Diagnostic tests on pericardial fluid.
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Blood Proteins↗
Biomedical subjects
L S Efferen
Publications and source records attributed to L S Efferen.
In pursuit of tuberculosis control: civil liberty vs public health.
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Antitubercular Agents↗
Tuberculosis update: will good news become bad news?
Recent efforts to reestablish control of tuberculosis have resulted in some success. However, deaths from tuberculosis continue to increase worldwide. Molecular techniques have dominated investigators' efforts to improve diagnostic methods and therapeutic options. Unfortunately, no significant advances in the development of new drugs have occurred. Ongoing attempts to develop more effective vaccines hold some preliminary promise, but delineation of the protective antigens on Mycobacterium tuberculosis and the development of a vaccine for use in humans is considered decades away from clinical use. The lack of political commitment worldwide and the potential loss of support nationally remain major obstacles to the establishment of effective and long-lasting tuberculosis control.
Humans↗
Tuberculosis reemerges: the captain remains aboard.
The resurgence of tuberculosis and the emergence of multidrug resistant tuberculosis have led to renewed interest in this ancient disease. Advances in the field of molecular biology have increased our understanding of the epidemiology and transmission of infection. This has had a particular impact on the documentation of, and the subsequent development of guidelines to prevent, the nosocomial transmission of tuberculosis. Molecular techniques have dominated the efforts of investigators to improve diagnostic methods and therapeutic options. Recent information regarding the mechanism of developing protective immunity to tuberculosis may lead to the development of more effective vaccines and a role for immunotherapy in treatment. National and international organizations have formulated guidelines for the diagnosis and treatment of disease and infection. The development of a global response to the problem of tuberculosis in order to ensure the establishment of long-lasting control is needed.
Antitubercular Agents↗
Survival following mechanical ventilation for Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome: a different perspective.
PURPOSE: Pulmonary infection is a frequent cause of morbidity and mortality in patients with acquired immunodeficiency syndrome (AIDS), and Pneumocystis carinii pneumonia (PCP) is the predominant infection in these patients. In those patients who experience progression to respiratory failure from PCP, the reported mortality rate has been between 87% to 100%. This, in addition to the ultimately fatal outcome of patients with AIDS, has led many physicians to question the advisability of instituting mechanical support for respiratory failure in the setting of PCP. It had been our impression that the outcome of patients on our service was not as poor as was generally reported. We therefore undertook a retrospective analysis of our clinical experience. PATIENTS AND METHODS: We reviewed the clinical course of patients admitted to our service between December 1984 and June 1988 who required intubation and mechanical ventilation for PCP or presumed PCP. RESULTS: Thirty-three cases were identified with 18 survivors (54.5%) and 15 non-survivors (45.5%). Twenty-five of the 33 patients were intubated for their first episode of PCP, with 16 survivors (64%), whereas the remaining eight patients were intubated for their second episode of PCP, with two survivors (25%). We were not able to identify any parameters that predicted survival, although the serum lactate dehydrogenase level was useful in following the response to treatment. CONCLUSION: It is our belief that there is a reasonable chance of survival for patients requiring mechanical ventilation for PCP. We question the wisdom of avoiding intubation and mechanical ventilation altogether in patients with PCP due to the presumption of fatality in this clinical situation.
Acquired Immunodeficiency Syndrome↗