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Biomedical subjects

L Lieb

Publications and source records attributed to L Lieb.

At least 19 recordsLinked to original sources
PubMed1996

Evidence for recent growth of the HIV epidemic among African-American men and younger male cohorts in Los Angeles County.

To estimate the recent course of the human immunodeficiency virus type 1 (HIV) epidemic among men within birth cohorts, ethnic groups, and HIV-risk groups in Los Angeles County, backcalculation methods were combined with log-linear models and census data to reconstruct HIV incidence in subgroups from AIDS surveillance data. Results were compared with directly measured HIV seroprevalence in public sexually transmitted disease (STD) clinics in Los Angeles. Models of HIV incidence indicate that the initial epidemic pattern among men who have sex with men, including a decline in incidence since the mid-1980s, does not apply to all post-1960 birth cohorts. Later peaks were observed in younger birth cohorts and among injection drug users, especially among African-American men, with no evidence of a peak before the 1990s among men born after 1960. Our results indicate that HIV continued to spread near peak rates into the 1990s among younger birth cohorts, especially among young African-American men who have sex with men. Because of the lengthy incubation period from HIV infection to AIDS incidence, our results imply that the AIDS epidemic has not yet peaked in these cohorts and may continue to grow through the present decade in several subgroups. The large variation in HIV incidence and prevalence across birth cohorts and other subgroups needs to be addressed in future community intervention plans.

Adolescent↗
PubMed1995

Listeria monocytogenes infection and serotype distribution among HIV-infected persons in Los Angeles County, 1985-1992.

Persons infected with human immunodeficiency virus (HIV) are at greater risk of infection with Listeria monocytogenes (LM) than the general population. We quantify the risk of listeriosis in persons with acquired immune deficiency syndrome (AIDS) and HIV infection in Los Angeles County (LAC) and report the LM serotype distribution among HIV-infected patients with listeriosis. Active surveillance for listeriosis was performed in LAC during most of the period from 1985 through 1992. Thirty-four (10%) of 351 nonperinatal cases of listeriosis reported in LAC from 1985 through 1992 were in HIV-infected persons, 25 of whom met the 1987 AIDS case definition. The incidence of listeriosis was 95.8 and 8.8 cases per 100,000 person-years among persons with AIDS and all HIV-infected persons, respectively, but only 1.0 case per 100,000 person-years in the total population. Excluding cases from a 1985 listeriosis epidemic associated with consumption of contaminated Mexican-style cheese, 11 (65%) of 17 HIV-infected persons with available isolates were infected with LM serotype 1/2b, whereas only 64 (31%) of 208 other persons with listeriosis and available isolates were infected with LM serotype 1/2b (odds ratio = 4.1; 95% confidence interval = 1.3-14.1). LM serogroup 1/2b may have been more common among HIV-infected persons in LAC than among other persons with listeriosis because of differences in diet or sexual practices, or to chance alone. Persons with HIV-infection, especially those with AIDS, should be educated in avoiding foods at high risk of listerial contamination, such as soft cheeses, foods sold from delicatessen counters, and undercooked chicken.

Adolescent↗
PubMed1994

Liposomes: a novel topical delivery system for pharmaceutical and cosmetic applications.

This review will highlight work done in our laboratories evaluating topical liposomal delivery in a wide variety of animal models and human skin using both in vivo and in vitro techniques. The mechanism by which liposomes facilitate deposition of drugs into the skin and some potential applications of topically applied liposomes will be discussed. Particular emphasis will be placed on the development of analytical techniques that allow the quantification of drug levels in the various skin strata and in pilosebaceous structures. Appropriate models of skin representing the two cases, as well as those wherein both routes are available for skin deposition, were examined using a wide variety of liposomal preparations containing radiolabeled and fluorescent molecules as marker compounds.

Animals↗
PubMed1993

Causes of death among persons reported with AIDS.

OBJECTIVES: This study describes causes of death in persons with acquired immunodeficiency syndrome (AIDS) and assesses the completeness of reporting of human immunodeficiency virus (HIV) infection or AIDS on death certificates of persons with AIDS. METHODS: AIDS case reports were linked with death certificates in 11 local/state health departments; underlying and associated causes of death were available for 32,513 persons with AIDS who died. RESULTS: HIV/AIDS was designated as the underlying cause of death for 46% of persons with AIDS who died between 1983 and 1986 and 81% of persons with AIDS who died since 1987 (the year specific coding procedures were implemented for HIV/AIDS). Most other underlying causes of death were conditions within the AIDS case definition (notably Pneumocystis carinii pneumonia), pneumonia, infections outside the AIDS case definition, and drug abuse. Unintentional injuries, suicide, and homicide were less common. HIV/AIDS was listed as underlying or associated on 88% of death certificates from 1987 to 1989; reporting varied primarily by HIV exposure category and time between diagnosis and death. CONCLUSIONS: Physicians and other health care professionals should realize their critical role in accurately documenting HIV-related mortality on death certificates. Such data can ultimately influence the allocation of health care resources for HIV-infected individuals.

Acquired Immunodeficiency Syndrome↗
PubMed1993

HIV infection in hospitalized patients and Medicaid enrollees: the accuracy of medical record coding.

To evaluate the accuracy of computerized medical-record coding for human immunodeficiency virus (HIV), medical charts were reviewed in six sites. In 7601 hospital and 867 Medicaid records with a listed diagnosis of HIV, the predictive value for HIV was 91% or higher. HIV was identified in 34% of 1155 Medicaid records listing immune disorder or illness in the acquired immunodeficiency syndrome (AIDS) surveillance definition (without an HIV code). In hospital and Medicaid records, AIDS was identified both in records listing AIDS and records listing HIV without AIDS. HIV codes on hospital and Medicaid records were highly predictive for HIV; undercoding of HIV occurred in Medicaid records.

AIDS-Related Opportunistic Infections↗
PubMed1992

The completeness of AIDS case reporting, 1988: a multisite collaborative surveillance project.

OBJECTIVES: The purpose of this study was to evaluate the completeness of acquired immunodeficiency syndrome (AIDS) case reporting. METHODS: Statewide or hospital-specific 1988 medical records were linked with AIDS surveillance in six sites. Medical records were reviewed for persons who had diagnoses suggesting human immunodeficiency virus (HIV) infection or AIDS but were not reported to AIDS surveillance by September 1989. RESULTS: Among 4500 hospitalized persons diagnosed with AIDS through 1988 in the six sites, completeness of reporting was 92% (95% CI = 89%, 96%; range across sites = 89% to 97%). Completeness of reporting was high in males (92%), females (95%), Whites (95%), Blacks (90%), Hispanics (92%), men reporting sexual contact with men (92%), persons reporting injecting-drug use (91%), and persons exposed to HIV through heterosexual contact (99%). In Medicaid enrollees (two states), completeness of reporting was 99% (95% CI = 95%, 99%) in inpatients and 90% (95% CI = 79%, 90%) in outpatients. Of previously reported persons with AIDS, 82% were reported within 5 months of diagnosis. CONCLUSIONS: Completeness of AIDS reporting was high, overall and in each major demographic and HIV exposure group. These results demonstrate that current surveillance data in these six sites provide timely and accurate information regarding persons with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Serum hyposomolarity, brain edema and the bulbar brain syndrome as complications in the course of severe cranio-cerebral injuries in children].

It is reported on a severe craniocerebral trauma in a child with a rarely occurring spontaneously induced serum hypoosmolality which led to brain edema combined with intracranial increase of pressure and bulbar brain syndrome. By means of bedside brain ventricle catheterization for liquor drainage following drill-hole trepanation, the complication could be controlled. Later the recovery was completed under supervision of the outpatient department. Pathophysiological metabolic peculiarities, especially osmolality, are discussed. The necessity of special and repeated controls of the metabolic characteristics osmolality, sodium and potassium in serum and urine as well as the water and sodium balance within 24 hours is emphasized.

Brain Edema↗
PubMed1991

Neuropsychological functioning in human immunodeficiency virus type 1 seropositive children infected through neonatal blood transfusion.

The neuropsychological development of 15 human immunodeficiency virus type 1 (HIV-1) seropositive children infected through neonatal blood transfusion was compared with that of a control group of 33 HIV-1 seronegative children who had also received blood transfusions as neonates. Human immunodeficiency virus type 1 infection was identified on the basis of a callback blood testing. Two thirds of the HIV-1-infected children were asymptomatic at time of enrollment in the study of development. The children were administered two psychological batteries approximately 8 months apart. The results indicated that the two serostatus groups did not differ in overall intelligence, even as long as 8 years after HIV-1 infection. Significant group differences, though slight, were found on school achievement and on tasks that require motor speed, visual scanning, and cognitive flexibility. Continued longitudinal study of this cohort will be important in characterizing the evolution of neuropsychological deficits.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Requirements of intensive care medicine for laboratory diagnosis].

The effective utilization of the laboratory diagnostics in the intensive care medicine requires a close co-operation between physician and laboratory diagnostician beginning from discriminated requests and the faultless specimen collection until the computerised evaluation and interpretation. Out of the numerous necessary parameters of investigation special attention is directed to the assessment of the electrolyte and water balance, the transcapillary exchange and the oxygen consumption. In the following years the laboratory diagnostics has to meet important demands which result from pathobiochemical research conclusions with critically ill patients.

Acid-Base Equilibrium↗
PubMed1989

HIV seroprevalence in intravenous drug users: Los Angeles, California, 1986.

To estimate the seroprevalence and investigate risk behaviors for HIV (human immunodeficiency virus) infection in intravenous drug users in Los Angeles County, a stratified, random sample of 790 clients, enrolled in either methadone maintenance or detoxification programs, were studied. Thirteen study participants (1.8 per cent) were seropositive; of these, five were homosexual/bisexual males and three were female prostitutes. Ninety-five per cent of all participants reported sharing needles. Risk reduction education efforts must be expanded before the HIV antibody prevalence rate increases.

Female↗
PubMed1989

Declining rates of amebiasis in Los Angeles County: a sentinel for decreasing acquired immunodeficiency syndrome (AIDS) incidence?

In Los Angeles County from 1983-1988, rates of amebiasis declined 65 percent among White males 15-44 years. No such decline occurred among White females 15-44 years or White males less than 15. Reported acquired immunodeficiency syndrome (AIDS) cases in the district of highest AIDS incidence has followed the initial decline in amebiasis by four years. Amebiasis trends may be a useful predictor of human immunodeficiency virus (HIV) transmission and future rates of AIDS among gay men.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Listeriosis: an uncommon opportunistic infection in patients with acquired immunodeficiency syndrome. A report of five cases and a review of the literature.

Between January 1985 and March 1986, five cases of listeriosis were reported in Los Angeles County in patients with the acquired immunodeficiency syndrome (AIDS). All patients were homosexual men with no other risk factors for AIDS. Two patients had sepsis only, two patients had sepsis and meningitis, and one patient had sepsis and signs of meningitis. Sixty percent of the cases (three patients) had a prior or concurrent gastrointestinal illness. Eighty percent of the cases (four patients) also had no prior history of antibiotic administration. Both of these findings may have predisposed these AIDS patients to be at increased risk for listeriosis. Although listeriosis is an infrequent illness in AIDS patients, people with AIDS or human immunodeficiency virus infection should probably refrain from ingesting food items associated with listeriosis. These food items include improperly pasteurized dairy products, and raw fruits and vegetables not properly washed.

Acquired Immunodeficiency Syndrome↗