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Biomedical subjects

F J Bia

Publications and source records attributed to F J Bia.

8 recordsLinked to original sources

Comparison of enzyme-linked immunosorbent and indirect immunofluorescence assays for the detection of human T-cell lymphotropic virus type-I antibodies in sera from rural Haiti.

Serum samples were obtained from 340 healthy individuals without evidence of neurologic disease living in rural Haiti. Sera were screened for antibodies to human T-cell lymphotropic virus type I (HTLV-I) using two commercially available enzyme immunoassays (EIA) and by an indirect immunofluorescence assay (IFA) using a mixture of uninfected H9 cells and HTLV-I-infected MT-2 cells. Repeatedly positive samples were confirmed by Western blot (WB). Results with the two EIA systems were concordant and detected 13 positive samples, each of which was confirmed by WB. Only 9 (69%) of 13 WB-positive sera were detected by IFA, and four additional samples, positive by IFA, could not be confirmed by WB. The prevalence of HTLV-I seropositivity in this selected rural Haitian population was 3.8% (13 of 340).

Adolescent

Special health considerations for travelers.

Special health considerations include many issues that affect travelers at both ends of the age spectrum. Pulmonary diseases may seriously alter the physiologic responses to both cabin pressures in commercial airliners and exposure to high altitudes, but many of these responses can be predicted by blood gas determinations and simple measurements of pulmonary function conducted at sea level. Cardiac events represent the most common and unpredictable health problems that threaten both serious morbidity and death for adult travelers. Diabetic travelers require insulin dosage adjustments during east-west travel and well-stocked travel kits with adequate supplies. Human immunodeficiency virus-infected travelers require consideration of their levels of immunosuppression at the time of immunizations and special precautions for preventing potentially chronic enteric infections. Young children pose similar questions, and there is the additional problem posed by a limited number of readily available antimalarial agents for pediatric use.

Aircraft

Trends and controversies in the prophylaxis and treatment of malaria.

Several areas of clinical concern and investigation have emerged over the past year in the malaria field. Mefloquine prophylaxis has required a change in its dosing regimen. Continued monitoring for potential mefloquine toxicity has shown this agent to be safe for use for many populations, but not routinely for pregnant women or for young children. Chloroquine-resistant Plasmodium vixax may be geographically limited currently, but its presence in Irian Jaya has serious implications, should be problem spread. The currently available fluoroquinolone antibiotics possess antimalarial activity but they have not proven to be clinically dependable for the treatment of resistant Plasmodium falciparum infections. However, continued investigation of both their mechanisms of action and efficacy should not be abandoned. Adjunctive measures for the control of mosquito vectors and the prevention of human contact with mosquitoes assume greater importance as both pharmacological prophylaxis and therapy for malaria infections become increasingly difficult. Health professionals who advise travelers to endemic regions should emphasize the use of safe topical repellents and residual insecticides, which can be impregnated into bed netting and clothing.

Chloroquine

Medical considerations for the pregnant traveler.

The care of pregnant travelers requires clinical information and skills that are derived from many disciplines. Issues to be considered include the safety of both mother and fetus during commercial air travel, vigorous exercise, scuba diving, and even high-altitude trekking. Immunizations require a balanced approach to the risk of disease versus the risks of vaccine complications. Safe or treated water sources are of paramount importance to prevent unnecessary exposure to antimicrobial and antiparasitic agents during pregnancy. Malaria prophylaxis is made even more difficult by an increasingly widespread resistance of Plasmodium species to chloroquine.

Diarrhea

Cytomegalovirus infection in guinea pigs. III. Persistent viruria, blood transmission, and viral interference.

Chronic persistent infection with cytomegalovirus (CMV) was studied in random-bred Hartley and inbred strain 2 guinea pigs. Infectious virus was isolated from the urine, kidney, spleen, pancreas, salivary gland, and cervix, but not from buffy coat of persistently infected guinea pigs. Strain 2 animals developed a high rate of chronic viruria, which was not related to isolation of CMV from renal tissue. In female strain 2 guinea pigs viruria was more than twice as prevalent as in males (56% vs. 24%). Transfusion of buffy coat from persistently infected strain 2 animals resulted in CMV infection in both isogenic and allogenic blood recipients, but buffy coat from uninfected donors did not activate CMV in persistently infected isogenic and allogenic blood recipients. Experimental CMV infection of young strain 2 guinea pigs interfered with the expression of guinea pig herpes-like virus, a common endogenous virus in strain 2 animals.

Animals

Malaria prophylaxis: taking aim at constantly moving targets.

The prevention of malaria infections is one of the most important functions that any clinician can perform for those traveling to tropical geographic regions where malaria risks are present. The prophylaxis question has become complicated by continued emergence of chloroquine-resistant strains of Plasmodium falciparum, the recent appearance of Plasmodium vivax resistance, and the availability of a wide choice of antimalarial pharmaceuticals. Chemoprophylaxis may produce different toxicities among various patient populations. With increasing numbers of women who travel during their professional lives, there are potential implications for using chemoprophylaxis during pregnancy. Children are unable to tolerate certain antimalarials because of toxicities unique for them. In some instances, the safest and most palatable formulations for children are not even available in the United States and must be purchased in Canada or elsewhere. Reliance upon chemoprophylaxis alone has proven to be increasingly futile. With the introduction of new repellent formulations and nontoxic insecticides for use on clothing or bed netting, there are non-pharmacologic adjunctive measures which can now be considered first-line for the prevention of malaria infections.

Amodiaquine

Current prevention and management of acute mountain sickness.

Acute mountain sickness was known to the Chinese in ancient times, as they traversed mountain passes between the Great Headache and Little Headache mountains into present-day Afghanistan. The Jesuit priest, Father Joseph Acosta, lived in Peru during the sixteenth century; he described both this syndrome and deaths which occurred in the high Andes. The incidence of high-altitude illness will rise as previously remote sites become more accessible to trekkers and skiers. Prevention and treatment are important concerns for those physicians who wish to advise their more adventuresome patients properly. This article incorporates a selected review of pertinent investigations, in the English-language literature over the past five years, into material previously presented at travel symposia for clinicians managing the prophylaxis and treatment of acute mountain sickness.

Altitude Sickness