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Biomedical subjects

G R Istre

Publications and source records attributed to G R Istre.

At least 37 records · Page 2Linked to original sources
PubMed1990

Syphilis, human immunodeficiency virus infection, and targeting prevention.

To examine the interaction between syphilis and human immunodeficiency virus-type 1 (HIV-1) infection in Oklahoma, we conducted an unlinked HIV seroprevalence survey using serum specimens submitted to the Oklahoma State Department of Health for serologic test for syphilis. Of specimens with positive results from fluorescent treponemal antibody absorption test (FTA-ABS), 6.3% were HIV-1 seropositive compared to 0.8% of those that had negative results from FTA-ABS. Among specimens positive for syphilis, HIV-1 seropositivity was found almost exclusively among those from persons 20 to 39 years of age and more often among those from men than those from women (9.9% vs 1.3%). Of syphilis-positive specimens from 20- to 39-year-old men, 17.6% were HIV-1 seropositive. In Oklahoma, an area with a relatively low overall prevalence of HIV-1 infection, targeting prevention efforts to young adults who test positive for syphilis should be an efficient way to reach some persons at high risk for HIV-1 infection.

AIDS Serodiagnosis↗
PubMed1990

Epidemiologic and clinical characteristics of persons with serologic evidence of E. canis infection.

The results of a serosurvey of Oklahomans for the presence of antibody to Ehrlichia canis is reported. Paired serum specimens, from patients lacking the serologic criteria for diagnosis of Rocky Mountain spotted fever (RMSF), were tested. A four-fold increase in E. canis-IFA antibody was found in 16/144 (11 percent) of these paired serum samples. Patients with serologic evidence of E. canis infection had a mean age of 34 years, 69 percent were male, and 63 percent lived in a town less than 10,000 population. Signs and symptoms included: fever 94 percent, headache 94 percent, fatigue 94 percent, anorexia 81 percent, nausea 60 percent, and rash 44 percent. When compared to control patients, whose sera were submitted for RMSF testing but did not meet serologic criteria for RMSF or E. canis, case-patients were more likely to have had leukopenia (OR = 4.9, 95 percent Cl = 1.2, 19.0) and tick exposure (OR = 9.5, 95 percent Cl = 1.4, 62.7). The results suggest E. canis, or a closely related agent, is a cause of human illness. Ticks are probable vector.

Adult↗
PubMed1989

Fatal injuries in Oklahoma: descriptive epidemiology using Medical Examiner data.

To characterize mortality associated with injuries and other health problems in Oklahoma, we examined data from the Office of the Chief Medical Examiner of the State of Oklahoma for the years 1978 through 1984. Each year, approximately 1,500 and 800 deaths resulted from unintentional injury (UI) and intentional injury (ie, suicide and homicide), respectively. The medical examiner (ME) data differed substantially from the state's vital statistics (VS); over the seven years, the ME records showed 2,021 (16%) fewer UI deaths than did the VS, as well as 24 (1%) more cases of suicide and 499 (23%) more cases of homicide. Rates for UI and suicide were highest for young adults and for the elderly; in contrast, rates for homicide were highest for young adults, and then decreased with age. For each of the three categories of injury-related deaths, rates for male subjects were approximately three times those for female subjects; rates also varied by race-ethnic group. Deaths due to UI and homicide occurred more often in the summer and on weekends, though suicides did not vary by month and were slightly more common on weekdays. This study indicates that ME data represent an important source of epidemiologic information for the surveillance and study of injury-related mortality.

Adolescent↗
PubMed1989

Outbreaks of hepatitis A among illicit drug users, Oklahoma, 1984-87.

Transmission of hepatitis A has been described in many settings, although few outbreaks have been reported among illicit drug users. We report six unrelated outbreaks of hepatitis A among users of marijuana and intravenously administered methamphetamine. Although the exact mode of transmission could not be determined, practices associated with illicit drug use may have facilitated transmission of hepatitis A. These outbreaks and other recent information indicate that illicit drug users may be at increased risk of acquiring hepatitis A infection.

Adolescent↗
PubMed1988

Characteristics of fatal gunshot wounds in the home in Oklahoma: 1982-1983.

Children are a unique group at risk of injury from firearms because of their immaturity, curiosity, and imitative behavior. All unintentional firearm deaths in persons younger than age 20 years that occurred in Oklahoma in 1982 and 1983 were reviewed. There were 32 unintentional deaths from firearms in children from birth to age 19 years. The death rate in rural counties was four times that of urban counties. Twenty-seven deaths (85%) occurred at home, with an adult present in only two cases. The home death rate for males was 5.2 times that of females, with 15- to 19-year-old males most at risk. The rates among whites and Native Americans were similar, at 1.5 and 1.2 per 100,000, respectively, with no deaths among the black population. This review concurs with previous studies that firearms are a significant cause of mortality in the pediatric age group. Counseling parents about the hazards of firearms may prevent deaths through better supervision and more responsible gun care and storage.

Accidents, Home↗
PubMed1988

The epidemiology of Rocky Mountain spotted fever in Arkansas, Oklahoma, and Texas, 1981 through 1985.

From 1981 through 1985, a total of 851 laboratory-confirmed cases of Rocky Mountain spotted fever were reported in Arkansas, Oklahoma, and Texas. Annual incidence rates in each state increased from 1981 through 1983, ranging from a 17% increase in Arkansas to a 137% increase in Texas. In the period 1984 through 1985, the annual incidence rates in each state decreased over 50%. A total of 519 cases were males. A majority of cases (51%) were 19 years of age or younger. April through August were the months of onset of symptoms for 83% of the cases. Differences in distribution of month of onset of symptoms were noted when comparing age groups and state of residence of the cases. The case-fatality ratio was 4.7%. Case-fatality ratios were higher in blacks and in older age groups. An endemic focus of Rocky Mountain spotted fever exists in Arkansas, Oklahoma, and Texas. The annual incidence trend for spotted fever in these three states is dissimilar to the trends in other states.

Adolescent↗
PubMed1987

Salmonella newport infections transmitted by fiberoptic colonoscopy.

During a 2-week period following the colonoscopy and biopsy of a patient with acute Salmonella newport gastroenteritis, S. newport was recovered from colonic aspirates or fecal specimens of eight of 28 patients from whom specimens were cultured during or after colonoscopy. Two of the eight persons from whom S. newport was isolated developed acute gastroenteritis, two had asymptomatic infections, and four had positive aspirates collected through a colonoscope but did not become infected. Although S. newport was never recovered from the four colonoscopes used during the outbreak, cultures of one of the colonic biopsy forceps grew S. newport. Contamination of the equipment most likely occurred during colonoscopy of the index patient. Inadequate disinfection of the equipment allowed the organism to survive and possibly to cross-contaminate other colonoscopes, and the organism was then transmitted to other patients by use of the contaminated colonoscopes or the contaminated biopsy forceps. Implemented control measures terminated the outbreak.

Adult↗
PubMed1987

Transmission of invasive Haemophilus influenzae type b disease in day care settings.

We prospectively studied the risk of secondary transmission of invasive Haemophilus influenzae type b (Hib) disease among children in day care in Oklahoma. We established a statewide surveillance system for the reporting of all forms of invasive Hib disease from physicians, clinical laboratories, county health departments, and infection control practitioners from all hospitals in and bordering Oklahoma. For the 2-year period March 15, 1984, to March 15, 1986, there were 409 culture-confirmed cases of invasive Hib disease in children 12 years of age or younger; 147 (37%) case-patients attended day care. When a case-patient attended day care during the week before illness, we prospectively identified and observed all classroom contacts (n = 2147) for the next 60 days. Of 1253 classroom contacts younger than 4 years of age, seven (0.6%) secondary cases were identified. Isolates from all paired index and secondary cases had identical outer membrane protein (OMP) patterns. Strains causing primary disease were indistinguishable by OMP distribution from those causing secondary disease. Of 685 classroom contacts younger than 2 years of age from whom rifampin use was ascertained, five (1.7%) of 292 who did not receive rifampin became secondary cases, compared with one (0.3%) of 393 who received rifampin (rate ratio 6.7; 95% confidence limits 1.1, 42.5; P less than 0.05). Of 495 classroom contacts 24 to 47 months of age for whom rifampin use was ascertained, one (0.5%) of 194 who did not receive rifampin became a secondary case, compared with none of 301 who received rifampin. This experience indicates that secondary transmission of invasive Hib disease can be appreciable in day care settings, particularly in children younger than 2 years of age, and that rifampin prophylaxis reduces this risk.

Child↗
PubMed1987

Invasive disease due to Streptococcus pneumoniae in an area with a high rate of relative penicillin resistance.

During 1984 we conducted a population-based survey of culture-confirmed invasive disease due to Streptococcus pneumoniae among persons who lived in the Oklahoma City, Oklahoma, metropolitan area (population, 846,000) through the 20 clinical laboratories in the area. There were 139 residents identified with invasive pneumococcal disease (11 with meningitis and 128 with other bacteremic infections), for an infection rate of 16.4 per 100,000 population (meningitis, 1.3 cases per 100,000; other bacteremias, 15.1 cases per 100,000). Cases peaked in January-May and December (75% of cases). Rates were highest among infants less than 12 months old (97 cases per 100,000) and persons greater than or equal to 80 years old (87 cases per 100,000). Seventeen (12.2%) of the pneumococcal isolates were relatively penicillin resistant. These isolates were most prevalent among elderly persons greater than or equal to 70 years old (six [17.6%] of 34) and young children 0-4 years old (7 [15.9%] of 44) compared with persons 5-69 years old (four [6.6%] of 61).

Adolescent↗