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Biomedical subjects

M Fast

Publications and source records attributed to M Fast.

At least 19 recordsLinked to original sources
PubMed1999

Risk factors for acquisition of hepatitis C virus infection in blood donors: results of a case-control study.

BACKGROUND & AIMS: Few studies have explored risk factors predicting hepatitis C virus (HCV) infection in blood donors; their results are contradictory. The aim of this study was to evaluate the association between HCV infection and various risk factors in Canadian volunteer blood donors. METHODS: Four transfusion centers were involved in this case-control study. A total of 267 confirmed anti-HCV-positive blood donors were interviewed along with 1068 seronegative blood donors matched for sex, age, donation site, and date. Information was collected using a structured telephone interview. The main outcome measures were odds ratios (ORs) and 95% confidence intervals (CIs) for various risk factors from univariate and multivariate analyses using conditional logistic regression. RESULTS: By univariate analysis, 23 variables were associated with anti-HCV positivity. In the final multivariate analysis, only 5 factors remained independently predictive of HCV infection: previous intravenous drug use (OR, 127.5; 95% CI, 26.0-625.0), having lived in a prison or juvenile detention center (56.1; 11.4-275.7), previous blood transfusion (10.5; 4.7-23.2), sexual contact with an intravenous drug user (6.9; 3.1-15.2), and tattooing (5.7; 2.5-13). CONCLUSIONS: Most blood donors acquire infection by percutaneous exposure to contaminated blood. A role for sexual transmission is suggested by this study.

Adult↗
PubMed1999

Regional dissemination and control of epidemic methicillin-resistant Staphylococcus aureus. Manitoba Chapter of CHICA-Canada.

A methicillin-resistant Staphylococcus aureus (MRSA) strain introduced into the largest tertiary-care teaching hospital in Manitoba in 1993 led to a sustained outbreak with secondary outbreaks at one community hospital, two large long-term-care facilities, and nosocomial transmission at a second teaching hospital. Control measures were consistent at each institution and were coordinated on a province-wide basis. MRSA is not currently endemic in any facility in the province.

Cross Infection↗
PubMed1997

Shigellosis on Indian reserves in Manitoba, Canada: its relationship to crowded housing, lack of running water, and inadequate sewage disposal.

OBJECTIVES: This study compares incidence and hospitalization rates for shigellosis between Indians and the rest of the population in Manitoba, Canada. It examines the relationship between shigellosis and environmental conditions on reserves. METHODS: Rates were calculated with surveillance data and a survey of environmental infrastructure was done. RESULTS: Indians had shigellosis incidence and hospitalization rates that were 29 and 12 times as high, respectively, as those of the rest of the population. Household crowding, lack of piped water, and inadequate sewage disposal were significantly associated with an increased incidence of shigellosis on reserves. CONCLUSIONS: Many cases of shigellosis may be prevented by improving living conditions on Indian reserves.

Adolescent↗
PubMed1996

Serological study of responses to selected pathogens causing respiratory tract infection in the institutionalized elderly.

In a prospective 2-year study, serological responses to selected pathogens were analyzed in 224 episodes of fever attributable to respiratory tract infection (51.8%) or of unknown source (48.2%) in 131 residents of two long-term-care facilities. A serological response was identified in 45 episodes (20.1%): Chlamydia pneumoniae (14 episodes), Haemophilus influenzae type b (1), influenza virus type A (14), respiratory syncytial virus (RSV;2), parainfluenza virus type 3 (7), C. pneumoniae and H. influenzae (3), C. pneumoniae and influenza virus type A (2), C. pneumoniae and RSV (1), and C. pneumoniae and parainfluenza virus type 3 (1). No serological responses to Chlamydia psittaci, Chlamydia trachomatis, parainfluenza virus types 1 and 2, influenza virus type B, or Mycoplasma pneumoniae were seen. Vaccination did not affect the duration of fever in those residents with serologically confirmed influenza A. Serologically confirmed C. pneumoniae infection was detected in 9.4% of all febrile episodes. Serological responses to a second agent were detected in 33% of the patients with C. pneumoniae infections, and these dual infections were associated with an underlying malignancy (P = .02). C. pneumoniae should be recognized as a potential pathogen when choosing empirical antimicrobial therapy for respiratory tract infection in residents of long-term-care facilities.

Aged↗
PubMed1996

Vaccine-induced hepatitis B surface antigen positivity in adult hemodialysis patients: incidental and surveillance data.

This report describes hepatitis B vaccinations that resulted in transient hepatitis B surface antigen positivity in six adult hemodialysis patients. Initially, three patients were incidentally discovered to be hepatitis B surface antigen-positive temporally related to hepatitis B vaccination. Two other patients who displayed transient positivity were among 15 hemodialysis patients under prospective surveillance after receiving a dose of hepatitis B vaccine. The sixth patient was negative for hepatitis B surface antigen when monitored in the prospective surveillance group but was incidentally found to be positive after a nonsurveillance dose of the vaccine. All positive cases cleared hepatitis B surface antigen within 20 days of vaccination. In our search of the literature, this is the first report of hepatitis B vaccine inducing hepatitis B surface antigen positivity in adult hemodialysis patients. Because this study proposes that this transient surface antigen positivity is vaccine-induced and not a true hepatitis B infection, we recommend that renal dialysis patients not be screened for hepatitis B surface antigen for at least 21 to 28 days after hepatitis B vaccination. As well, blood donors should not donate blood in this early postvaccination period. These guidelines would incorporate a measure of safety to prevent individuals in the early postinoculation period from being erroneously labeled as having hepatitis B viral infections.

Adult↗
PubMed1995

Epidemiology of juvenile rheumatoid arthritis in Manitoba, Canada, 1975-92: cycles in incidence.

OBJECTIVE: To determine the yearly incidence of juvenile rheumatoid arthritis (JRA) and to seek correlations between this and cyclic infections occurring in the province of Manitoba, Canada, during the same period. METHODS: An estimate of the incidence of JRA in Manitoba was determined from a disease registry of the Pediatric Rheumatology Clinic, Children's Hospital, Winnipeg. The numbers of confirmed Mycoplasma pneumoniae and viral respiratory infections were determined from annual reports of Cadham Provincial Laboratory. Both facilities provide centralized services for the province. RESULTS: Between 1975 and 1992 the onset of JRA occurred in 261 patients (136 with pauciarticular, 91 polyarticular, and 34 systemic onset). The average annual incidence of JRA for this period was 5.34/100,000. However, a cyclic incidence was apparent with peaks in 1979, 1982, 1986, and 1990-91. Increases in confirmed M. pneumoniae infections were concurrent with peaks in the incidence of JRA. A significant correlation was found between the incidence of JRA and the number of M. pneumoniae infections detected in the province between 1985 and 1992 (R = 0.76, p = 0.044). In contrast, there was no consistent variation in the incidence of seronegative spondyloarthropathies in children (n = 103 patients). CONCLUSION: These data suggest the need for further study of a possible infectious etiology for JRA.

Adolescent↗
PubMed1994

Epidemiology of infection due to Chlamydia trachomatis in Manitoba, Canada.

In a study of the epidemiology of Chlamydia trachomatis infection in Manitoba during 1981-1990, we retrospectively reviewed laboratory and clinical case notification records as well as hospital and health insurance data concerning pelvic inflammatory disease and ectopic pregnancy. After implementation of a control program in 1987, the annual incidence of chlamydial infection was highest among females aged 15-24 years (3,418 cases per 100,000 residents). Recurrent infection, which occurred in 13.4% of patients, was more common in women (P < .001), patients aged 15-24 years (P < .001), registered North American Indians (P < .001), and persons with concomitant gonorrhea (P < .001). Risk factors for dual (chlamydial and gonococcal) infection included male sex (P < .001) and young age (P < .001). Although the incidence of hospitalization and outpatient visits for pelvic inflammatory disease decreased (P < .001) from 1981 to 1990, the annual incidence of ectopic pregnancy increased from 10 to 16 cases per 1,000 reported pregnancies (P < .001). Control activities focusing on the primary prevention of C. trachomatis infection are presented. Strategies for improving secondary prevention (through case detection and treatment of lower genital infection) include the targeting of individuals with recurrent and multiple sexually transmitted diseases.

Adolescent↗
PubMed1988

[Intracranial arterial aneurysm in children. A cooperative study. Apropos of 43 cases].

This joint study describes 43 cases of intracranial arterial aneurysms in children diagnosed on the basis of clinical symptoms. In the pediatric age group, this malformation is notable because of the marked sex predilection in males (70%) and an unequal topographic incidence in the circle of Willis, where carotid artery (39.3%) and anterior communicating artery lesions (30%) predominate. The most frequent clinical sign was subarachnoid hemorrhage (81%), although symptoms caused by compression revealed the abnormality in 2.3% of patients. In this series, 11% of the patients suffered a head injury at the time of the hemorrhagic accident; this finding has been reported previously in the literature. Today, treatment is always surgical, consisting in removal of the aneurysmal sac. Surgical results are encouraging; all grade lesions considered together, 63.4% of the children were cured without any sequelae, 19.5% lost one school year but were able to lead a normal life, and 4.8% remained severely handicapped; overall postoperative mortality was 12.3%. Cerebral plasticity and tolerance of spasm in children are fundamental features of this aneurysmal pathology which partially explain the favorable results obtained with surgery.

Adolescent↗
PubMed1988

Seroprevalence and demographic information of patients at risk for human immunodeficiency virus (HIV) infection in Manitoba, Canada.

Two hundred fifty individuals from high risk categories were enrolled in a seroprevalence survey for human immunodeficiency virus (HIV) infections in Winnipeg. The overall seroprevalence in the Manitoba AIDS Virus Epidemiology Study (MAVES) was 5.2%. Of 2651 diagnostic and screening specimens in the province of Manitoba submitted over a similar period, 103 were positive (3.9%). HIV seropositivity in Manitoba was noted mainly in homosexual/bisexual males (especially those who were also intravenous drug abusers), hemophiliacs, and individuals from endemic regions of the world. Individuals whose only risk factor was intravenous drug abuse, those with sexually transmitted diseases, or those with high risk sex contacts have not demonstrated HIV seropositivity in Manitoba to date. Manitoba is currently a low seroprevalence region for HIV infection. Our study demonstrated that the awareness level of people at risk for HIV infections was low. In our study population, one-on-one counseling was demonstrated to be an effective way to improve short-term knowledge about HIV infections. Appropriate education approaches must be considered for Native/Metis peoples (26.4% of our MAVES study population), who were younger and had a lower educational and employment level compared to Caucasian/other racial groups.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Umbilical evagination of the bladder in a newborn infant].

A 4,000 g male infant two hours old, product of normal pregnancy and delivery was admitted in our hospital because of bladder intussusception though umbilico vesical fistula (persistent foetal bladder). The anomaly coexisted with hernia in the umbilical cord. The whole upper part of the bladder was everted and could not be brought in. The surgical correction was performed on the fourth hour. The everted bladder was reduced from inside, severed from abdominal wall and closed in two layers. Pan endoscopy revealed no lower urinary tract obstruction. The post-operative course was uneventful. A bilateral vesico-ureteral reflux grade II was observed on post-operative cystography. On sixth month follow up the infant was growing well and there was no more reflux on cystography. Diagnostic and treatment of this unusual malformation are discussed.

Fistula↗
PubMed1986

[Grave respiratory distress in the newborn infant caused by mediastinal teratoma].

Mediastinal tumor is a rare cause of severe respiratory distress in the newborn. A recent patient was transferred++ to our intensive care nursery with severe distress due to a large mediastinal teratoma. The presence of calcifications on the plain chest roentgenogram suggest the diagnosis. At two hours of age the tumor developed in the left hemi-thorax was completely removed. Microscopically it was a typical well differentiated+ benign teratoma, but the postoperative course was marked by a continuing respiratory distress due to a paralysed left diaphragm. This situation was surgically corrected by infolding the diaphragm at twenty days of life. At the fourth postoperative day the endotracheal tube was removed and the baby is now well with a normal chest. X-ray at six month of age. Because the rarity of this tumor in the newborn, because the possibility of antenatal echographic diagnosis, we record this experience and review the literature.

Female↗
PubMed1979

Ecthyma gangrenosum.

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Anti-Bacterial Agents↗