Osteoporosis in Johannesburg Bantu males. Its relationship to siderosis and ascorbic acid deficiency.
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Adult↗
Biomedical subjects
G B Miller
Publications and source records attributed to G B Miller.
Hospital-acquired infections in intensive care unit patients: an overview with emphasis on epidemics.
Surveillance activities for the detection of nosocomial infections at the University of Virginia Hospital (Charlottesville, Virginia) and at hospitals participating in the Virginia Statewide Infection Control Program have focused on outbreaks and device-related infections which are potentially preventable. Eleven outbreaks of nosocomial infections were identified at the University of Virginia Hospital between January 1, 1978 and December 31, 1982 (9.8 outbreaks/100,000 admissions). Ten of the 11 were centered in critical care units. The 269 patients involved in the epidemics represented 0.2% of all hospital admissions and 3.7% of all patients who developed nosocomial infections. Eight of the 11 outbreaks involved infection of the bloodstream, and the 90 patients who developed a bloodstream infection as part of an epidemic represented 8% of all patients with nosocomial bloodstream infections identified during the five-year study period. The reservoir of the 11 outbreaks involved devices (5), contaminated cocaine (1), probable blood products (1), other patients (3), and nursing personnel (1). Forty-one percent of all nosocomial bloodstream infections and 41% of all nosocomial pneumonias occurred in intensive care units (ICUs). In 38 hospitals in the state of Virginia with ICUs and practitioners who voluntarily reported surveillance data between June 1, 1980 and May 31, 1982, there were 264,757 patients admitted and a crude infection rate of 3%. Of note is that 1,867 of the 7,407 nosocomial infections (25%) occurred in the ICU patients. Several factors point to a compelling argument that the highest priority in infection control resources be assigned to the prevention and control of ICU infections: ICU patients often have serious device-related infections and may be identified as high risk prior to infection.(ABSTRACT TRUNCATED AT 250 WORDS)
Cross Infection↗
Outbreak of fatal arsenic poisoning caused by contaminated drinking water.
An outbreak of subacute poisoning occurred among nine members of a family; eight were ill with gastrointestinal symptoms, four developed encephalopathy, and two died. Abnormal liver function tests and leukopenia were common laboratory findings. Epidemiologic and environmental investigations traced the source of arsenic exposure to a farm well with water containing 108 ppm arsenic. The soil adjacent to the well was also contaminated with arsenic, possibly from waste pesticide. Presumably, arsenic gained access to the well through obvious leaks in the well's casing. To our knowledge, this is only the second reported outbreak of fatal arsenic poisoning from contaminated drinking water and one of few instances where illness followed exposure to a toxic substance which was disposed of, or possibly disposed of, in an indiscriminate manner.
Adolescent↗
A 1949 outbreak of Pontiac fever-like illness in steam condenser cleaners.
A 1949 outbreak of flu-like illness in steam-turbine condenser cleaners was investigated in 1979. Clinical and epidemiologic features matched those in previously described outbreaks of nonpneumonic legionellosis (Pontiac fever). Titers by indirect immunofluorescence using polyvalent Legionella pneumophila antigen were significantly higher for late convalescent-phase serum samples from condenser workers than for control serum samples submitted to the Centers for Disease Control. Three workers who had cleaned the condensers on several occasions had experienced recurrent illness associated with these operations, which might support the theory that nonpneumonic legionellosis is caused by an immune reaction to an inhaled antigen or bacterial toxin of L. pneumophila, rather than a true infection.
Aged↗
Identification of procedure-related nosocomial infections in high-risk patients.
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Catheterization↗
Two pseudo-outbreaks of infectious mononucleosis.
Two outbreaks of suspected infectious mononucleosis (IM) were investigated. In the first outbreak IM was diagnosed in nine children attending a day care center. They had been tested in physicians' offices for heterophile antibody using rapid differential slide tests; all tests had been reported positive. On retesting, none of the suspected cases had detectable serum heterophile antibody. The initial test results had been falsely positive as a result of poor laboratory technique. In the second outbreak IM had been diagnosed in 285 college students. Suspected cases had been found to have serum IgG antibody to the viral capsid antigen of Epstein-Barr virus, but most had not been tested for the presence of heterophile antibody. Retesting of 64 students within 1 month of initial testing yielded only one with heterophile antibody. With the exception of young children (less than 4 years of age), differential slide tests for heterophile antibody are sensitive and specific for recent Epstein-Barr virus infection if properly performed. Viral capsid antigen to Epstein-Barr virus (IgG) titers are of limited usefulness in diagnosing acute IM. The misdiagnosis of IM can be prevented by the appropriate selection, performance and interpretation of diagnostic laboratory tests.
Adolescent↗
State epidemiology programs and state epidemiologists: results of a national survey.
In 1983, the State Epidemiologists in 46 States completed a survey questionnaire describing the professional qualifications, training, and experience of State health department epidemiologists and the scope of participation by the State Epidemiologists and their staffs in public health programs. The survey identified 224 State health department epidemiologists (estimated U.S. ratio 1.1 per million population). A State health department epidemiologist was most often male (80 percent), frequently (57 percent) was a physician, had an average age of 41 years, and had worked as an epidemiologist for 9 years. Participation in public health programs (either by supervising or providing consultation) by the State Epidemiologists and their staffs focused mainly on general epidemiology and communicable disease programs; fewer than half had participated in programs relating to the health of women and children, chronic diseases, injuries, or in other programs directed towards preventing premature mortality. Recently, the State Epidemiologists have been trying to broaden their activities into these areas; however, the demands created by the acquired immunodeficiency syndrome (AIDS) will mostly likely slow this process. Based on the overall findings and collective experience, it was concluded that State health departments have too few epidemiologists to address the wide variety of important public health problems facing our communities. It was proposed that each State health department have at least four epidemiologists (including one or more physician epidemiologists) and at least one master's level biostatistician and that the epidemiologists-per-population ratio not be less than 1 per million.
Adult↗