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Biomedical subjects

D M Allen

Publications and source records attributed to D M Allen.

At least 19 recordsLinked to original sources
PubMed1992

Youth at risk. Sex, drugs, and human immunodeficiency virus.

Adolescents and young adults are at risk for human immunodeficiency virus type 1 infection due to unprotected sexual intercourse and drug use. In 1988 and 1989, blinded surveys were conducted in 84 sexually transmitted disease clinics, 115 women's health clinics, and 19 drug treatment centers in 38 metropolitan areas. Blood specimens from 153,242 clients, aged 15 to 24 years, were tested for human immunodeficiency virus type 1 antibodies after all client identifiers were removed. In sexually transmitted disease clinics, the median rate was 0.4% among 15- to 19-year-olds, compared with 1.4% among 20- to 24-year-olds. Among heterosexual adolescents, rates in females were significantly higher than in males (Wilcoxon signed rank test). Rates in heterosexuals were highest in the northeastern and southeastern United States and in Puerto Rico. In 20- to 24-year-old male clients in sexually transmitted disease clinics who had sex with males, rates ranged from 9.7% to 55.6%. In drug treatment centers, the median rate among 20- to 24-year-old men and women was 8.3% (range, 0% to 33.3%). Rates in women's health clinics were much lower (median, 0.1%). The high rates of infection in certain groups of adolescents and young adults indicate the need for improved care, education, and outreach targeted toward those at high risk.

Adolescent↗
PubMed1992

A 7-day course of ciprofloxacin for enteric fever.

A prospective, open and non-randomised clinical trial using a 7-day short course of oral ciprofloxacin 500 mg twice daily was conducted on 25 adult patients with bacteraemic enteric fever. Twenty-four patients (96%) were cured and there was one treatment failure. Two patients with typhoid fever relapsed 6 weeks after finishing treatment. Defervescence of fever was rapid (median: 4 days) and the duration of hospitalisation was short (median: 8 days). Both factors resulted in patient satisfaction. A short-course regime of ciprofloxacin for the treatment of enteric fever, is therefore, highly promising.

Administration, Oral↗
PubMed1992

Transmission of disseminated histoplasmosis via cadaveric renal transplantation: case report.

A 30-year-old woman received a cadaveric renal allograft from a donor who was subsequently found to have renal infection due to Histoplasma capsulatum. The recipient had funguria in the early postoperative period and later developed cutaneous manifestations of disseminated histoplasmosis. We report a case of histoplasmosis transmitted via renal transplantation and describe the subsequent 20-year clinical course.

Adult↗
PubMed1992

HIV infection in intravenous drug users entering drug treatment, United States, 1988 to 1989. The Field Services Branch of the Centers for Disease Control.

BACKGROUND: Intravenous drug use has played a key role in the human immunodeficiency virus (HIV) epidemic. Standardized surveillance of HIV infection among intravenous drug users (IVDUs) is needed to determine HIV prevalence rates, to monitor changes in prevalence over time, and to describe behaviors associated with HIV infection. METHODS: In 1987, the Centers for Disease Control began collaborating with state and local health departments to conduct a national program of HIV seroprevalence surveys in a variety of populations and settings. This program includes unlinked HIV seroprevalence surveys in IVDUs entering sentinel drug treatment programs. RESULTS: From April 1988 through December 1989, annual studies were completed in 59 drug treatment centers in 33 US cities. Center-specific seroprevalence rates ranged from 0% to 48.2%, with a median of 4.6%. HIV seroprevalence rates varied widely by geographic area, with rates highest in the Northeast, intermediate in the Middle Atlantic cities of Baltimore and Washington, DC, and lower in other parts of the country. Median rates were 15.6% among African Americans, 3.2% among Hispanics, and 3.3% among Whites. CONCLUSIONS: Intravenous drug use is likely to remain an important factor in HIV transmission. This study supports the need to develop or expand programs to prevent the further introduction and spread of HIV among IVDUs and to prevent HIV transmission to their sexual partners.

Adult↗
PubMed1992

The prevalence of invasive candidiasis in patients with extensive burns.

A retrospective study of patients admitted to the Singapore General Hospital Burn Unit with > 30% total body surface area burns was performed to establish the prevalence of fungal colonisation and invasive fungal disease (IFD). Forty-eight percent of patients surviving at least ten days following thermal injury had fungi isolated. IFD was documented in ten patients. Risk factors associated with the development of IFD, clues to assist in diagnosing IFD, and therapeutic options for managing IFD are reviewed.

Acute Disease↗
PubMed1992

Cytomegalovirus pneumonitis in AIDS--a case report.

Respiratory infections occur commonly in patients with advanced human immunodeficiency virus (HIV) infection. Prompt accurate diagnosis is essential as many of the various available therapies have significant toxicities. We describe a patient previously diagnosed with the acquired immunodeficiency syndrome (AIDS) who was found to have cytomegalovirus (CMV) pneumonitis on bronchoscopy. His pneumonitis responded to treatment with the nucleoside analogue ganciclovir. Our patient is the first documented CMV pneumonitis in the Singapore HIV seropositive population.

AIDS-Related Opportunistic Infections↗
PubMed1992

Sentinel surveillance of human immunodeficiency virus infection in women seeking reproductive health services in the United States, 1988-1989. The Field Services Branch.

Cases of AIDS among women of reproductive age have increased dramatically since 1981; nearly a third of all cases among females were reported in 1990 alone. Surveillance of human immunodeficiency virus (HIV) infection among women is essential for monitoring the spread of HIV over time and identifying specific populations and geographic areas in need of HIV counseling, testing, and prevention services. Blinded (unlinked) serologic surveys were conducted in the United States and Puerto Rico in sentinel clinics providing reproductive health services to women, including family planning, prenatal care, and abortion services. Seventy-eight of 94 clinics (83%) in 30 cities conducting surveys during 1988 and 1989 detected at least one HIV-positive woman. Clinic-specific prevalence ranged from 0-2.28% (median 0.22%), with rates over 1% occurring in clinics predominantly on the East Coast and in Puerto Rico. Seroprevalence varied by primary type of service, race-ethnicity, and age group. Median rates were higher in clinics offering prenatal services and lower in abortion and family planning clinics in the same cities. In general, women 25-29 years of age showed the highest median rate of infection (0.32%), and rates were higher among black women (median 0.34%) than among Hispanic (median 0.11%) and white women (median 0%). Our data indicate the need to educate women about recognizing and reducing their risk of HIV infection. Reproductive health clinics with high seroprevalence should implement voluntary HIV counseling and testing with appropriate follow-up clinical evaluation and referral for infected women. Clinics with low prevalence should seize the opportunity to enhance HIV education and prevention efforts.

Abortion, Legal↗
PubMed1991

Infections in the elderly.

Infections are a leading cause of morbidity and mortality in the elderly. Altered host defences, a senescent immune system, chronic illnesses, and environmental factors all contribute to the aged's predisposition to infection. Infections can present in atypical fashion contributing to diagnostic and therapeutic delays. Awareness of altered antibiotic absorption, metabolism, and excretion in the elderly is essential to correct antibiotic selection and dosing. Additionally, antibiotic interactions with medications commonly used to treat chronic illnesses should be taken into consideration prior to antibiotic prescribing. Prevention of infectious complications in the elderly requires interest, education, vaccination, and early intervention.

Aged↗
PubMed1990

Readability of pediatric biomedical research informed consent forms.

Informed consent forms are used in biomedical research as a mechanism to convey study information to potential subjects so that they may arrive at a decision concerning their willingness to participate. Although the Department of Health and Human Services Regulations for the Protection of Human Subjects require the presentation of specific study information at a level that is easily understood, according to research concerning adult biomedical consent forms, the typical form is not readily comprehensible. Unfortunately, no data exist concerning the readability of informed consent forms that are used in the context of pediatric biomedical research. In the present study, readability analyses were conducted on a large sample (N = 238) of pediatric biomedical informed consent forms obtained during a 10-year period from a large midwestern children's hospital. For the entire sample, results derived from two readability estimates (Fry grade equivalent and Flesch Reading Ease methods) indicated that the consent forms were written at the college graduate level. Although there was a linear increase in the length of the consent document during the 10-year period evaluated, expanded length was not associated with improved readability. According to analyses, a differential pattern of reading difficulty was associated with specific sections of the informed consent document. Findings are highly consistent with those from studies of adult biomedical consent form and document that the purpose of the informed consent form is being compromised, in part, by a readability factor. Suggestions for solving this critical problem are advanced.

Comprehension↗
PubMed1989

Depressive characteristics of physically abused children.

Physically abused and nonabused children were compared on child-completed measures of depression, hopelessness, self-esteem, and locus of control. Results indicated that, in comparison with nonabused controls, abused children evidenced more depressive symptoms, heightened externality, lower self-esteem, and greater hopelessness about the future. Group differences in depressive symptomatology were not accounted for on the basis of differences in age, sex, race, gender, IQ, or socioeconomic status. Results replicate the results of Kazdin, Moser, Colbus, and Bell (1985) derived from a sample of physically abused psychiatric inpatients and extend the generality of these findings to abused children of nonpatient status. Implications of the findings for clinical interventions, theoretical models of child depression, and future research are discussed.

Adaptation, Psychological↗
PubMed1987

Effects of zeranol-implantation periods on palatability of longissimus steaks from young bulls and steers.

Fifty-five fall-born, Simmental-crossbred, male calves were allotted at birth to one of five treatments: bulls castrated at 5 mo and implanted from birth to slaughter (ST); bulls implanted from birth to slaughter (BI-BS); bulls implanted from birth to weaning (BI-BW); bulls implanted from weaning to slaughter (BI-WS) and non-implanted control bulls (CB). Implanted calves received 36 mg of zeranol at approximately 100-d intervals. Calves were fed a high-concentrate diet from 8.1 mo of age to an average slaughter age of 17 mo. Longissimus steaks (LS) were evaluated for palatability traits by both a trained sensory panel (TSP) and a take-home consumer panel (CP). Conclusions from both panels were similar. The TSP found LS from ST to be juicier (P less than .05) than LS from all bull groups, and to be more tender (P less than .05) than LS from BI-BW and BI-WS. The CP found LS from ST to be juicier, more tender and more acceptable (P less than .05) than LS from BI-BW, BI-WS and CB. Steaks from BI-BS were more tender (P less than .05) than LS from BI-WS and CB. Steaks from BI-BS and BI-BW had lower (P less than .05) shear values than LS from CB, but LS from ST had lower (P less than .05) shear values than LS from all bull groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗