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Biomedical subjects

J M Mann

Publications and source records attributed to J M Mann.

At least 91 records · Page 5Linked to original sources
PubMed1987

Evaluation of a clinical case-definition of acquired immunodeficiency syndrome in Africa.

A provisional clinical case-definition for acquired immunodeficiency syndrome (AIDS) developed by the World Health Organisation (WHO) for use in Africa was tested on 174 inpatients at Mama Yemo Hospital, Kinshasa, Zaire. In this hospital population with a 34% infection rate of human immunodeficiency virus (HIV), the clinical case-definition had a specificity of 90%, a sensitivity of 59%, and a predictive value of 74% for HIV seropositivity. These results support the use of the WHO clinical definition for AIDS in Africa. However, since HIV prevalence and disease expression vary, similar evaluations should be carried out in different regions.

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↗
PubMed1987

Detection of human T cell leukemia virus type I and human immunodeficiency virus in cultured lymphocytes of a Zairian man with AIDS.

We report the detection of human T cell leukemia virus type I (HTLV-I) and human immunodeficiency virus (HIV) in the cultured lymphocytes of a 45-year-old Zairian man with AIDS. HIV was successfully isolated and analyzed by SDS-PAGE and competition radioimmunoassay. However, by the culture techniques used, HTLV-I could not be separated from the HIV. Western blot analysis of the patient's serum showed the presence of both HTLV-I- and HIV-specific antibodies. The finding of this dual infection may explain reports that greater than or equal to 30% of patients with AIDS are positive for antibodies to HTLV-I.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Nonbronchoscopic lung lavage for diagnosis of opportunistic infection in AIDS.

Thirty patients known to have or suspected of having acquired immunodeficiency syndrome (AIDS) were evaluated for opportunistic pulmonary infection using a double lumen lavage catheter (DLL). Lavage specimens obtained were cytocentrifuged and initially stained by the Papanicolaou technique as a means of rapid evaluation for Pneumocystis carinii. If no opportunistic organism was identified, the patient underwent further diagnostic investigations. In 18 patients receiving mechanical ventilatory support, the procedure was performed via the endotracheal tube. Twelve patients who were less severely ill underwent the procedure via the transnasal route. In 43 percent (13/30), opportunistic infections were diagnosed by DLL. Twelve had P carinii, one of whom had cytomegalovirus and another of whom had Herpes simplex viruses, and one with Toxoplasma gondii. Thus, the sensitivity for all opportunistic infections was 86 percent (12/14). The volume of fluid recovered averaged 93 percent of that instilled. There was no significant difference between prelavage and postlavage PaO2. In this group of patients, double lumen lavage obviated the need for more invasive and expensive procedures.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Generalized papular pruritic eruption in African patients with human immunodeficiency virus infection.

Of 284 patients hospitalized with HIV infection, 52 (18%) presented with a generalized pruritic papular eruption. No significant association between this eruption and other HIV manifestations or any opportunistic infection was found. Fifty-three of 61 (87%) consecutive African patients referred for a generalized papular pruritic eruption of unknown etiology of at least 1 month's duration were HIV seropositive, including 15 (65%) of 23 in good general condition. Thirty-seven (95%) of 38 patients with this eruption and severe weight loss (greater than 10% of normal body weight) were seropositive. The initial skin lesions were small, firm, intensely pruritic papules which released a small drop of clear fluid when scratched. Scratched papules became later hyperpigmented macules. Lesions were symmetrically distributed over the body and were most frequently found on the extensor surfaces of the arm, the dorsal surface of the hands, the inferior part of the legs, the ankles and the dorsum of the feet. Histologic examination showed a non-specific inflammatory reaction. Thirty-three (51%) patients reported that the skin eruption was their initial disease manifestation. In African patients, the presence of an unexplained generalized pruritic papular eruption is highly indicative of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Absence of association between Plasmodium falciparum malaria and human immunodeficiency virus infection in children in Kinshasa, Zaire.

The possible associations between Plasmodium falciparum malaria and HIV (human immunodeficiency virus) seropositivity were investigated in 1986 at the Mama Yemo Hospital in Kinshasa, Zaire. No significant difference was found in the HIV seropositivity rate of 164 children presenting with P. falciparum malaria (1.2%) and 169 healthy controls (0.6%). Secondly, no association was found between P. falciparum slide positivity (51.6%) and HIV seropositivity (3.8%) among 1046 children presenting to the hospital with medical complaints. Infants less than 6 months old had the lowest slide-positivity rate, but among infected children the younger ones more frequently had high parasitaemias. HIV seropositivity rates were highest for children less than 6 months old. In older children, seropositivity was strongly associated with a history of blood transfusion. Thus, in Kinshasa children, P. falciparum malaria is a major public health problem; perinatal transmission and blood transfusions constitute important mechanisms of HIV infection; and P. falciparum does not appear to act as an opportunistic agent in children infected with HIV.

Animals↗
PubMed1987

Plague meningitis--a retrospective analysis of cases reported in the United States, 1970-1979.

Meningitis caused by Yersinia pestis developed in 6 (6%) of a total of 105 patients with plague reported to the Centers for Disease Control from 1970 to 1979. Five of the six cases occurred in children aged 10 to 15 years. All six patients received antibiotic therapy before meningitis developed, which appeared between the 9th and 14th days after the onset of acute illness in five of the six patients. There were no neurologic sequelae. The antigenic and biochemical profiles of the Y pestis strains isolated from cerebrospinal fluid in the meningitis cases did not differ from those of the Y pestis strains obtained from blood and bubo aspirates in the other 99 patients, and neither did in vitro studies suggest antibiotic resistance. While plague meningitis is an uncommon complication of acute plague infection, physicians in the western United States should be aware that it may develop as much as 14 days after antibiotic therapy for the acute plague infection has been initiated.

Adolescent↗
PubMed1987

AIDS--A global perspective. Global epidemiology.

A total of 62,811 cases of the acquired immunodeficiency syndrome (AIDS) have been reported to the World Health Organization from throughout the world. Extensive epidemiologic studies have shown that human immunodeficiency virus (HIV) infections are transmitted by three routes: sexual, parenteral and perinatal. Three geographic patterns of transmission have been defined. In pattern I, transmission occurs predominantly among homosexual and bisexual men and urban intravenous drug abusers; transmission via blood products has been controlled; the male:female sex ratio is 10:1 or more; population HIV seroprevalence is low, and perinatal transmission is uncommon (for instance, United States, western Europe). In pattern II, transmission is predominantly heterosexual and perinatal; transmission via blood products exists but is being reduced; unsterile needles and other skin-piercing instruments cause some parenteral transmission (magnitude not known); the male:female sex ratio is 1:1, and population seroprevalence often exceeds 1% (central Africa, Haiti). In pattern III, AIDS cases are just being documented and are generally due to sexual exposure abroad or imported blood products (Middle East, Asia).

Acquired Immunodeficiency Syndrome↗
PubMed1987

The World Health Organization's global strategy for the prevention and control of AIDS.

The magnitude of the human immunodeficiency virus (HIV) pandemic and its broad impact have been seriously underestimated and underappreciated. The Special Programme on AIDS (acquired immunodeficiency syndrome) of the World Health Organization (WHO) was created on February 1, 1987, as the architect and keystone of the global AIDS plan. The Special Programme on AIDS has designed the global strategy, has raised sufficient funds to begin implementing the strategy and, for this effort, has marshalled the support of every nation in the world. AIDS affects both the developing and the industrialized worlds; therefore, every country will need a national AIDS program. This is vital not only for national interests but also because ultimately AIDS cannot be stopped in any one country unless it is stopped in all countries. National AIDS programs are being rapidly established throughout the world with the technical and financial support of WHO's Special Programme on AIDS. At the global level, the Special Programme is responsible for strategic leadership, developing consensus, coordinating scientific research, exchanging information, assuring technical cooperation and mobilizing and coordinating resources. National AIDS committees have already been established in more than 150 countries and, by the end of 1988, the Special Programme will support every country in the world that requests collaboration.

Acquired Immunodeficiency Syndrome↗