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Biomedical subjects

R Berkelman

Publications and source records attributed to R Berkelman.

6 recordsLinked to original sources
PubMed1998

Emerging and reemerging infectious diseases: a multidisciplinary perspective.

Predictions that infectious diseases would be eliminated as a major threat to human health have been shattered by emerging and reemerging infections, among them acquired immunodeficiency syndrome (AIDS), hemorrhagic fevers, marked increases in infections caused by antimicrobial-resistant bacteria, and the resurgence of tuberculosis and malaria. Understanding the dynamics of emerging and reemerging infections is critical to efforts to reduce the morbidity and mortality of such infections, to establish policy related to preparedness for infectious threats, and for decisions on where to use limited resources in the fight against infections. In order to offer a multidisciplinary perspective, 23 infectious disease specialists, epidemiologists, geneticists, microbiologists, and population biologists participated in an open forum at Emory University on emerging and reemerging infectious diseases. As summarized below, the group addressed questions about the definition, the identification, the factors responsible for, and multidisciplinary approaches to emerging and reemerging infections.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Transmission of human immunodeficiency virus in a dental practice.

OBJECTIVE: To determine if patients of a dentist with the acquired immunodeficiency syndrome (AIDS) became infected with human immunodeficiency virus (HIV) during their dental care and, if so, to identify possible mechanisms of transmission. DESIGN: Retrospective epidemiologic follow-up of the dentist, his office practice, and his former patients. SETTING: The practice of a dentist with AIDS in Florida. PARTICIPANTS: A dentist with AIDS, his health care providers and employees, and former patients of the dentist, including eight HIV-infected patients. MEASUREMENTS: Identification of risks for HIV transmission (if present), degree of genetic relatedness of the viruses, and identification of infection control and other office practices. RESULTS: Five of the eight HIV-infected patients had no confirmed exposures to HIV other than the dental practice and were infected with HIV strains that were closely related to those of the dentist. Each of the five had invasive dental procedures, done by the dentist after he was diagnosed with AIDS. Four of these five patients shared visit days (P greater than 0.2). Breaches in infection control and other dental office practices to explain these transmissions could not be identified. CONCLUSION: Although the specific incident that resulted in HIV transmission to these patients remains uncertain, the epidemiologic evidence supports direct dentist-to-patient transmission rather than a patient-to-patient route.

Acquired Immunodeficiency Syndrome↗
PubMed1991

AIDS-associated non-Hodgkin lymphoma.

Non-Hodgkin lymphoma is associated with HIV infection. We investigated the epidemiology and aetiology of AIDS-related non-Hodgkin lymphoma by analysing data from cases reported to the Centers for Disease Control, Atlanta, USA, up to June 30, 1989. During this period 97,258 AIDS cases were reported, of whom 2824 (2.9%) had non-Hodgkin lymphoma. The condition was about 60 times more common in AIDS patients than in the general US population. 1686 cases were immunoblastic lymphoma, 548 primary lymphoma of the brain, and 590 Burkitt's lymphoma, a condition which is not normally associated with immunosuppression. The proportion of AIDS patients with immunoblastic lymphoma increased from 0% in those under 1 year old to 3.5% in those aged 50 or more. Primary lymphoma of the brain was constant at 0.6% for all ages. The frequency of Burkitt's lymphoma increased from zero in infants to a peak at 10-19 years of age (1.8%). Each type of lymphoma was twice as common in whites as in blacks and in men as in women. Lymphoma was most common in patients with haemophilia or clotting disorders and least common in those born in the Caribbean or Africa who had acquired HIV by heterosexual contact. Epidemiological data suggested that whilst infectious agents (eg, Epstein-Barr virus) may be associated with development of non-Hodgkin lymphomas in AIDS patients there was probably no single cause for all the types of lymphoma. Perhaps the most puzzling question is why Burkitt's lymphoma is commonly associated with HIV infection but not with other types of immunosuppression.

Acquired Immunodeficiency Syndrome↗
PubMed1987

The social and economic costs of alcohol abuse in Minnesota, 1983.

Alcohol abuse in the State of Minnesota has an impact on health, health care resources, and the economy. Alcohol abuse was related to 3.3 per cent (1,150) of deaths in Minnesota in 1983; of these, almost one-third were the result of fatal injuries. Alcohol abuse contributed to 12 per cent (33,909) of all years of potential life lost, two-thirds of which were secondary to injury. The estimated cost of alcohol abuse ranged from $1.4 billion to $2.1 billion, representing from 2.8 per cent to 4.3 per cent of all personal income of Minnesotans, from 32 per cent to 50 per cent of State expenditures, and from 26 to 39 times the alcohol excise tax revenues generated in 1983. Alcohol-related direct medical care costs were estimated to be at least $216 million, 3.8 per cent of Minnesota medical costs for 1983. Costs of reduced on-the-job productivity and short-term absenteeism related to alcohol abuse were estimated to be between $630 million and $1.2 billion. The documentation of the costs of alcohol abuse is an important step in the campaign to reduce alcohol-related deaths, morbidity, and health care costs.

Accidents, Traffic↗