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Biomedical subjects

L B Reichman

Publications and source records attributed to L B Reichman.

At least 109 records · Page 6Linked to original sources
PubMed1979

Drug dependence, a possible new risk factor for tuberculosis disease.

A study was performed to assess the risk of drug-dependent persons for developing tuberculosis. Tuberculosis prevalence was 3,740/100,000 drug-dependent inpatients compared with 584/100,000 non-drug-dependent discharges. In another program, prevalence was 3,750/100,000; in the New York Methadone Program, prevalence was 2,652/100,000 patients in Harlem and 1,372/100,000 city-wide. The city-wide prevalence rate in the entire population was 86.7/100,000 in 1971 and 64.7/100,000 in 1973. Similar elevations in incidence also were found in drug-dependent vs non-drug-dependent populations. Our data show that disease rate is elevated in drug-dependent populations, suggesting that drug dependency reflects a high-risk situation for tuberculous infected individuals developing tuberculosis disease. We suggest that infected drug-dependent persons (tuberculin positive) be considered for preventive therapy with isoniazid, which can be piggybacked onto a drug treatment program.

Humans↗
PubMed1978

Tuberculous infection in a large urban population.

A positive tuberculin reaction, which indicates tuberculous infection, is known to correlate with increased rates of tuberculous disease, but current data concerning possible relationships with factors such as ethnic group, socioeconomic status, age, and sex are unpublished or unavailable. Current background rates of tuberculous infection are also generally not available, so that expected prevalence rates of tuberculous infection in urban areas have not been confidently established. In 1973/74, the New York City Health Code presented an opportunity to study these factors in more than 50,000 employees of the Board of Education. For the first time, a specific index was used to quantitate socioeconomic status. The relative effect of each of these variables on reactor rate was measured. It was found that tuberculous infection was related to race or ethnic group, socioeconomic status, age, and sex, in that order. The over-all data presented a recent picture of the prevalence of tuberculous infection in an urban population.

Adult↗
PubMed1977

The influence of a history of a previous test on the prevalence and size of reactions to tuberculin.

Ten millimeters of more of induration to the Mantoux tuberculin test indicates present or past infection with Mycobacterium tuberculosis in the overwhelming majority of cases. Because a number of patients gave a history of a previous positive reaction that was not confirmed on retesting, we carefully evaluated, as part of a large tuberculin testing survey, 1,428 persons who claimed to have had a previous positive test. Of these, 606 (42.4 per cent) had a positive reaction on retesting. When compared to subjects with no history of a previous tuberculin test, this group had only a slightly higher percentage of large reactions (greater than 24 mm). The difference was not significant. This discrepancy between history and test results cannot be assumed to be due to technique or to anergy in the current testing because of appropriate controls. It probably reflects variability in the use of antigens, technique at the previous testing, or faulty recollection of the subject. Because presumption of tuberculosis infection may lead to further diagnostic or therapeutic decisions, it is recommended that all skin test histories be documented or confirmed by retest before consideration of further examinations or therapy. In those with a history of a previous reaction, very large reactions (greater than 24 mm) were only slightly more frequent (but not to a significant degree) than those without such a history; thus, a previous reaction history should not be sufficient to preclude retesting.

Adult↗
PubMed1976

Treponemal antigen in immunopathogenesis of syphilitic glomerulonephritis.

A patient with syphilitic glomerulonephritis had a renal biopsy and was treated for secondary syphilis. Light, electron, and immunofluorescence microscopic studies revealed an acute proliferative glomerulonephritis with subepithelial, intramembranous, and subendothelial immune complex deposits containing IgG, IgA, IgM, C4, and C3. Similar local deposits containing predominantly IgM were noted in areas of mesangial proliferation. Indirect fluorescent antibody studies employing rabbit treponemal antibody and sheep antirabbit globulin conjugate revealed the presence of treponemal antigen in the glomerular deposits. This finding provides strong evidence for the immunopathogenesis of the glomerular lesion as well as a causal link with Treponema pallidum.

Adult↗
PubMed1975

Monitoring preventive therapy patients for liver disease as well as compliance.

An apparently increasing incidence of isoniazid-associated hepatitis concurrent with interest in the problem has led to the universal teaching that patients on isoniazid preventive therapy must be carefully monitored for liver disease. This teaching has been reinforced and endorsed in a recent report of the tuberculosis advisory committee and special consultants to the director of the Center for Disease Control; this report, in turn, led to an American Thoracic Society statement concluding that the use of isoniazid with appropriate safeguards must be based on a comparison of the benefit of preventive therapy with the risk of hepatic injury and, therefore, should be used when necessary, under careful control and follow-up. In New York City, with increasing use of the tuberculin skin test leading to increased numbers of patients receiving this treatment in nurse-operated clinics, a new control form and protocol were designed. These insure that all individuals on preventive therapy are carefully monitored for liver disease as well as compliance in taking the drug. This system also insures the safeguards alluded to, as well as increasing concern and awareness among the health professionals in prescribing the treatment.

Chemical and Drug Induced Liver Injury↗