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Biomedical subjects

M A Fischl

Publications and source records attributed to M A Fischl.

102 records · Page 6Linked to original sources
PubMed1984

Tuberculosis, atypical mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in south Florida.

To study the association between mycobacterial disease and the acquired immunodeficiency syndrome, we reviewed the records of all cases of tuberculosis and all cases of the syndrome reported in Dade County, Florida, from January 1980 through June 1983. Tuberculosis was diagnosed in 27 of 45 Haitians with the syndrome, but in only 1 of 37 non-Haitians with the syndrome (p less than 0.001). Among the 27 Haitians with the syndrome and tuberculosis, 19 had extrapulmonary tuberculosis, whereas among 286 Haitian patients with tuberculosis without the syndrome, only 56 had extrapulmonary tuberculosis (p less than 0.001). Tuberculosis preceded the syndrome by 1 to 17 months (mean, 6) in 22 patients. In 10 patients with the syndrome and positive sputum cultures who were treated with conventional antituberculosis drugs, the cultures became negative within 1 to 4 months and tuberculosis did not recur. The frequency of disseminated atypical mycobacteriosis or positive sputum cultures for atypical mycobacteria was not significantly different between Haitian (11.3%) and non-Haitian (8.3%) patients with the syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Acquired immune deficiency syndrome in low-risk patients. Evidence for possible transmission by an asymptomatic carrier.

Two patients who contracted acquired immune deficiency syndrome (AIDS) could not be included in any of the known high-risk groups for this syndrome (ie, they were not homosexual, intravenous [IV] drug abusers, Haitian, or hemophiliacs). Patient 1, however, had regular sexual contact with her husband, an IV drug abuser who is asymptomatic despite a severe T-cell defect (T-helper cells, 33/cu mm; T-helper/T-suppressor ratio, 0.32; and a depressed lymphoproliferative response to mitogens and antigens). We hypothesize that he may be an asymptomatic carrier of an AIDS agent that he transmitted to his wife through intimate heterosexual contact. This mode of sexual transmission may provide a vector for the spread of AIDS to low-risk populations.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Opportunistic infections and Kaposi's sarcoma among Haitians: evidence of a new acquired immunodeficiency state.

Twenty Haitian patients, hospitalized from 1 April 1980 to 20 June 1982, had Pneumocystis carinii pneumonia, central nervous system toxoplasmosis, esophageal candidiasis, cryptococcosis, disseminated cytomegalovirus, progressive herpes simplex virus, chronic enteric coccidiosis, or invasive Kaposi's sarcoma. Ten patients died. Opportunistic infections were frequently multiple and were recurrent in three patients. In seven patients disseminated tuberculosis preceded the other infections by 2 to 15 months. There was no evidence of an underlying immunosuppressive disease, and no history of homosexuality or intravenous drug abuse. At least three patients probably acquired the syndrome in Haiti. Lymphadenopathy was common. Seventeen patients tested had anergy, and 18 had lymphopenia. Monoclonal antibody analysis of peripheral-blood T-cell subsets done on 11 patients showed a marked decrease in T-helper cells and an inversion of the normal ratio of T-helper cells to T-suppressor cells. This syndrome among heterosexual Haitians is strikingly similar to the syndrome of immunodeficiency described recently among American homosexuals.

Acquired Immunodeficiency Syndrome↗
PubMed1981

An index predicting relapse and need for hospitalization in patients with acute bronchial asthma.

In an attempt to define guidelines for the assessment of acute asthma, we evaluated 205 patients who presented to the emergency room for treatment of asthma. Of the 205, 120 were successfully treated and discharged from the emergency room, 45 were hospitalized, and 40 were treated and discharged from the emergency room but had relapses within 10 days. A predictive index using a combination of presenting factors was developed: pulse rate greater than or equal to 120 per minute, respiratory rate greater than or equal to 30 per minute, pulsus paradoxus greater than or equal to 18 mm Hg, peak expiratory flow rate less than or equal to 120 liters per minute, moderate to severe dyspnea, accessory-muscle use, and wheezing. The index ranged from 0 to 7, increasing with the severity of symptoms. The index scores of the relapse group (4.9 +/- 1.0) and the admitted group (5.1 +/- 1.0) were both significantly different (p less than 0.001) from that of the successfully treated group (1.6 +/- 1.2). An index of 4 or higher was 95 per cent accurate in predicting the risk of relapse and 96 per cent accurate in predicting the need for hospitalization.

Acute Disease↗
PubMedDate not supplied

Hepatitis C virus infection in a sexually active inner city population. The potential for heterosexual transmission.

The prevalence of hepatitis C virus (HCV) infection and associated risk factors in an inner city sexually active heterosexual population participating in a prospective study for the evaluation of heterosexual transmission of human immunodeficiency virus type-1 (HIV-1) were examined. Individuals with prior history of injection drug use or receipt of blood products were excluded from the study. Of 571 participants, 25 (4.4%) were seropositive for HCV, 39 (7%) for HIV, and 125 (22%) for hepatitis B virus (HBV). Multivariate analysis revealed that those with more than ten heterosexual partners in the past 5 years (OR = 3.7; 95% CI = 1.3, 10.2; P = 0.01), engaging in sexual practices more than once per week (OR = 3.3; 95% CI = 1.1, 10.1; P = 0.04), with antibody to hepatitis B core (HBc) antigen (OR = 2.9; 95% CI = 1.1, 7.4; P = 0.03), and antibody to HIV-1 (OR = 5.8; 95% CI = 1.9; 17.6; P = 0.002) were independently associated with HCV infection. These findings suggest that heterosexual transmission of HCV may occur in an inner city sexually active heterosexual population.

Adolescent↗
PubMedDate not supplied

Report of 24 cases of Listeria monocytogenes infection at the University of Miami Medical Center.

To examine the epidemiological spectrum of human listeriosis at a large municipal hospital in Miami, we reviewed the cases of Listeria monocytogenes infection seen at the University of Miami Medical Center over a nine-year period (1986-94). Twenty-four patients (13 adults, 11 neonates) with bacteriologically proven Listeria monocytogenes infections were identified. The annual rate of listeriosis for the entire period 1986-1994 was 0.042 cases/1,000 hospital admissions. The rates of listeriosis during the first half of the study period (0.0628/1,000 admissions) were three times higher than the rates observed during the second half of the study (0.0214/1,000 admissions). Four (57%) of the 7 adult cases of listeriosis seen after 1987 occurred in HIV-seropositive patients. Compared with the hospital population, the annual rates of listeriosis were several fold higher in patients post-renal transplant (4.65 cases/1,000 renal transplant-related admissions) and patients with HIV/AIDS (0.27 cases/1,000 HIV-related admissions). No deaths were recorded. The decline in the annual rate of listeriosis noted in our study parallels national trends recently reported by the Centers for Disease Control and Prevention.

AIDS-Related Opportunistic Infections↗