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Biomedical subjects

D E Snider

Publications and source records attributed to D E Snider.

At least 127 records · Page 7Linked to original sources
PubMed1976

A continuing survey of primary drug resistance in tuberculosis, 1961 to 1968. A U.S. Public Health Service cooperative study.

From 1961 through 1968 the incidence of primary drug resistance was monitored among patients admitted to 22 participating hospitals. The patients were believed to have newly diagnosed, previously untreated, bacteriologically proved pulmonary tuberculosis. During the study period the level of primary resistance to isoniazid, streptomycin, and para-aminosalicylic acid remained very low; there was no indication that primary resistance to these drugs was increasing. Investigation of patient histories revealed that a significant proportion of persons initially believed to have been previously untreated actually had received prior chemotherapy. Resistance rates to both isoniazid and streptomycin were significantly higher among younger patients than among older patients. No relationship was found between race or sex and primary resistance rates. The low incidence of drug resistance found in this survey suggests that disease caused by virulent resistant organisms occurs infrequently.

Adult↗
PubMed1976

Aspirin effects on lymphocyte cyclic AMP levels in normal human subjects.

In purified lymphocytes from the peripheral blood of healthy human subjects who had ingested therapeutic doses of aspirin, there was a significant decrease in resting cyclic AMP levels as well as a partial inhibition of the rise in cyclic AMP with isoproterenol or prostaglandin E1. These changes were seen as early as 30 min after aspirin ingestion and did not appear to result from aspirin effects on lymphocyte recovery, purity, viability, or relative number of thymus- or bone marrow-derived lymphocytes. In contrast, the direct addition of aspirin to suspensions of purified peripheral lymphocytes did not significantly alter their cyclic AMP levels. However, an effect of aspirin could be obtained in vitro if aspirin was added to unprocessed whole blood during the dextran sedimentation phase of the cell purification. Thus the effect of aspirin on lymphocyte cyclic AMP metabolism, may be indirect, through other cells present in the peripheral blood.

Aspirin↗
PubMed1975

Extrapulmonary tuberculosis in Oklahoma, 1965 to 1973.

Three hundred seventy cases of extrapulmonary tuberculosis were reported to the Oklahoma State Department of Health between January 1, 1965 and December 31, 1973. The annual number of cases reported showed no tendency to decrease with time. A greater proportion of cases reported in recent years had bacteriologic confirmation. When compared to the distribution of all newly diagnosed cases of tuberculosis in the population, a greater proportion of newly diagnosed cases of extrapulmonary tuberculosis occurred in nonwhites. This was especially true to tuberculous meningitis, tuberculous lymphadenitis, and miliary tuberculosis. Possible reasons for the failure of the number of newly reported cases of extrapulmonary tuberculosis to decrease in recent years are presented.

Adolescent↗
PubMed1975

Skin testing: a comparison of the jet injector with the Mantoux method.

Employees in a large industry in Baltimore were tested with 5 TU of purified protein derivative (PPD)-S and PPD-B using both jet injector and Mantoux methods. Wheal sizes tended to be larger among men than women and larger among blacks than whites, regardless of the technique used. Within any given race-sex group, and also within subjects, considerable systematic and nonsystematic variations in wheal size occurred when the jet injector was used. On the contrary, there was little variation in wheal size within race-sex groups when the Mantoux method was used. Mean wheal sizes elicited with the jet injector tended to be smaller than those elicited with the Mantoux method. There were also considerable differences in the reactions elicited by the 2 techniques. The Mantoux method elicited more and larger reactions than the jet injector, which suggests that the 2 injections are in some way qualitatively or quantitatively different. For jet injector tests, the frequency of reactions of different size tended to be related to the size of the wheal measured immediately after injection. This was not true for the Mantoux method. On the basis of these findings, it is suggested that the jet injector method is inferior to the Mantoux method in tuberculin skin testing.

Child↗
PubMed1975

Reactivation of tuberculosis in Oklahoma: 1970-1973.

The medical records of 53 patients who had reactivation of tuberculosis between 1970 and 1973 in Oklahoma were reviewed. Reactivation accounted for 4 percent of all cases reported in this period. No correlation was found between race or sex and risk of reactivation. The interval between original diagnosis and reactivation (median 14.0 years) was longer than has been reported in other series but was felt to be an encouraging finding. The most important factor influencing reactivation appeared to be inadequate chemotherapy. Minimal disease appeared to be particulary prone to undertreatment in the past. Patients with reactivation of tuberculosis responded to treatment almost as well as those with a recent diagnosis, as measured by sputum conversion rates. The paucity of patients presenting with reactivated cases after having been adequately treated supports recent recommendations to discharge patients from further followup when treatment is adequate and complete.

Adolescent↗
PubMedDate not supplied

Rifabutin (ansamycin LM 427): a new rifamycin-S derivative for the treatment of mycobacterial diseases.

Rifabutin (ansamycin LM 427), a semisynthetic spiropiperidyl derivative of rifamycin S, shows good in vitro activity against most mycobacterial species, including Mycobacterium avium complex. In animal models, the drug is more active against both Mycobacterium tuberculosis and Mycobacterium leprae than in rifampin, and studies indicate that rifabutin is active against some rifampin-resistant strains of both species. The drug has a long half-life (16 hr) in humans and a marked tissue tropism, with tissue levels five- to 10-fold higher than that in the serum. In animals rifabutin is no more toxic than rifampin. A large experience from the compassionate use of rifabutin for life-threatening mycobacterial infections in humans, most commonly disseminated M. avium complex disease in patients with AIDS, has also indicated relative drug safety. Although some data suggest that rifabutin is effective, firm conclusions about drug efficacy await results from controlled clinical trials.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Isoniazid hepatitis among pregnant and postpartum Hispanic patients.

On request of local health officials, the authors investigated isoniazid (INH) hepatitis morbidity and mortality among patients attending an Hispanic prenatal clinic. Among 3,681 women treated with INH during and after pregnancy to prevent tuberculosis (TB), 5 developed INH hepatitis, and 2 of the 5 women died. Comparison with previously collected Public Health Service data concerning 3,948 nonpregnant women, using the Cox proportional hazards model, revealed a 2.5-fold increased risk of INH hepatitis in the prenatal clinic group. The mortality rate was four times higher in the prenatal clinic group. However, statistical power was low because of the small number of cases, and neither of these findings was statistically significant (P greater than 0.05). In the absence of controlled studies, the issue of INH safety during the perinatal period remains unresolved. Nevertheless, current American Thoracic Society-Centers for Disease Control recommendations regarding TB screening, implementation of INH chemoprophylaxis programs, and adequate monitoring of individuals on INH should be adhered to. The results of this investigation raise concern that deviations from existing policy may contribute to unnecessary morbidity and mortality.

Adolescent↗
PubMedDate not supplied

Tuberculosis: an increasing problem among minorities in the United States.

Although the number of tuberculosis cases reported annually in the United States has decreased markedly during the past three and a half decades, the decrease among whites has been considerably greater than among nonwhites. As a result of this widening gap, nearly two-thirds of the cases reported in 1987 occurred in minority populations and, for the first time in history, the number of cases among blacks exceeded the number of cases among non-Hispanic whites. From 1985 to 1987, tuberculosis among blacks increased 6.3 percent and among Hispanics, by 12.7 percent, but it decreased 4.8 percent among non-Hispanic whites. Much of the increase appears attributable to tuberculosis occurring among persons infected with the human immunodeficiency virus (HIV). Although there are many obstacles to the elimination of the disease in minority populations, numerous strategies have been developed and are being implemented to address this situation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The need for epidemic intelligence.

The past decade has witnessed an unprecedented upturn in tuberculosis morbidity and outbreaks of difficult- to-treat and highly lethal multidrug-resistant tuberculosis. In the early 1990s, a national consensus developed among public health officials to define more comprehensively the problem, and in January 1993, expanded tuberculosis surveillance was implemented nationwide. Carefully selected epidemiologic and case management variables were added to the Report of Verified Case of Tuberculosis form. Information is collected on the health status and treatment of patients, including human immunodeficiency virus status, drug susceptibility test results, and the initial drug regimen. Completion of therapy and use of directly observed therapy are also monitored. The new surveillance system allows a comparison of the quality of care of patients in the public and private sectors. Additional epidemiologic variables include membership in high-risk groups (the homeless, residents of correctional or long-term care facilities, migrant workers, health care workers, and correctional employees) and substance abuse (injecting drug use, non-injecting drug use, and excess alcohol use). The additional information derived from expanded tuberculosis surveillance is crucial to optimal patient management, policy development, resource allocation, as well as program planning, implementation, and evaluation at Federal, State, and local levels.

AIDS-Related Opportunistic Infections↗