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Biomedical subjects

S Safyer

Publications and source records attributed to S Safyer.

8 recordsLinked to original sources

Early postoperative angiographic assessment of radial grafts used for coronary artery bypass grafting.

UNLABELLED: Despite a revival of interest in using the radial artery as an alternative conduit for myocardial revascularization, little angiographic documentation of early postoperative results has been presented, particularly in North America. Accordingly, 60 of 150 patients who underwent coronary artery bypass with radial arteries from November 1993 to July 1995 have had postoperative cardiac catheterization at our institution. The patency rate of the radial artery grafts was 95.7% (90 of 94 grafts patent) with an average internal diameter of 2.51 mm. Four radial artery grafts showed diffuse narrowing. The patency rate of the internal thoracic artery grafts was 100% with an average internal diameter of 2.25 mm. Three of 62 grafts demonstrated diffuse narrowing. Two of 24 (7.7%) saphenous vein grafts were occluded; the average internal diameter was 3.23 mm. The internal thoracic artery, the radial artery, and saphenous vein grafts were, respectively, 7.5%, 19.5%, and 53.3% larger than the anastomosed native coronary arteries. Graft-dependent flow was found in 81.1% of the radial artery grafts. CONCLUSION: The results of this study demonstrate that the short-term patency rate of radial artery grafts is excellent.

Adult↗

Human immunodeficiency virus infection care is unavailable to inmates on release from jail.

BACKGROUND: The human immunodeficiency virus (HIV) seroprevalence in urban jails is higher than that in the general community. METHODS: We interviewed a cohort of HIV-infected inmates in a jail in New York, NY, during incarceration and after release to assess the accessibility of medical and social services. RESULTS Of the 170 inmates who were interviewed and released into the community, 40 (24%) came to a follow-up interview. Of the 40, 25 (62%) had not received an appointment with an infectious disease clinic by the time of the new interview. Only eight (27%) of the 32 who received zidovudine in jail obtained zidovudine; and only one of the 13 who received isoniazid prophylaxis in jail obtained isoniazid prophylaxis. Twenty (65%) had applied for but not yet received Medicaid. CONCLUSION: Inmates infected with HIV may encounter difficulties obtaining medical care and social services on release into the community, which can potentially lead to active infectious tuberculosis. Family physicians may encounter HIV-positive patients who are newly released from jail and who need follow-up medical care, and they must help address the needs of HIV-positive, formerly incarcerated people.

AIDS-Related Opportunistic Infections↗

Abnormal chest x-rays in intravenous drug users: implications for tuberculosis screening programs.

OBJECTIVES: The purpose of the study was to (1) determine the prevalence of significant abnormalities in routine chest x-rays used to screen for pulmonary tuberculosis in intravenous drug users and (2) evaluate the ability of the purified protein derivative skin test to identify persons with such abnormalities. METHODS: We conducted a cross-sectional screening study on 1314 persons admitted to an opiate detoxification unit in an urban jail. Purified protein derivative tuberculin reactivity and the prevalence of abnormalities consistent with tuberculosis on screening chest x-rays were evaluated. The chest x-ray was obtained independent of the skin test. RESULTS: The chest x-rays of 73 of the inmates (5.6%) showed abnormalities consistent with tuberculosis. Tuberculin skin testing missed 17 of 26 chest x-rays (65%) with significant infiltrates. CONCLUSIONS: Purified protein derivative screening is insensitive to chest x-ray abnormalities that require additional diagnostic evaluation for tuberculosis. Routine chest studies should be performed on all intravenous drug users admitted to congregate housing settings.

Adult↗

Anergy compromises screening for tuberculosis in high-risk populations.

Anergy may occur in groups at high risk for tuberculosis, compromising tuberculin skin testing. Within New York City's correctional system, anergy prevalence was 25% among opiate users referred to detoxification programs and 3% in the general population. Correlates of anergy were recent weight loss and needle sharing. The high prevalence of anergy among opiate users compromises the utility of tuberculosis screening and suggests the need for routine chest x-rays to detect pulmonary tuberculosis in some high-risk-populations.

Adult↗

Homelessness and indicators of mental illness among inmates in New York City's correctional system.

Data from three cross-sectional samples of inmates in the New York City correctional system (N = 299, 236, and 151) were analyzed to determine the prevalence of homelessness among detainees. One-fourth to one-third of each sample had been homeless at some time during the two months before arrest, and 20 percent of the primary sample of 299 inmates had been homeless the night before arrest. Further analysis of the primary sample showed that homelessness was strongly associated with mental illness: 50 percent of those who had ever been homeless during the past three years responded positively to at least one mental illness screening question, compared with 25 percent of the never-homeless inmates. More than a third of the ever-homeless group had received mental health treatment, compared with a fifth of those who had never been homeless.

Adult↗

Human papillomavirus, gonorrhea, syphilis, and cervical dysplasia in jailed women.

We assessed the prevalence of human papillomavirus (HPV) by cervicovaginal lavage and Southern blot and inquired about behavioral risk factors for cervical disease and sexually transmitted diseases by interview in 114 female detainees at a large New York City jail. Of the women screened, 8% had abnormal Pap smears, 35% had HPV, 7% had gonorrhea, and 22% had serologic syphilis. Given the high rates of HPV infection and cervical cytology, Pap smears should be a routine intake procedure for incarcerated women.

Adult↗