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Biomedical subjects

G Slutkin

Publications and source records attributed to G Slutkin.

29 records · Page 2Linked to original sources
PubMed1985

A demonstration of lack of variability among six tuberculin skin test readers.

The variability of tuberculin skin test readings among six trained and experienced readers was evaluated using a modified sliding caliper method. Each of 537 tests were read independently by two readers. There were 23 disagreements between paired readers resulting in an overall interobserver reliability of 95.7 per cent. In 82 per cent of the paired readings the results were different by 2 mm or less. The observer lack of variability was likely due to the training and experience of the readers.

Aged↗
PubMed1984

Infectious diseases of travelers and immigrants.

Many tropical and other unusual infections can occur in travelers or among foreign-born persons who have emigrated to the United States. The approach to the differential diagnosis includes considering the patient's geographic history, dates of travel, and clinical presentation, along with the geographic distribution and possible incubation periods of suspected pathogens. Important considerations include malaria, typhoid fever, rickettsial disease, dengue, brucellosis, tuberculosis, and leptospirosis. Traveler's diarrhea and dysentery are also common.

Bacterial Infections↗
PubMed1984

Infections acquired in the fields and forests of the United States.

Sportsmen, backpackers, and outdoor workers may present with unusual infections acquired in the fields and forests of the United States. Infections to be considered in such persons with a febrile illness include Rocky Mountain spotted fever, Colorado spotted tick fever, babesiosis, borreliosis, and Lyme disease. The differential diagnoses for clinical presentations of pulmonary and gastrointestinal disease are also discussed.

Agricultural Workers' Diseases↗
PubMed1983

Tropical pyomyositis of the iliacus muscle in American Samoa.

Ten cases of pyomyositis of the iliacus muscle are described in otherwise healthy young Samoans. The correct diagnosis was frequently delayed. Staphylococcus aureus was the most common pathogen isolated from drained abscesses. Preference for hip flexion was seen in six patients, and localized pain or induration at the anterior superior iliac spine were found in seven patients. These clues may help expedite a correct diagnosis.

Adolescent↗
PubMedDate not supplied

Comparison of cefonicid and cefazolin for treatment of soft-tissue infections.

Cefonicid was compared with cefazolin for the treatment of serious infections of soft tissue. According to a randomized, prospective protocol designed to assign twice as many patients to cefonicid, 38 patients were treated with cefonicid and 19 patients, with cefazolin. Dosages used were 1.0 g once daily intramuscularly or intravenously for cefonicid and 0.5-1.0 g three times a day intramuscularly or intravenously for cefazolin. Clinical diagnoses included cellulitis (39 patients), abscesses (14), infected ulcers (3), and bursitis (1). Bacteriologic diagnoses included Staphylococcus aureus alone (8 patients), group A Streptococcus alone (13), combined S. aureus plus streptococci (8), viridans group streptococci alone (1), and mixed anaerobes (1). Gram-negative rods were isolated from 11 patients, all in mixed cultures with gram-positive species. For two patients, gram-negative organisms were thought to be etiologic. All 57 patients responded satisfactorily to treatment. Treatment with either drug was neither interrupted nor discontinued because of toxicity. Both cefonicid and cefazolin appear to be effective for the treatment of infections of skin and soft tissues. Cefonicid has the advantage of once-daily dosing.

Abscess↗
PubMedDate not supplied

Tuberculin skin test reactivity and conversions in United States- and foreign-born Latino children.

The rate of positive tuberculin skin tests for Latino children was examined to help define high risk groups. We reviewed 330 charts of subjects, 18 years of age or younger, with one or more tuberculin (5 tuberculin units, purified protein derivative) skin test readings in a 5-year period. Overall 9% of United States-born and 53% of foreign-born Latinos had positive tuberculin tests (P less than 0.01). Repeat applications identified 35 converters and a greater proportion of United States-born Latinos were in this group (P less than 0.05). Radiographic changes on chest films consistent with active tuberculous disease were found in four of the foreign-born converters. The calculated tuberculin conversion rate of these Latinos is 15 to 30 times that of the United States general population. Unsuspected transmission of tuberculosis may be one possible explanation. We recommend that: clinicians should perform routine tuberculin skin tests in healthy Latino children whether born in the United States or in a foreign country; and active screening for tuberculosis of Latino immigrants by local health departments be conducted with appropriate funding support.

Adolescent↗
PubMedDate not supplied

Paromomycin therapy of endemic amebiasis in homosexual men.

A prospective evaluation was made of the therapeutic efficacy of paromomycin, an orally administered, nonabsorbable aminoglycoside, in 114 homosexual men with mild-to-moderate (nondysenteric) intestinal amebiasis. All patients received 25-35 mg/kg daily in three divided doses for seven days. Of the 80 patients with gastrointestinal complaints at the onset of therapy, 55 (80%) of 69 were asymptomatic within four to six weeks after completion of treatment; 11 patients were lost to follow-up. Paromomycin produced long-term eradication of intestinal Entameba histolytica infection in 92% of all men evaluated. The rate of microbiologic cure among patients with symptoms at the onset of therapy was comparable to that among asymptomatic individuals. Paromomycin was well tolerated, with mild diarrhea during therapy the only frequent adverse effect (67% of patients). Thus, paromomycin is an effective alternative to conventional multi-drug therapy for intestinal amebiasis, and it has the advantages of low toxicity, brief duration of therapy, and a high rate of patient compliance.

Adult↗
PubMedDate not supplied

Management of tuberculosis in urban homeless indigents.

Tuberculosis patients who are homeless, indigent, and alcoholic infrequently complete a course of chemotherapy, risking treatment failure, recurrence, and continued spread of infection in the community. Obstacles to successful treatment include an erratic schedule, mistrust of authority, and uncooperative or aggressive behavior. Successful management of this problem requires the use of proven case holding techniques, a correct choice of drug regimen, and a prompt and appropriate response to the patient who is lost or refuses treatment. Nine- and six-month drug regimens with proven success are now available; however, the direct observation of medication-taking should be maximized. Patient default may be further minimized by encouraging prompt notification of the health department. Occasionally, the threat or use of existing public health laws on confinement for purposes of treatment are required for noncompliant patients.

Antitubercular Agents↗