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H W Jaffe

Publications and source records attributed to H W Jaffe.

At least 91 records · Page 5Linked to original sources
PubMed1984

Heterosexual and homosexual patients with the acquired immunodeficiency syndrome. A comparison of surveillance, interview, and laboratory data.

Homosexual and heterosexual patients with the acquired immunodeficiency syndrome were compared by risk group. Race; diagnoses; history of sexually transmitted diseases, sexual behavior, and drug use; and socioeconomic indicators differed considerably among risk groups, suggesting different risk factors for acquisition of the syndrome. Patients in the homosexual, intravenous drug user, and Haitian risk groups differed in their serologic response to cytomegalovirus and syphilis testing, presumably due to lifestyle-related exposures. Differences in the rate of recovery of cytomegalovirus, serum levels of IgA and IgG, and antibody titers to Epstein-Barr virus were noted among patients with different diagnoses. We conclude that in studies of risk factors for the acquired immunodeficiency syndrome, patients should be analyzed by risk group and diagnoses.

Acquired Immunodeficiency Syndrome↗
PubMed1984

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↗
PubMed1983

Acquired immune deficiency syndrome in the United States: the first 1,000 cases.

Between June 1981 and February 1983, the Centers for Disease Control (Atlanta) received reports of 1,000 patients living in the United States who met a surveillance definition for the acquired immune deficiency syndrome (AIDS). Seventy-three percent of these patients were diagnosed after January 1, 1982. The 1,000 patients included 284 with Kaposi's sarcoma (KS), 497 with Pneumocystis carinii pneumonia (PCP), 83 with KS and PCP, and 136 with opportunistic infections other than PCP. The overall mortality has been 39.2%. Cases have been reported from 32 states and the District of Columbia; New York, California, New Jersey, and Florida account for 82.7% of the reports. All but 61 of the patients could be classified into one or more of the following groups: homosexual or bisexual men, intravenous drug abusers, Haitian natives, or patients with hemophilia. Epidemiologic trends in AIDS cases are consistent with the gradual extension of an infectious agent into new populations.

Acquired Immunodeficiency Syndrome↗
PubMed1983

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↗
PubMed1982

Gentamicin-resistant staphylococci as hospital flora: epidemiology and resistance plasmids.

In 1979, gentamicin-resistant (Gmr) Staphylococcus aureus was recovered from the clinical specimens of 22 epidemiologically unrelated hospitalized patients; 78% of the patients evaluated were also colonized with Gmr coagulase-negative staphylococci. Endonuclease fingerprinting was used to compare the Gmr plasmids within pairs of isolates of S. aureus and coagulase-negative staphylococci recovered from nine patients. Plasmids differed between pairs but were concordant within four pairs. Thus, in vivo interspecific plasmid transfer, although infrequent, may be important in the sporadic occurrence of Gmr S. aureus. To define the epidemiology of endemic Gmr coagulase-negative staphylococci, culture surveys were performed over two years. Gmr coagulase-negative staphylococci were acquired by 80% of the infants in a special-care nursery that previously had an outbreak of Gmr S. aureus. Among adult inpatients, a 48% colonization rate was related to prior exposure to antibiotics. In contrast, no colonization was found in outpatients or antepartum mothers.

Adult↗
PubMed1982

Diagnosis of gonorrhea using a genetic transformation test on mailed clinical specimens.

The genetic transformation test (GTT), a technique used for the detection of gonococcal DNA in clinical specimens, was compared with culture testing for the diagnosis of gonorrhea. At the De Kalb County Venereal Disease Clinic, Decatur, Ga., 454 cervical and 160 rectal specimens from women and 191 urethral specimens from men were collected in duplicate. One of each of the two specimens from each anatomic site was immediately plated on Martin-Lewis medium and incubated; the other specimen was mailed to Philadelphia for a GTT. Using culture results as a standard, the GTT had a specificity of 98.1% although some "false-positive" GTT results were probably a reflection of false-negative culture results. The sensitivity of the GTT was greater than 96% except when specimens were collected with Culturettes (Marion Laboratories, Kansas City, Mo.). In situations where Gram staining is not appropriate or where on-site culture facilities are not available, GTT may be the method of choice for the diagnosis of gonorrhea.

Biological Assay↗
PubMed1982

Structural and phenotypic varieties of gentamicin resistance plasmids in hospital strains of Staphylococcus aureus and coagulase-negative staphylococci.

We previously described a neonatal nursery epidemic of infections caused by a single strain of Staphylococcus aureus bearing a gentamicin resistance plasmid (Vogel et al., Antimicrob. Agents Chemother. 13:466-472, 1978). The same plasmid was present in two isolates of Staphylococcus epidermidis from the patients in this nursery and was transferable interspecifically from either S. aureus or S. epidermidis. During the ensuing 3 years, in the absence of further epidemics, we collected 162 gentamicin-resistant strains of S. aureus and coagulase-negative staphylococci from patients distributed throughout our hospital. Gentamicin resistance plasmids obtained from 41 representative S. aureus and coagulase-negative staphylococcal strains differed as determined by phenotypic and molecular analyses from the plasmid in the neonatal nursery epidemic. Nevertheless, these plasmids were structurally related to each other and to the plasmid of the original epidemic. Our results suggest an evolutionary relationship among these plasmids and support the hypothesis of a genetic reservoir of gentamicin resistance in coagulase-negative staphylococci transferable to S. aureus.

Coagulase↗
PubMed1980

Identity and interspecific transfer of gentamicin-resistance plasmids in Staphylococcus aureus and Staphylococcus epidermidis.

The hypothesis that emergence of gentamicin-resistant strains of Staphylococcus aureus and Staphylococcus epidermidis in a neonatal special care nursery was the result of transfer of a single plasmid between these two species was examined. In experiments with mixtures of staphylococci, either in mixed cultures or on human skin, isolates of S. aureus and S. epidermidis transferred their gentamicin-resistance plasmids both intra- and interspecifically. By electron microscopy, the molecular masses of the plasmids from S. aureus and S. epidermidis were the same, 12.2 +/- 0.36 (standard deviation) and 12.3 +/- 0.56 megadaltons, respectively. Restriction endonuclease analysis of the plasmids from five isolates of S. aureus and two isolates of S. epidermidis, with use of the enzymes HaeIII, EcoRI, XbaI, and HindIII, showed no differences in the digestion patterns of the seven gentamicin-resistance plasmids. The results supported the hypothesis that plasmid transfer between S. aureus and S. epidermidis occurs in nature.

Conjugation, Genetic↗
PubMed1979

Pharmacokinetic determinants of penicillin cure of gonococcal urethritis.

In a 1964 study of the pharmacokinetic determinants of penicillin cure of gonococcal urethritis, 45 male prisoner volunteers were experimentally infected with strains of Neisseria gonorrhoeae having known in vitro penicillin susceptibility. After developing urethritis, subjects received intramuscular penicillin G and had serum samples obtained serially to determine penicillin concentration. Using a multiple regression technique, we studied patient-associated parameters and parameters of the serum penicillin curves to determine the best predictors of treatment results. Cure was best predicted by the time the serum penicillin concentration remained above three to four times the penicillin minimum inhibitory concentration of the infecting strain (probability of correct classification, >0.80). Those cured had serum penicillin concentrations which remained in this range for means of 7 to 10 h. Our findings confirm principles of antimicrobial therapy derived from animal models and may have application in studying therapy of gonorrhea and other infectious diseases.

Adult↗
PubMed1979

Selective mass treatment in a venereal disease control program.

To control syphilis among prostitutes and seasonal farm workers in Fresno County, California, we developed a program of selective mass treatment of prostitutes. From August 1976 to July 1977, 512 women entered the program. Overall, 4.6 per cent of women treated prophylactically for syphilis were actually infected. Compared to cases in the previous year, infectious syphilis cases among prostitutes and seasonal farm workers decreased 51.3 per cent and 26.8 per cent, respectively.

Adult↗
PubMed1978

Hemagglutination tests for syphilis antibody.

In a study of serodiagnosis of syphilis, the authors compared the specificities and sensitivities of two hemagglutination tests, a sheep-erythrocyte test (MHA-TP) and a trukey-erythrocyte test (TPHA), with those of the Fluorescent Treponemal Antibody-Absorption (FTA-ABS) test. In tests of sera from 935 patients without syphilis, the MHA-TP, TPHA, and FTA-ABS tests were reactive for 0.96, 0, and 1.3% respectively. The false-positive results were usually transient and not associated with underlying illness. For the 68 patients with syphilis, the MHA-TP test was as sensitive as the FTA-ABS test in all stages except untreated primary disease. The TPHA test appeared to be undersensitive, and testing of follow-up sera from persons with latent syphilis showed unexplained conversion of false-negative TPHA results to reactive results. Reproducibilities of the two hemagglutination tests were comparable. The MHA-TP test is a valuable confirmatory test for syphilis. Further study is needed before the use of the TPHA test can be recommended.

Animals↗
PubMed1978

Patient variables associated with penicillin resistance in Neisseria gonorrhoeae.

In an ongoing cooperative study of uncomplicated genital gonorrhea within the United States, 6,735 pretreatment gonococcal isolates were tested for their in vitro resistance to penicillin. By using a regression analysis technique, we examined 99 patient-associated variables which might be associated with penicillin resistance of the isolates. Patients were most likely to have relatively resistant isolates if they were black, had used antimicrobial agents within 2 weeks of treatment for gonorrhea, or were men with symptomatic urethritis.

Female↗
PubMed1978

Tests for treponemal antibody in CSF.

We studied the potential usefulness of CSF treponemal tests in the diagnosis of neurosyphillis. The CSF was tested with the microhemagglutination test for Treponema pallidum (CSF-MHA-TP test) and with the CSF-FTA test by using undiluted CSF and CSF diluted in saline and in sorbent. In a prospective evaluation, of 177 nonsyphilitics, none had reactive CSF-MHA-TP tests and only one had a reactive CSF-FTA test. However, five of 15 syphilitics with no other evidence of neurosyphilis had reactive CSF-FTA tests. The CSF-FTA test reactivity appeared most likely when the titer of the serum FTA test was high. In a retrospective evaluation of syphilitics with reactive CSF-FTA tests, similar patterns of reactivity occurred in patients with and without other evidence of neurosyphilis. Without other supporting clinical or laboratory data, the diagnostic value of a reactive CSF-FTA test is unknown.

Adult↗