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Biomedical subjects

F N Judson

Publications and source records attributed to F N Judson.

At least 19 recordsLinked to original sources
PubMed1979

Health effects of urban air pollution. Special consideration of areas at 1,500 m and above.

Urban air pollution, when sufficiently severe, can cause death in humans; these deaths occur preponderantly among those with increased susceptibility. Pollution--carbon monoxide and oxidants in particular--is capable of aggravating preexisting chronic heart and lung diseases. Pollution and tobacco (especially cigarette) smoke act synergistically in a causative role in chronic bronchitis and in an aggravating role in emphysema. Susceptibility to the effects of urban air pollution varies widely, with the most susceptible being fetuses, the newborn, the elderly, the infirm, those with chronic heart and lung diseases, and those who smoke. The carbon monoxide standards for sea level are probably too lenient for an altitude of 1,500 m and above. Using a broad definition of health, which takes into account concepts such as quality of life and social and mental well-being, few metropolitan residents would deny that their health is compromised by air that is malodorous, that irritates mucous membranes, and that obscures beautiful scenery.

Adult↗
PubMed1979

Penile veneral edema.

A one-year epidemiologic study of penile venereal edema in a clinic for sexually transmitted diseases identified 25 cases, a rate of 1.7 per 1,000 male visits. Twenty-four patients had coexisting urethritis (36%), infected penile lesions (36%), or both (24%). Men with penile edema were significantly more likely to have gonococcal urethritis (40%), genital scabies (12%), genital herpes (12%), and inguinal adenopathy (52%) than men without penile edema. Penile edema is self-limited and seems to resolve along with the underlying penile disease. Lymphatic involvement may be the final common factor.

Circumcision, Male↗
PubMed1979

Effect of hysterectomy on genital infections.

In a study of women with anogenital gonorrhoea who had undergone hysterectomy, the sensitivities of urethral, vaginal, and anal canal cultures were 88.9, 55.7, and 40.7% respectively in specimens from 27 woemn. To obtain the greatest sensitivity, however, we recommend that specimens from all three sites should be cultured routinely. After the raising effects of trichomoniasis and menstrual blood on the pH values have been allowed for, the vaginal pH of 74 women in the study group and of 137 healthy controls was similar.

Adult↗
PubMed1979

Rescreening for gonorrhea: an evaluation of compliance methods and results.

To evaluate the cost-effectiveness of a routine rescreening (RS) culture several weeks after treatment for gonorrhea, as well as the specific efforts to ensure return visits, we followed 438 consecutive patients, 347 men and 91 women. Return visit compliance rates were 70 per cent for a test-of-cure culture, 27 per cent for a six-week RS, and 15 per cent at 12 weeks. The program detected seven cases of gonorrhea at $796 per case. In our clinic, RS is not a cost-effective way go control gonorrhea.

Cost-Benefit Analysis↗
PubMed1979

Gonococcal urethritis--diagnosis and treatment.

For men with urethral discharge, a simple gram stained smear is 98% sensitive and over 99% specific in detecting gonococcal infection when compared to a single Thayer-Martin culture. The smear is less than 50% sensitive in asymptomatic urethritis. Neither Fluorescent antibody nor various serologic tests offer any diagnostic advantages over smears and/or cultures and they are not cost-effective. Treatment of gonococcal urethritis may be successfully accomplished with a variety of antibiotic regimens. Tetracycline hydrochloride (500 mg four times a day for 5 days) is highly effective, inexpensive, and is active against Chlamydia trachomatis; post gonococcal urethritis (PGU) is therefore uncommon. Aqueous Procaine Penicillin G (4.8 million units IM with 1 g of probenecid) has become the standard in the United States but suffers from higher cost, the need for refrigeration, occasional alarming toxic procaine reactions, and a high incidence of PGU. Spectinomycin 2 g IM remains expensive but is the regimen of choice for treatment failures and for Neisseria gonorrhoeae that produce penicillinase (PPNG). Other antibiotics active against PPNG are cotrimoxozole, cefoxitin, and cefuroxime. PNNG have now been reported from 27 countries throughout the world, but have attained significant prevalence in only a few areas of East Asia and West Africa. Because gonococcal patterns of antibiotic resistance are constantly changing, each region of the world needs to monitor treatment results and maintain some surveillance over sensitivity to antibiotics.

Gonorrhea↗
PubMed1978

Pseudomonas folliculitis acquired from a health spa whirlpool.

Three cases of an unusual Pseudomonas skin infection acquired from a health spa whirlpool were reported, and an epidemiologic survey showed 17 additional cases. This dermatosis is characterized by the abrupt onset of urticarial papules and superficial and deep papulopustules that spare only the head and neck and occur eight to 48 hours after using the whirlpool. Cultures from one patient's pustules and from the spa whirlpool environment were positive for P aeruginosa, serotype O-11. The condition cleared in all but one patient, without treatment, within seven to ten days. This patient continues to have recurrent follicular pustules three months after exposure. Samples from whirlpools at six other selected establishments were also positive for P aeruginosa.

Adult↗
PubMed1978

Anogenital infection with Neisseria meningitidis in homosexual men.

Among monosexual men anal infection with Neisseria meningitidis was more prevalent (15 of 731 men) than expected and significantly more prevalent than urethral infection with N. meningitidis (three of 669 men, P less than 0.01). Anal infection was also significantly more prevalent among homosexual men than among heterosexual women (two of 1,197 women, P less than 0.001). These differences in rates of prevalence may be best explained by a preference of meningococci for anal mucosa and by the common homosexual practice of oral-anal sexual contact. Serogrouping of the 17 anal and three urethral isolates revealed a broad representation of serogroups often found in meningococcal pharyngeal carriage in the community. Of 14 patients who returned for a test-of-cure culture within seven days of treatment with an antibiotic regimen recommended for anogenital gonococcal infection, each was culture-negative for N. meningitidis. Minor and symptoms in three men and profuse urethral discharges in two men resolved with treatment.

Ampicillin↗
PubMed1978

Relative and seasonal incidences of the sexually transmitted diseases. A two-year statistical review.

In the United States statistics on sexually transmitted diseases (STDs), other than gonorrhoea and syphilis, are meagre. In this study the relative and seasonal incidences of most STDs in an American clinic where 34,938 patient visits were recorded over a two-year period (1975-76) are assessed. Gonorrhoea was the most common STD in male and female patients combined (18%), while nongonococcal urethritis (NGU) was most common in men (23%), and vaginitis (trichomonal 7.5%, yeast 7.1%, and non-specific 7.1%) was the most common in women. A significantly higher incidence of NGU occurred in Caucasian (63%) than in black (42%) men (P less than 0.005). No other STD was diagnosed in more than 5% of patients, and 31% had normal findings on clinical examination and investigation, and could be described as the 'worried well'. Two or more STDs co-existed in 4.2% of patients. In 1976 the incidence of genital herpes and scabies decreased in contrast to other STDs and total patient visits, which increased. A seasonal peak in late summer and early autumn was observed for most STDs. These observations indicate the importance of a comprehensive approach when attempting to compile accurate statistics on selected epidemiological aspects of sexually transmitted diseases.

Black or African American↗
PubMed1977

The FTA-ABS test: a diagnostic help or hindrance?

The fluorescent treponemal antibody absorption (FTA-ABS) test, an excellent confirmatory treponemal test, has been used increasingly for syphilis screening and case detection. To evaluate its performance as an initial test, we did Venereal Disease Research Laboratory (VDRL) slide and FTA-ABS tests on 1,043 patients suspected of having syphilis. When retested in both a local and a reference laboratory, sera from 226 patients with borderline or reactive results demonstrated interlaboratory consistency for the VDRL but not the FTA-ABS. Borderline FTA-ABS results correlated poorly with the diagnosis of syphilis in both laboratories; a reactive FTA-ABS test correlated well only in the reference laboratory. Performance of the test appeared to be diminished by its use in a low-prevalence population and by seemingly minor alterations in the test procedure at the local laboratory.

Absorption↗
PubMed1977

Recent micturition does not affect the detection of urethral gonorrhoea.

In 202 men with urethral gonorrhoea (176 symptomatic and 26 asymptomatic) who had modified Thayer-Martin cultures taken before and within five minutes after micturition there was complete agreement between results of the two cultures. Micturition did, however, temporarily eliminate the discharge in 100 (56.8%) and make interpretation of Gram-stained smears more laborious.

Gonorrhea↗
PubMed1977

Screening for gonorrhea and syphilis in the gay baths--Denver, Colorado.

During 33 screening sessions in Denver gay steambaths, 48 of 419 (11.5 per cent) men were found to have asymptomatic gonorrhea and six (1.4 per cent) had early latent syphilis. Questionnaires were administered to 160 men who reported a mean of 7.9 different male sex contacts per month. Female sex contacts were also reported by 30 per cent. The respondents used the baths an average of 2.2 times per month, having an average of 2.7 different sex contacts per visit, 84 per cent of whom were not previously known to the respondent. Gay steambaths are productive locations for detecting asymptomatic gonorrhea and syphilis.

Colorado↗
PubMed1976

Tetracycline in the treatment of uncomplicated male gonorrhea.

A clinical trial was performed to test a loading dose regimen of tetracycline (1.5 gm po sTAT and 0.5 mg po quid for 4 days) against a no-loading dose (0.5 gm po quid for 4 1/2 days) in the treatment of 477 cases of uncomplicated male urogenital gonorrhea. The regimens were equivalent, with an overall cure rate of 96%. A crossover pharmacokinetic study in 10 healthy volunteers demonstrated higher blood levels during the first day on the loading regimen, but equivalence thereafter. Tetracycline, in a total dose of 9.5 gm, is highly effective treatment, and a loading dose is not necessary.

Adult↗
PubMedDate not supplied

An evaluation of the microcult gonorrhea detection system.

The Microcult Gonorrhea Detection System employs a dehydrated selective medium adsorbed into a cellulose matrix. The medium is rehydrated before use, then incubated in a foil pouch with a tablet that releases carbon dioxide. Duplicate specimens were plated in parallel on modified Thayer-Martin media and Microcult media. In all, 131 urethral specimens which contained gram-negative intracellular diplococci, 311 cervical specimens and 308 anal specimens were studied. Gonococci were isolated on modified Thayer-Martin media from 128 urethral, 63 cervical, and 29 anal specimens. In contrast 109 urethral, 48 cervical, and 5 anal specimens were shown to contain gonococci using the Microcult system. The Microcult system is inferior to fresh modified Thayer-Martin media for detecting gonococci.

Anal Canal↗
PubMedDate not supplied

A rational basis for the epidemiologic treatment of gonorrhea in a clinic for sexually transmitted diseases.

Epidemiologic treatment of gonorrhea refers to the administration of antibiotics when the diagnosis is considered likely, but before the results of confirmatory tests are available. Unfortunately, the risk of infection is seldom known. To place epidemiologic treatment on a more rational basis, infection rates were determined for groups of clinic patients defined by easily collected indexes of risk such as reason for attending the clinic, sex, race, and sexual preference, history of contact with gonorrhea, and history of a urethral or vaginal dischange. Infection rates ranged from 0.8% for men seeking marriage licenses to 65.1% for female contacts of men with "established" gonorrhea. By selectively employing gram-stained smears, it is possible to reduce further the need for epidemiologic treatment within the various defined groups of patients. Epidemiologic treatment policies should be determined by each large clinic and should be based on known infection rates for clearly defined groups of patients. Such rates are necessary for obtaining informed consent from patients and for evaluation of the cost-effectiveness of epidemiologic treatment in the overall effort to control gonorrhea.

Colorado↗
PubMedDate not supplied

A clinic-based system for monitoring the quality of techniques for the diagnosis of gonorrhea.

The author describes a clinic-based system that monitors the quality of techniques for diagnosis of gonorrhea by continuous comparison of the results of gram-strained smears of urethral and cervical specimens with the corresponding cultures. Discrepant results are immediately reviewed. During a two-year period, the system detected two defects in culture incubation, visual defects in a laboratory technician, and three unexplained reductions in cultural sensitivity. The system motivates clinicians and laboratory technicians to maintain a high level of quality control. In 11,474 comparisons of urethral smear and culture results, there was agreement in 96.9% while the smear alone was positive in 1.6% and the culture alone in 1.5%. Review of positive-smear-negative-culture discrepancies indicated that most smears judged "false-positive" were so classified on the basis of false-negative cultures. In study of 1,331 women, the endocervical smeras identified 60% (273/455) of those with positive culture discrepancies. Many of these may have represented false-negative cultures.

Clinical Laboratory Techniques↗
PubMedDate not supplied

Strategic planning system for control of venereal disease: record keeping in a clinic for treatment of sexually transmitted diseases.

A manual data processing system and a computer-based system that was integrated into the operations of a clinic for treatment of sexually transmitted diseases were developed. The automated system can generate routine management reports and cross-tabulate data for special studies. It is flexible and adaptable to other localities but is not a panacea for clinical problems.

Centers for Disease Control and Prevention, U.S.↗