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Biomedical subjects

H F Hull

Publications and source records attributed to H F Hull.

At least 55 records · Page 3Linked to original sources
PubMed1989

Cryptosporidiosis and surface water.

In the period July through October, 1986, 78 laboratory-confirmed cases of cryptosporidiosis were identified in New Mexico. To determine possible risk factors for development of this disease, we conducted a case-control study; 24 case-patients and 46 neighborhood controls were interviewed. Seventeen (71 per cent) of the 24 case-patients were females, seven (29%) were males; their ages ranged from 4 months to 44 years, median 3 years. There was a strong association between drinking surface water and illness: five of the 24 case-patients, but none of the 46 controls drank untreated surface water. Among children, illness was also associated with attending a day care center where other children were ill (odds ratio = 13.1).

Adolescent↗
PubMed1989

Injury mortality in New Mexico's American Indians, Hispanics, and non-Hispanic whites, 1958 to 1982.

New Mexico has extraordinarily high injury mortality rates. To better characterize the injury problem in New Mexico, we calculated proportionate injury mortality and age-adjusted and age-specific injury mortality rates for the state's 3 major ethnic groups--American Indians, Hispanics, and non-Hispanic whites. According to death certificate data collected from 1958 to 1982 and US population census figures, age-adjusted mortality rates for total external causes varied widely between the sexes and among the ethnic groups. Males in each ethnic group consistently had higher average annual age-adjusted external mortality rates than females. Injury mortality rates for American Indians of both sexes were 2 to 3 times higher than those for the other New Mexico ethnic groups. Motor vehicle crashes were the leading cause of death from injury for all 3 groups. Homicide accounted for twice the proportion of injury death in Hispanic compared with non-Hispanic white males (12.5% and 6.1%, respectively), while the proportion of males dying of suicide was highest in non-Hispanic whites. Deaths from excessive cold and exposure were leading causes of injury mortality for American Indians, but these causes were not among the leading causes of injury mortality for Hispanics or non-Hispanic whites. We conclude that the minority populations in New Mexico are at high risk for injury-related death and that the major causes of injury mortality vary substantially in the state's predominant ethnic populations.

Adolescent↗
PubMed1988

Comparison of HIV-antibody prevalence in patients consenting to and declining HIV-antibody testing in an STD clinic.

All patients attending a sexually transmitted disease (STD) clinic were offered voluntary, anonymous human immunodeficiency virus (HIV)-antibody testing and counseling as part of routine clinical evaluation. During a three-month evaluation period, 82% of patients accepted HIV testing. Testing was accepted equally by men and women and by heterosexual and homosexual men. Black men were more likely to refuse testing than men from other ethnic groups. Eight (0.7%) of 1146 STD clinic patients tested were infected with HIV. A blinded study of 237 patients who refused testing identified nine (3.8%) additional HIV-infected patients. Men who refused testing were 5.3 times more likely to be infected than men who accepted testing. Male homosexuals and black and Hispanic men who refused testing were 7.3 and 8.8 times, respectively, more likely to be infected with HIV than were their counterparts who accepted testing. Human immunodeficiency virus testing and counseling should be routinely offered to STD clinic patients. Male STD clinic patients, especially homosexual or minority men, who refuse voluntary HIV testing should be counseled regarding reducing their risk for HIV transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Feline plague in New Mexico: risk factors and transmission to humans.

The epidemiologic features of 60 cases of feline plague from 1977-1985 in New Mexico are reviewed. The most frequent clinical presentation was lethargy, anorexia, fever, and enlarged lymph nodes or abscesses. A history of hunting rodents was reported in 75 per cent of all cases. Five human plague cases were associated with five feline cases. Recommendations are presented for prevention of plague infection and transmission to humans, including restraining cats from roaming and hunting by neutering and keeping them indoors, treating them for fleas, and seeking medical care for febrile illnesses, especially when accompanied by enlarged lymph nodes.

Animals↗
PubMed1987

Acquired immunodeficiency syndrome in low-incidence areas. How safe is unsafe sex?

Serum specimens from the cohort of persons who attended sexually transmitted disease clinics in New Mexico during a two-month period were tested for human immunodeficiency virus (HIV) antibody. Twenty-seven (2.0%) of 1374 serum specimens had repeatedly low-positive reactions by enzyme-linked immunosorbent assay testing, and 22 (1.6%) had repeatedly high-positive reactions. All sera (sufficient for testing by Western blot) with low-positive reactions gave negative results, and all sera (sufficient for testing by Western blot) with high-positive reactions gave positive results. All persons whose serum had high-positive reactions were male. Most (86%) had been seen at the only urban sexually transmitted disease clinic in New Mexico, and most (72%) were openly gay or bisexual. Of all gay and bisexual men evaluated, 14% (16/112) had high-positive reactions. Rapid plasma reagin positivity was significantly associated with HIV enzyme-linked immunosorbent assay low (false) positivity. The relatively high rate of HIV seropositivity among gay men with other sexually transmitted diseases indicates that transmission of acquired immunodeficiency syndrome is continuing in this low-incidence area and documents the need for testing and counseling programs in sexually transmitted disease clinics.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Septicemic plague in New Mexico.

Eighteen of the 71 cases of plague reported in New Mexico from 1980 to 1984 were septicemic. We reviewed these cases to better describe the clinical presentation of this disorder and to identify risk factors for developing septicemic plague. The symptoms (fever, chills, malaise, headache, and gastrointestinal symptoms) and signs (tachycardia, tachypnea, and hypotension) of septicemic plague are similar to those of other forms of gram-negative septicemia. Abdominal pain was reported in nearly half of the cases, and differential white blood cell counts revealed a marked shift to the left. The risk of developing septicemic plague was higher for persons greater than 40 years of age. Because of empirical antibiotic treatment of older persons, deaths from septicemic plague occurred primarily among persons less than 30 years old. Deaths from septicemic plague could be reduced by aggressive antibiotic therapy for patients with a clinical presentation suggesting gram-negative septicemia, especially patients less than 30 years old.

Adult↗
PubMed1986

Haemophilus influenzae b polysaccharide vaccine. Physician acceptance and use of a new vaccine.

The introduction of Haemophilus Influenzae type b (Hib) polysaccharide vaccine in 1985 provided an opportunity to study the extent to which physicians have adopted the use of the new vaccine in their routine practice behavior, the factors that predict Hib vaccine use by physicians, and how physicians have chosen to deal with differing recommendations for its administration. We surveyed all physicians providing primary care to children in New Mexico six to eight months after vaccine licensure to assess their knowledge of existing recommendations and their current behavior regarding use of the Hib vaccine. Of the 369 primary care physicians who responded, 100% of pediatricians, 98% of family practitioners, and 91% of general practitioners were aware that a vaccine against invasive Hib disease had been licensed. Sixty-three percent of physicians surveyed were currently using the vaccine. Vaccine usage varied significantly by specialty, with 86% of pediatricians reporting use compared with 61% of family practitioners and 31% of general practitioners. Physicians were significantly more likely to use Hib vaccine if they were young and if they worked in the private sector rather than the public sector. The three sets of recommendations for Hib vaccine use had been widely read; 85% of respondents had read at least one set. Practitioners confronted with differing recommendations had elected to give the vaccine permissively within existing guidelines. Our findings suggest that practitioners have adapted quickly to the introduction of Hib vaccine but that nonuse of the vaccine in the public sector remains an obstacle to full implementation of this prevention strategy.

Attitude of Health Personnel↗
PubMed1986

Plague.

Explore the source record for details and available documents.

Humans↗
PubMed1986

Child restraint law effects on motor vehicle accident fatalities and injuries: the New Mexico experience.

The New Mexico State Legislature passed a child restraint law applicable to children less than 5 years of age that became effective in June 1983. To evaluate the effectiveness of this law, we analyzed traffic accident data for New Mexico from January 1981 through September 1984. During this period, there were 20,972 children younger than 5 years of age in motor vehicle accidents. Restraint usage increased for this age group from a low of about 10% in 1981 to more than 40% in 1984 (P less than 10(-6)). Unrestrained children younger than 5 years of age were five times more likely to be killed and two times more likely to be injured than restrained children. Analysis of motor vehicle accident fatality and injury rates pre- and post-law revealed a 33% reduction in motor vehicle accident fatality rates and a 12.6% reduction in nonfatal injury rates for children younger than 5 years. We conclude that child restraint devices are effective in reducing motor vehicle accident fatalities and injuries in young children and the child restraint law has been effective in increasing child restraint usage and in reducing childhood death and injury in New Mexico.

Accidents, Traffic↗
PubMed1986

Plague masquerading as gastrointestinal illness.

In clinical descriptions of human plague, fever and tender lymphadenitis are emphasized and gastrointestinal manifestations are rarely mentioned. A review of 71 human plague cases showed that gastrointestinal symptoms occurred commonly (57%). Vomiting (39%) was the most frequent symptom, with nausea (34%), diarrhea (28%) and abdominal pain (17%) occurring less often. Physicians treating patients who reside in or have recently visited plague-endemic areas should include plague in the differential diagnosis in the presence of gastrointestinal symptoms and fever.

Adolescent↗
PubMed1985

Incidence of hepatitis B in the penitentiary of New Mexico.

A study was conducted to determine the incidence of hepatitis B (HB) in a prison population. Forty-seven per cent of 455 male prisoners had evidence of past HB infection. HB seropositivity was most strongly correlated with: 1) a history of IV drug abuse; 2) age; 3) total time in any prison; and 4) race. During a one-year study period there were no clinical cases of HB in the prison and the seroconversion rate was 0.8 per cent among prisoners still incarcerated.

Adolescent↗
PubMed1985

Cost-effectiveness of immunization in The Gambia.

Cost-effectiveness studies were carried out in The Gambia to estimate costs of preventing childhood morbidity and mortality through immunization. For the four priority diseases--neonatal tetanus, pertussis, measles and poliomyelitis--costs per case prevented ranged from $1.30 for pertussis to $655.54 for poliomyelitis. In terms of preventing childhood deaths through immunization, measles at $40.83 per death prevented, pertussis at $99.85 per death prevented and neonatal tetanus at $152.53 per death prevented were most cost-effective. For developing countries, immunization is an efficient use of limited health resources.

Adolescent↗
PubMed1985

Risk factors for measles vaccine failure among immunized students.

An outbreak of measles occurred in a municipal school system which had reported 98% of students immunized against measles. A case-control study was conducted to determine reasons for vaccine failure. Vaccine failure was associated with immunizations that could not be documented in the provider's records. Among children with provider-documented immunization, vaccine failure was associated with vaccination at 12 to 14 months of age with an odds ratio of 4.73. Among children vaccinated at 15 months or older, vaccine failure was not associated with time elapsed since vaccination. Studies should be conducted to determine whether unreliable immunization records are a more widespread problem. Further consideration should be given to routine revaccination of children previously vaccinated at 12 to 14 months of age.

Adolescent↗