Biomedical subjects

R Duma

Publications and source records attributed to R Duma.

3 recordsLinked to original sources

PubMed1995

Establishing a national universal vaccination programme.

The collaborative efforts of healthcare providers, governmental policy and law makers and the public are often needed to provide the pressure necessary to establish a national universal vaccination programme. Key initiatives for those beginning to establish such a programme are the following: secure a scientific consensus or base of support; clarify relevance of the subject to all concerned; increase awareness of everyone (providers and consumers); recruit and involve influential people (angels) for support; seek out agendas within which to review the topic; generate cost-benefit data; encourage a consensus to be reached; identify legislative pathways to be used; convince politicians of the value of such a programme; request budgeting and funding; and, finally, follow up with surveillance studies to demonstrate the benefits of the programme.

Hepatitis B↗

PubMed1990

Epidemiology of Lyme disease in Virginia.

Prior to January 1986, only one case of Lyme disease was reported from Virginia. In 1986-87, however, the Virginia Department of Health observed an increase in reports of suspected Lyme disease by physicians, despite the fact that Ixodes dammini is not highly prevalent in the Virginia tick population. Twenty-eight cases of Lyme disease were identified in Virginia, of which eight cases occurred in 1986 and 20 in 1987. Lyme disease appears to be increasing in frequency in Virginia and moving southward along the Eastern Atlantic Seaboard.

Adolescent↗

PubMed1979

Fungus balls of the urinary tract.

Fungus balls of the urinary tract are rare and usually associated with infection by Candid albicans. Since 1968 five patients seen at the Medical College of Virginia Hospitals presented with this peculiar manifestation of candidiasis. Summaries of their epidemiologic clinical, pathologic, and mycologic data are presented. All Candida fungus balls involved the upper collecting system and were detected by radiography and confirmed by culture and/or pathologic section. Two of the five patients completely recovered. Three patients were treated with flucytosine and/or local irrigation with a polyene antifungal agent. Two recovered and the third died of probable bacterial sepsis. One patient was treated successfully with surgical removal of the fungus ball and a brief period of local irrigation with amphotericin B (AMB). The fifth patient recovered after 28 days of parenteral AMB. Predisposing factors and pathogenetic mechanisms are discussed, and a rational approach to therapy is outlined.

Adult↗