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Biomedical subjects

H W Haverkos

Publications and source records attributed to H W Haverkos.

At least 73 records · Page 4Linked to original sources

Acquired immunodeficiency syndrome in the United States: an analysis of cases outside high-incidence groups.

From 1 June 1981 through 31 January 1984, 201 cases of the acquired immunodeficiency syndrome were reported involving persons who could not be classified into a group identified to be at increased risk for this syndrome. Thirty-five had received transfusions of single-donor blood components in the 5 years preceding diagnosis of the syndrome and 30 were sexual partners of persons belonging to a high-risk group. Information was incomplete for most remaining patients, but because many of these patients were demographically similar to populations recognized to be at increased risk for the syndrome, previously identified risk factors may have been present but not reported for some of them. Additionally, a few persons who met the case definition for the syndrome probably had other reasons for their opportunistic disease and did not have the acquired immunodeficiency syndrome. The slow emergence of the acquired immunodeficiency syndrome in new populations is consistent with transmission mediated through sexual contact or parenteral exposure to blood.

Acquired Immunodeficiency Syndrome↗

Diagnosis of pneumonitis in immunocompromised patients by open lung biopsy.

The records of 59 immunocompromised patients with fever and pulmonary infiltrates who underwent open lung biopsy, were reviewed. A specific diagnosis was made by lung biopsy in 49 (83%) patients, and in 32 instances (54%) the diagnosis was a treatable infection. Only two (3.4%) false-negative biopsies occurred. Transplant recipients were more likely to have a specific, treatable pneumonia (74%) than patients with a reticuloendothelial malignancy (42%, P less than 0.05). This was due to a greater frequency of bacterial pneumonias, primarily due to Legionella, in transplant recipients (P less than 0.01). However, obtaining a specific diagnosis by lung biopsy did not appear to improve outcome. Seventeen of 32 (53%) patients with treatable infections survived, compared to 8 of 16 (50%) with specific, but untreatable, diagnosis and 6 of 11 (55%) with nondiagnostic biopsies. Advanced age and a low platelet count were predictive of death in both transplant recipients and patients with leukemia and lymphoma (P less than 0.05); a high serum creatinine was an additional predictor in renal transplant recipients.

Adult↗

Unusual causes of death in Haitians residing in Miami. High prevalence of opportunistic infections.

Twenty-one (100%) Haitians and 42 (21.5%) of 192 native black Americans autopsied in a 33-month period at Jackson Memorial Hospital, Miami, were included in this review. All autopsied materials were examined. Among the Haitians autopsied, infectious diseases accounted for 11 (52%) of 21 deaths. Toxoplasma encephalitis was the leading cause of death (five cases). Other infectious causes of death included disseminated cryptococcosis (one), disseminated cytomegalovirus diseases (one), Pneumocystis carinii pneumonia (one), chronic active hepatitis B (two), and bacterial pneumonia (one). Malignant neoplasms were also found to be causes of death and these included a single cases of each of the following: adenocarcinoma of the lung, multiple myeloma, diffuse histiocytic lymphoma, hepatoma, and Kaposi's sarcoma. Deaths of the remaining cases were due to hypertensive cardiovascular diseases (two), rheumatic heart disease (one), glomerulonephritis (one), and intimal fibroplasia of coronary arteries (one). Seven Haitian cases fulfilled the Centers for Disease Control case definition for the acquired immune deficiency syndrome (AIDS). For comparison, autopsies of black Americans were chosen from conditions that would most likely predispose them to opportunistic infections. Among the autopsies on black Americans there were no cases of opportunistic infections or Kaposi's sarcoma that were considered to be consistent with the AIDS.

Acquired Immunodeficiency Syndrome↗

National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results.

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi's sarcoma and pneumocystis pneumonia.

Acquired Immunodeficiency Syndrome↗

Moxalactam therapy. Its use in chronic suppurative otitis media and malignant external otitis.

Moxalactam disodium is a new broad-spectrum antibiotic structurally related to the cephalosporins. Eleven patients with chronic suppurative otitis media with mastoiditis and four patients with malignant external otitis were treated with moxalactam. Pseudomonas aeruginosa was isolated from external ear or mastoid in all patients. Twelve of 15 patients had undergone prior surgical procedures and 11 of 15 had failed recent antibiotic therapy. Three patients with malignant external otitis did not respond to parenteral carboxypenicillin and aminoglycoside therapy. Success rate for chronic suppurative otitis media was 73% as judged by eradication of P aeruginosa and resolution of symptoms 30 days after moxalactam therapy. Two patients with malignant external otitis were cured, and two were unevaluable since they may have died of noninfectious causes. Moxalactam disodium, at a dosage of 9 g/day, may be useful for serious Pseudomonas ear infections, including those refractory to other antibiotic therapy.

Aged↗

Effect of prolonged administration of interferon-alpha on pharmacokinetics, fever, lymphocyte proliferative response, and NK cell activity.

Over a 60-week period, a patient with multiple warts received a total of 281 x 10(6) units of human leukocyte interferon (IFN-alpha) by intramuscular (IM) or intralesional (IL) injections. Circulating IFN was significantly higher following IM administration than after IL administration. These pharmacokinetics did not change. The patient's body temperature was always significantly elevated after administration of IFN. However, hyporeactivity to the febrile response developed when the interval between repeated injections of IFN was less than six days. The lymphocyte count was significantly decreased within 5-7 h after administration of IFN and had returned to normal by 24 hours, whereas total WBC, platelet, and monocyte counts were not altered. There was a depression of specific lymphocyte proliferative response to herpes simplex virus after multiple daily injections, but not after prolonged therapy. Circulating natural killer (NK) levels were not elevated during the first two months of IFN therapy. After the patient had received about 100 x 10(6) units of IFN, however, the NK cell level became elevated and remained elevated upon cessation of treatment. NK activity was stimulated by in vitro incubation of peripheral mononuclear cells with 1000 units of IFN during the initial phase of treatment. A decline of in vitro stimulation of NK activity by interferon developed during two subsequent periods of treatment with mean daily doses of 2.46 and 1.07 x 10(6) units of IFN. Long-term therapy in our patient with an average of 4.7 x 10(6) units of IFN/week was well tolerated, did not irreversibly affect platelet or white cell counts or nonspecific or virus-specific cell mediated immune responses, and enhanced circulating NK levels.

Adult↗

Effects of interferon-alpha on human warts.

Two patients with extensive warts which were stable for two years or more were treated with human interferon-alpha to assess the ability of interferon to affect this benign tumor of viral etiology. Intramuscular administration of 96.6 and 135 million units over 12-15 weeks produced softening and decreased scaling of each patient's warts. Double blind, placebo-controlled intralesional injections resulted in progressive disappearance of interferon treated warts. A dose response relationship was shown in eight warts. The minimum effective dose was 1.2 x 10(6) units injected over 15.5 weeks.

Adult↗

Acupuncture treatment for drug abuse: a technical review.

Conflicting opinions exist regarding the efficacy of acupuncture for the treatment of substance abuse. On October 23, 1991, the National Institute on Drug Abuse (NIDA) sponsored a technical review to discuss this issue. The purpose of the meeting was to review the current status of research regarding acupuncture treatment for drug abuse and to propose directions for future studies. This report represents a summary of the meeting which consisted of presentations by individuals currently involved in acupuncture treatment and discussions by a panel of experts in the field of substance abuse treatment research.

Acupuncture Points↗

AIDS update: prevalence, prevention, and medical management.

This article summarizes the epidemiology of AIDS and human immunodeficiency virus (HIV) infection among intravenous drug abusers (IVDAs) in the United States and discusses the status of approaches to prevent HIV infection and to treat AIDS patients. Finally, the status of research of selected community-based prevention programs, such as needle-exchange programs and programs distributing bleach to IVDAs for needle and syringe cleaning, will be reviewed.

Acquired Immunodeficiency Syndrome↗

Adverse virus-drug interactions.

Over the last 3 decades, epidemiologists and clinicians have identified a few clinical entities that appear to result when a viral infection and a chemical exposure overlap and interact. Ampicillin rash during infectious mononucleosis, Reye's syndrome following salicylate ingestion and certain viral infections, and the association of AIDS-related Kaposi's sarcoma with abuse of nitrite inhalants and infection due to human immunodeficiency virus are examples of such phenomena. Preclinical research provides additional evidence that viruses and chemicals may interact and produce illnesses in animals. We hypothesize that other virus-drug interactions may exist. Identifying such interactions may lead to a better understanding of the pathogenesis of currently baffling illnesses and may provide insights into ways of preventing and/or treating diseases that appear uncontrollable now.

Acquired Immunodeficiency Syndrome↗

Disease manifestation among homosexual men with acquired immunodeficiency syndrome: a possible role of nitrites in Kaposi's sarcoma.

To identify risk factors that determine the major manifestations of the acquired immunodeficiency syndrome (AIDS), the authors analyzed data from three epidemiologic studies conducted by the Centers for Disease Control. The authors compared patients by outcome of disease. Eighty-seven homosexual patients (47 with Kaposi's sarcoma, 20 with Pneumocystis carinii pneumonia, and 20 with both) had participated in the earlier studies, and their interviews and laboratory test results were available. Compared with patients who have Pneumocystis carinii pneumonia only, patients with Kaposi's sarcoma and those with both diseases reported more different sexual partners, more recreational drug use, higher incomes and higher rates of non-B hepatitis. Multivariate analysis showed that the variable most strongly associated with Kaposi's sarcoma was the use of large quantities of nitrite inhalants. A multifactorial model is postulated to explain the various disease manifestations of AIDS. This study suggests that the use of nitrite inhalants may be a cofactor in the development of Kaposi's sarcoma. By identifying other cofactors, investigators may be able to define additional opportunities for prevention of the development of AIDS.

Acquired Immunodeficiency Syndrome↗