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Biomedical subjects

R E Pust

Publications and source records attributed to R E Pust.

At least 37 records · Page 2Linked to original sources
PubMed1985

Family tuberculosis contacts: resource-contingent management.

Recent findings in tuberculosis research have questioned the efficacy of bacille Calmette-Guérin (BCG) vaccination and demonstrated the effectiveness of combined-drug chemotherapy and isoniazid (INH) chemoprophylaxis, both in regimens of under 12 months duration. Because of the renewed emphasis on drug treatment in tuberculosis control, family physicians and the health personnel they supervise need to be involved in this effort. Despite differences in health care resources in different regions, rational and effective management of active cases and their contacts in the family can be devised. While the priority remains treatment of the active index case, family physicians have a unique opportunity to utilize family relationships to find and to treat other active cases and to reinforce compliance with INH chemoprophylaxis by high-risk family contacts.

Adolescent↗
PubMed1985

Health precautions for travelers to Mexico.

After Canada, Mexico is the most popular destination for Americans traveling outside the United States. As a developing country, Mexico presents numerous health hazards to American visitors, including the prevalent travelers' diarrhea (turista), from which 40% will suffer, and the less common typhoid, dengue, rabies, malaria, taeniasis, cysticercosis, and trichinosis. Environmental hazards, including sun, heat, high altitude, motion sickness, and accidents, also threaten the unwary traveler. In the event of illness or injury, Americans may find medical facilities unfamiliar and less well equipped than those in the United States. Utilizing both an individualized risk assessment for each traveler and readily available references, physicians, in partnership with local public health agencies, can develop comprehensive preventive health plans for their patients traveling to Mexico.

Diarrhea↗
PubMed1985

Palm oil and pyrantel as child nutrition mass interventions in Papua New Guinea.

Two mass interventions in the local low energy-density diet were evaluated for safety, acceptability and nutritional efficacy in a four-group matched study of 896 Papua New Guinea children aged 12-54 months. A single dose of 125 mg of pyrantel pamoate and an 800 mg supply of red palm oil were given monthly at the regular child health clinics. Both were safe and highly accepted. Children given palm oil gained more weight than controls (P less than .05) in the first three study months, confirming a pilot study. However, weight gain after one year was 94% of standard, with no differences in anthropometry, morbidity or mortality between groups. The lack of demonstrable differences at one year is attributed to secular improvement in control group nutrition and to diffusion of palm oil supplies within the family. While pyrantel was an effective antihelminthic, further study is needed to define the nutritional role of mass worm treatment. Palm oil was economical and culturally popular; thus it should be an ideal import substitution. It is clinically useful where diets are of low energy-density. However, any simultaneous demonstration of its nutritional safety, acceptability as a sustained mass intervention must be carried out in an area where major child growth deficits remain and expropriation of the oil by other household members can be controlled.

Anthropometry↗
PubMed1984

US abundance of physicians and international health.

American clinicians with careers encompassing both Third World and underserved American populations would benefit both regions and bring new perspectives to foreign policy and domestic health care problems. Application of the parallel concepts of Community-Oriented Primary Care and Health for All should help contain costs and extend access to appropriate clinical care both in the United States and abroad. As American physicians weigh their short- or long-term career options in the post-Graduate Medical Education National Advisory Council era, there is an urgent need both for a specific US policy on international health and for new partnerships to facilitate careers spanning domestic and Third World areas of need.

Community Health Services↗
PubMed1984

Determining Mycobacterium tuberculosis infection in high prevalence groups: a comparative study among Nigerian adults.

In populations where both tuberculosis and strong sensitization to nontuberculous mycobacteria are common, determining the proportion infected with M. tuberculosis is difficult. We skin tested 488 unvaccinated young Nigerian workers, typical of tropical populations having high prevalences of tuberculosis, with 4 low-dose Mantoux tests (PPD-RT-23, PPD-Tuberculin, PPD-Battey, and PPD-Gause) and with concentrated (2 mg/ml) PPD by the Heaf multiple-puncture method. Reactions (greater than or equal to 2 mm) to all 4 Mantoux sensitins (elicitins) unexpectedly were normal in distribution; however, the midpoint values (13 mm) of the RT-23 and PPD-T distributions were lower than the midpoints typically seen in groups of tuberculosis patients. Established methods for estimating the proportion tuberculous-infected (cutting point, dual-test, and curve-reconstruction) yielded a wide range, 32%-62%. Combining the 3 methods provided consistent estimates near 50%, despite interference due to strong sensitivity to PPD-B and especially to PPD-G in 80%-90%. PPD-T correlated well with RT-23 (r = .84), yet more closely resembled published PPD-S reaction distributions than did RT-23. All diagnostic-accuracy measures for the Heaf test, considering only grades 3 and 4 positive, exceeded 80%.

Adolescent↗
PubMed1983

Clinical epidemiology of tuberculosis in the Papua New Guinea Highlands.

In the Papua New Guinea Highlands, tuberculosis has an epidemiological setting unique in the developing world. Mycobacterium tuberculosis is slowly infiltrating a susceptible, formerly isolated population. Because of this unique situation, commonly-recommended standard programmes must be rationally, sometimes radically, altered if case finding is to be epidemiologically efficient.

Adolescent↗