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Biomedical subjects

R L Black

Publications and source records attributed to R L Black.

8 recordsLinked to original sources
PubMed1999

Tuberculosis prevention in methadone maintenance clinics. Effectiveness and cost-effectiveness.

To determine the effectiveness and cost-effectiveness of a program to provide screening for tuberculosis infection and directly observed preventive therapy (DOPT) in methadone maintenance clinics, we determined completion rates of screening for tuberculosis infection, medical evaluation, and preventive therapy, as well as the number of active tuberculosis cases and tuberculosis-related deaths prevented, in five clinics in San Francisco, California. Between 1990 and 1995, a total of 2,689 clients (of whom 18% were HIV-seropositive) were screened at least once. Of eligible clients, 99% received tuberculin skin tests, 96% received a medical examination, 91% began isoniazid preventive therapy, and 82% completed preventive therapy. Program effectiveness was enhanced by close collaboration between public health and methadone maintenance programs and the use of incentives and enablers. Over a 3-yr follow-up period, only one verified case of tuberculosis was reported among clients with a positive tuberculin skin test, thereby preventing as much as 95% of expected tuberculosis cases. Over 10 yr, we estimate the program would prevent 30.0 (52%) of 57.7 expected cases of tuberculosis, and 7.6 (57%) of 13.4 expected tuberculosis-related deaths. The program cost $771,569, but averted an estimated $876,229, for a net savings of $104,660 (average of $3, 724 per case prevented). Our study demonstrates that when effectively implemented, screening for tuberculosis infection and DOPT in methadone maintenance clinics is a highly cost-effective approach to prevent tuberculosis.

AIDS-Related Opportunistic Infections↗
PubMed1991

Ocular manifestations of thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura is a serious and uncommon disease of hemostasis. Severe disturbances in both blood components and chemistry may cause marked changes both systemically and in ocular tissues. Ocular manifestations include retinal and vitreal hemorrhage, retinal detachment, papilledema, and disc neovascularization. Management of mild cases is limited to supportive therapy and monitoring changes in the fundus. In advanced cases, photocoagulation, vitrectomy, and retinal reattachment surgery may be necessary. This article reviews the effects of this relatively rare blood disorder on the visual system.

Adult↗
PubMed1990

Treatment of chalazia with intralesional triamcinolone injection.

Chalazia are commonly encountered lesions of the eyelids. They often resolve spontaneously or respond to a conservative therapeutic regimen. Chalazia not responding to this type of treatment are often referred for surgical extirpation. This article presents an alternative to surgery, namely intralesional injection of a synthetic glucocorticoid. Reports show a high success rate with few complications using this procedure. A patient with chronic bilateral chalazia was given intralesional injections after conservative therapy was unsuccessful. Two corticosteroid injections produced complete resolution of the lesions.

Follow-Up Studies↗
PubMed1981

External laryngeal trauma.

Fifteen cases of external laryngeal trauma treated at the Princess Alexandra Hospital, Brisbane, over a two-year period are reported. It is suggested the diagnosis may often be overlooked and the extent of injury may be underestimated. Surgical intervention was necessary in nine cases. A more positive approach to the management of external laryngeal trauma with an emphasis on earlier surgical treatment if certain criteria are met, is recommended.

Airway Obstruction↗
PubMedDate not supplied

California's use of health statistics in child health planning.

The California Health Plan for Children, 1979, compiled by the Committee on Health Planning of California, District IX of the American Academy of Pediatrics, is an extensive report on health problems unique to the children of California. Since its publication, many local and state health agencies have been using it as a guide and source of data in their planning efforts for child and youth health. The creation of the plan demonstrated a successful working relationship between health care practitioners and biostatisticians, the acceptance by health professionals of the use of health statistics in planning, the different uses of health statistics in formulating recommendations, and an approach to organizing and summarizing large bodies of data. Nevertheless, our experience indicates that although collection systems for data on population, mortality, natality, morbidity, and health services statistics abound, their use in community health planning for subpopulations is still limited by problems in the definition, validity, and completeness of the data elements. The establishment of an individualized data system for the entire population, to be developed, coordinated, and controlled by one central agency, could be a significant step toward solving these long-standing problems in our data systems.

Adolescent↗