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F Bruce

Publications and source records attributed to F Bruce.

10 recordsLinked to original sources
PubMed2003

Standardizing contact investigation protocols.

SETTING: The State of Alabama Department of Public Health Division of Tuberculosis Control. OBJECTIVE: To standardize contact investigation protocols and implement an intervention to increase TB field worker adherence to the protocols with the goal of promoting efficiency and effectiveness in contact investigations. DESIGN: A process evaluation of existing data collection and management systems and protocols was performed. Standardized protocols and an intervention to increase TB field worker adherence to the protocols were created and pilot tested. These were then implemented and formative evaluation data were collected. RESULTS: The process evaluation revealed considerable variance among field workers with regard to protocols and definitions of variables related to contact investigations. Protocols were standardized and an intervention targeted at TB field workers was developed. The intervention consisted of a training workshop and the development of a computer-based contact investigation module. This was successfully implemented throughout the state. CONCLUSIONS: To perform effective contact investigations and conduct studies to improve the effectiveness of these investigations, TB control programs must pay careful attention to precisely defining variables and concepts related to the contact investigation. Furthermore, protocols must be standardized and resources devoted to training of TB field workers to ensure adherence to protocols.

Alabama↗
PubMed2002

The majority of cutaneous squamous cell carcinomas arise in actinic keratoses.

BACKGROUND: Retrospective studies have given conflicting results with respect to how many cutaneous squamous cell carcinomas (SCCs) arise in actinic keratoses (AK). OBJECTIVE: This study was conducted to determine what percentage of SCCs arise in AKs and to obtain more information about two histological features of SCCs, namely, thickness and ulceration. METHODS: A prospective study was done of all SCCs treated by the authors during one calendar year. RESULTS: Two hundred eight patients with SCC were entered into the study. An AK was contiguous with an SCC in 72% of the cases. This was taken as evidence that the SCC arose in the AK. Men presented with thicker and more ulcerated SCCs than women, but these were not statistically significant: p = 0.06 for thickness and p = 0.07 for ulceration. Ulcerated SCCs were more likely to arise on the head and neck (p = 0.02), on patients who had multiple skin cancers (p = 0.005), and on patients who had a family history of skin cancer (p = 0.03). CONCLUSION: Actinic keratoses need to be removed before they turn into SCCs. The prognostic significance of ulceration of cutaneous SCCs needs to be determined.

Adult↗
PubMed2001

Value of Mycobacterium tuberculosis fingerprinting as a tool in a rural state surveillance program.

OBJECTIVE: This study demonstrates the value of Mycobacterium tuberculosis fingerprinting used in conjunction with traditional epidemiologic methods to identify smoldering outbreaks of tuberculosis in endemic areas where background rates of tuberculosis are high. METHODS: IS6110 DNA fingerprinting was performed on isolates of M tuberculosis from verified cases of tuberculosis in Alabama from 1994 to 1998. A statewide database groups isolates into "clusters" and tracks them cumulatively over time. A large cluster was identified and was secondarily investigated using traditional epidemiologic methods. RESULTS: Twenty-five isolates were found to be identical by fingerprinting analysis. Patients were living within 10 counties across the state, and 12 cases were localized to a single county. This represented an ongoing, statewide tuberculosis outbreak previously unrecognized by local and state health officials. Secondary investigation of the cases revealed the primary sites of transmission to be a correctional facility and two homeless shelters. CONCLUSIONS: Population surveillance using M tuberculosis fingerprinting was successfully utilized to detect a significant and smoldering tuberculosis outbreak. Measures are currently in place to identify and prevent further transmission in the involved locations.

Adult↗
PubMed2000

Preventable childhood tuberculosis in Alabama: implications and opportunity.

UNLABELLED: Childhood tuberculosis (TB) cases indicate recent community transmission and thus reflect the effectiveness of TB control efforts, particularly the contact investigation. OBJECTIVE: To evaluate all preventable childhood TB cases and implications in the context of TB morbidity trends. DESIGN: Statewide morbidity trends are presented from 1983 to 1997. Since 1992, each child TB case is classified as either preventable or not preventable, based on a standard definition. MAIN OUTCOME MEASURES: Case characteristics (preventable and not preventable), TB disease rates over time, and reasons for preventable case classification. SETTING: Alabama TB control program, from January 1, 1983 through December 31, 1997. RESULTS: For the period 1983-1997, nonwhite children had a higher disease rate (rate ratio: 5.7; 95% confidence interval: 4.3,7.6) than white children. Since 1990, the overall child rate has increased significantly despite a decline in the adult rate. Among 120 child cases diagnosed from 1992 to 1997, 25 (21%) were classified as preventable. The causes were contact investigation interview failure (12/25 = 48%), delay to evaluation (16%), source case noncompliance with previously prescribed preventive therapy (16%), and source case diagnosed out of state (16%) with no initial investigation performed in Alabama. All preventable cases identified were black children; the proportion of preventable cases did not vary by age group or sex. During 1996, the case rate for nonwhite children exceeded that of adult whites. CONCLUSIONS: Childhood TB in Alabama for nonwhites is rising despite a national downward trend. TB is clearly a disproportionate disease burden for the state's African American population, and the median case age is falling. Additional research and improved training in contact investigation are required to assess this situation and effectively intervene.

Adolescent↗
PubMed1997

Could it be a drug eruption?

Drug eruptions can be a common reason for patients to present to the general practitioner. It has been estimated that as many as one in 40 visits to the GP may be related to adverse drug reactions. While many cutaneous drug reactions are readily recognisable, other potentially serious eruptions require the GP to have some knowledge of the varying clinical morphology of drug eruptions to make the diagnosis. It is also useful to be aware of certain groups of drugs that are associated with specific cutaneous reactions. In this article some of the typical patterns of drug reactions will be discussed, and some of the commoner causes listed. However, for many of these reaction patterns there are a huge number of possible drug causes, as well as other non drug causes that need to be considered.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1989

Clinical, biochemical, and radiographic effects of aminohydroxypropylidene bisphosphonate treatment in rheumatoid arthritis.

A placebo controlled, double blind study of aminohydroxypropylidene bisphosphonate (APD), given by monthly intravenous infusion, was conducted in 40 patients with rheumatoid arthritis. Biochemical markers of increased bone resorption, such as fasting urinary calcium/creatinine ratio and hydroxyproline/creatinine ratio, were suppressed significantly in the APD group to approximately 50% and 60% of the pretreatment level respectively, and serum calcium fell transiently after the first APD infusion. There was no significant effect on disease activity in either the APD or placebo groups as judged by clinical (grip strength, morning stiffness, visual analogue score) or laboratory (haemoglobin, platelet count, erythrocyte sedimentation rate, C reactive protein) criteria. An exception was the articular index which improved to a similar degree in both groups, falling from (mean (SEM] 13.8 (1.8) to 7.2 (2.2) in the APD group and from 13.7 (1.9) to 6.8 (1.5) in the placebo group. Radiological progression occurred to a similar degree in both groups as assessed by the Sharp index (mean (SEM) 86 (13.1) v 95 (12.9)-APD group; 103 (15.1) v 110 (15.8)-placebo group), but there was no significant change in the Larsen index in either group (mean (SEM) 53 (4.2) v 57 (3.8)-APD; 62 (5.8) v 63 (5.6)-placebo). The lack of effect on radiological progression in the APD group indicates that focal erosive disease may either have progressed as the result of a non-osteoclast related mechanism, or that the intensity of bone resorption was too great to be inhibited by the doses of APD used. The biochemical response to APD presumably reflected inhibition of bone resorption at other sites, suggesting that further studies of the effects of bisphosphates on periarticular and systemic osteoporosis in rheumatoid arthritis may be of the interest.

Arthritis, Rheumatoid↗
PubMed1987

Data acquisition and analysis of pulsatile signals using a personal computer: an application in cardiovascular physiology.

Software is described which collects and analyzes pulsatile analog signals using an APPLE PC and a modestly priced analog-digital interface. The program will input and output data, store and retrieve data to disk and display data on the monitor. Four types of data analysis determine mean, maximum and minimum values and frequency in various combinations. For example, the present program analyzes cardiovascular signals for heart rate, stroke volume, cardiac output, systolic, diastolic and mean pressures over a representative 10 s period. Simple modifications to the program are described which extend its range of application.

Computers↗
PubMedDate not supplied

School nursing 1966.

Explore the source record for details and available documents.

Nursing↗