sex and 10-year age group, to have: lived longer in Key West, been a nurse, ever owned a Siamese cat, had detectable antibody titers to coxsackievirus A2 and poliovirus 2, and ever visited a local military base (Fleming Key). Key West has an unusually high prevalence of multiple sclerosis that may be related to these risk factors.

Adult↗
PubMed1988

Risk factors for hypoglycemia associated with pentamidine therapy for Pneumocystis pneumonia.

In 1984, three patients died of severe hypoglycemia after receiving pentamidine isethionate to treat Pneumocystis pneumonia. These deaths occurred on days 8, 12, and 19 of treatment, respectively. To assess risk factors associated with pentamidine treatment and hypoglycemia, we reviewed records of patients treated with pentamidine in New York City in 1984; ninety-seven percent of these patients had a diagnosis of acquired immunodeficiency syndrome. Hypoglycemia occurred in 23 (14%) of 164 patients. Hypoglycemia was more likely to occur in patients who received therapy of longer duration and an increasing dosage of pentamidine. Patients at greater risk for hypoglycemia also included those who had received pentamidine previously and those who experienced azotemia during treatment. This serious, potentially fatal, reaction should be considered in all patients who are treated with pentamidine, particularly those receiving prolonged or recurrent therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1986

No evidence for increased risk of Lassa fever infection in hospital staff.

A prospective serological study was undertaken in hospital personnel who care for Lassa fever (LF) patients in an endemic region of Sierra Leone, West Africa. Among personnel from three hospitals where barrier nursing is practised, antibody prevalence and seroconversion by age and sex were consistently equal to or lower than those of persons in nearby village populations. No group among hospital personnel evaluated by age, sex, contact, or occupational exposure was at higher risk than another. Hospital staff in Sierra Leone who care for LF patients using simple barrier nursing methods have no higher risk of infection than the local population. These findings support the proposal that patients with LF in non-endemic countries need not be confined to isolators.

Adolescent↗
PubMed1984

Rocky Mountain spotted fever: clinical, laboratory, and epidemiological features of 262 cases.

Most previous reports of Rocky Mountain spotted fever (RMSF) have included cases either not laboratory confirmed or confirmed by relatively weak diagnostic criteria. In the present study detailed epidemiological, clinical, and laboratory features of 262 confirmed or highly probable cases of RMSF reported from six states from 1977 to 1980 were analyzed. This analysis revealed that early clinical diagnosis of RMSF is difficult because the illness may have a gradual or an abrupt onset, the symptoms and signs may be unusual in timing or frequency, and the clinical appearance may vary depending on such factors as age and location of residence. RMSF was diagnosed later in those who died than in survivors, primarily because of atypical initial symptoms and the late onset of rash. RMSF should be considered in any individual who, during the spring and summer, has been in RMSF-endemic areas and develops a fever, regardless of the absence of rash or history of tick exposure.

Adolescent↗
PubMed1983

The epidemiology of human rabies postexposure prophylaxis, 1980-1981.

Little is known about the epidemiology of human rabies postexposure prophylaxis (PEP), an important problem whether examined by the cost, the number of persons treated, or the public health resources required. Twenty-one states participated in a surveillance of PEP in 1980-1981. When state health departments were involved, PEP was given correctly to at least 88% of persons. The highest incidence of PEP was in young people up to age 15 years, males, and those in rural areas. Postexposure prophylaxis occurred primarily during the spring, summer, and fall months. The epidemiology of PEP varies depending on the source of exposure and age. Domestic animals and rodents-lagomorphs accounted for PEP far out of proportion to their small role in animal rabies. Postexposure prophylaxis can be prevented for many by not keeping wild animals as pets and reduced by having physicians consult with state or local health departments before starting treatment.

Age Factors↗
PubMed1982

Acute hemorrhagic conjunctivitis in Southeast Asian refugees arriving in the United States--isolation of enterovirus 70.

During July-September 1980, an epidemic of acute hemorrhagic conjunctivitis (AHC) occurred in several refugee camps and transit centers in Southeast Asia. Of 2,356 refugees examined in Bangkok, 200 (8.5%) had conjunctivitis, including 116 (58%) with hemorrhagic signs. Because increasing numbers of refugees were arriving in the United States with conjunctivitis, a program of surveillance and control was implemented. Enterovirus 70, not previously reported from patients in the Western Hemisphere, was cultured from four arriving refugees. A fourfold rise in titer to enterovirus 70 was found in 10 others, either in the United States or Thailand. After control measures were instituted, the prevalence of the United States or Thailand. After control measures were instituted, the prevalence of conjunctivitis in arriving refugees declined from 49.8 per 1,000 to 3.8 per 1,000. Follow-up of cases after arrival in the United States revealed only one possible secondary case. Extensive epidemics of AHC in the Western Hemisphere are most likely to occur following importation into the humid, coastal areas of Central and South America.

Asia, Southeastern↗
PubMedDate not supplied

Q fever control measures: recommendations for research facilities using sheep.

Q fever (Query Fever) is a zoonosis caused by the rickettsia Coxiella burnetii. domestic ungulates such as sheep, cattle, and goats serve as the reservoir of infection for humans and shed the desiccation-resistant organism in urine, feces, milk, and especially in birth products. In humans the illness is generally mild; however, Q fever hepatitis is often seen and Q fever endocarditis is an uncommon, but frequently fatal complication. Q fever long has been recognized as an occupational hazard among persons working with animals or animal products, and in laboratories working with C. burnetii. Recently, Q fever outbreaks have occurred in medical research facilities using sheep as research animals. Recommendations are presented for reducing the risk of exposure to Q fever in persons not working with sheep in research facilities that use sheep. In addition, recommendations are presented for reducing the risk of infection in persons who work with sheep in research facilities.

Animals↗
PubMedDate not supplied

Is there a risk to contacts of patients with rabies?

The number of persons in the United States potentially in contact with rabid humans has increased in recent years because of labor-intensive medical care, longer survival times, and care in two or more hospitals. Many of these persons request rabies prophylaxis, and their physicians prescribe it because of their insecurity, a situation that is expensive and often unnecessary. Records of the Centers for Disease Control and the literature were reviewed to examine the current practice of prophylaxis of contacts and the actual need for it. Rabies virus is present in a variety of human fluids and tissues during the first five weeks of illness, but there are only four well-documented reports of human-to-human transmission--all in corneal transplant recipients. Prophylaxis of contacts of 14 rabid patients was predominantly for saliva exposure to open wounds or mucous membranes and was given most often to medical personnel having the greatest contact with the patient. Although it has never been documented, human-to-human transmission of rabies following saliva exposure remains a theoretical possibility. Virus shedding by rabid patients should be studied thoroughly in the future. Recommendations for managing contacts of rabid patients are presented.

Humans↗