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Biomedical subjects

J W Curran

Publications and source records attributed to J W Curran.

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

AIDS - two years later.

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Acquired Immunodeficiency Syndrome↗
PubMed1983

AIDS--two years later.

Explore the source record for details and available documents.

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

The prevention of hepatitis B with vaccine. Report of the centers for disease control multi-center efficacy trial among homosexual men.

A randomized, double-blind, vaccine/placebo trial of the Merck 20-micrograms hepatitis B virus (HBV) vaccine was done among 1402 homosexual men attending venereal disease clinics in five American cities. Vaccination was followed by only minimal side effects. Two doses of vaccine induced antibody in 80% of vaccine recipients. A booster dose 6 months after the first dose induced antibody in 85% of recipients and markedly increased the proportion of recipients who produced high antibody titers. The incidence of HBV events was markedly less in the vaccine recipients compared to that in the placebo recipients (p = 0.0004). Between month 3 and 15 after the first dose, 56 more significant HBV events (hepatitis, or hepatitis B surface antigen positive, or both) occurred in the placebo group while only 11 occurred in the vaccine group. Ten of the 11 HBV events in the vaccine recipients occurred in hypo- or nonresponders to the vaccine. This vaccine appears to be safe, immunogenic, and efficacious in preventing infection with hepatitis B virus.

Adult↗
PubMed1980

Economic consequences of pelvic inflammatory disease in the United States.

Pelvic inflammatory disease is the most common serious complication of sexually transmitted infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Initial episodes of sexually transmitted acute PID occur most frequently in the 20 to 24 year age group, while sequelae such as infertility, ectopic pregnancy, and chronic PID are most common among 25- to 34-year-old women. The apparent chronicity of the disease process suggests that the epidemic of sexually transmitted disease, which began in the mid-1960s, could be followed by an epidemic of PID and its sequelae. More than 850,000 episodes of PID occur annually, requiring more than 212,000 hospital admissions, 115,000 surgical procedures, and 2,500,000 physician visits. Ectopic pregnancies in the United States tripled from 1967 to 1977. Direct and indirect costs for PID and PID-associated ectopic pregnancy exceeded $1.25 billion in 1979. If PID and ectopic pregnancy rates continue unabated, by the year 2000 there will have been more than one episode of PID and three related physician visits for every two women who reached reproductive age in 1970. Fifteen percent will require hospitalization, more than 3% will experience an ectopic pregnancy, and more than 10% will involuntarily become sterile because of PID.

Adolescent↗
PubMed1980

Gonorrhea in the emergency department: management, case follow-up, and contact tracing of cases in women.

From June, 1978, to June, 1979, all ten Columbus hospital emergency departments (EDs) participated in a program which provided test-of-cure, follow-up of untreated cases, and contact investigation of women infected with gonorrhea. Four hundred and eighty-nine women were found to be infected with gonorrhea; 99% of these were treated rapidly with recommended schedules. Sixteen percent of women with positive cultures required inpatient care for an average of 6.3 days. Seventy percent of women with positive cultures received counseling and test-of-cure for gonorrhea. Of 134 men treated as a result of these counseling efforts, 79 (59%) were asymptomatically infected. Source-spread analyses suggested that one third of asymptomatically infected male contacts had been infected for longer than 30 days. Only one fourth of women with gonococcal pelvic inflammatory disease (GC-PID) interviewed named male source contacts who were treated prior to her presentation with PID. Future approaches to GC-PID prevention must include cooperative efforts between health department clinics for sexually transmitted disease and hospital EDs.

Emergency Service, Hospital↗
PubMed1980

Accuracy of presumptive criteria for culture diagnosis of Neisseria gonorrhoeae in low-prevalence populations of women.

The accuracy of presumptive criteria for identification of Neisseria gonorrhoeae was assessed in two separate populations of women with a low prevalence of gonorrhea. Of the presumptively positive cervical isolates available for confirmation, 98.5% were identified as N. gonorrhoeae. Of 25 isolates that could not be confirmed, 20 failed to grow on subculture, and of the remaining 5, only 2 (0.6% of all viable recoveries) were identified as nongonococcal isolates (N. meningitidis). Our study confirms earlier findings that meningococcal isolates are rarely found in endocervical specimens. The benefits from early treatment and counselling of women for gonorrhea on the basis of presumptive criteria outweight the risks occasioned by the rarely encountered nongonococcal isolate.

Cervix Uteri↗
PubMed1980

Self-reported behavior patterns of patients attending a sexually transmitted disease clinic.

Records of the sexually transmitted disease (STD) clinic visits of 12,728 patients in Columbus, Ohio were analyzed to better understand the behavior patterns of these patients. Among heterosexual men, a greater proportion of Blacks than Whites reported a previous history of urethritis. After controlling for previous STD among heterosexual men with discharge or dysuria, we found that Black men sought treatment sooner and were more likely to curtail sexual activity than White men after becoming symptomatic with gonorrhea or nongonococcal urethritis.

Community Health Centers↗
PubMed1976

The role of the urban community hospital in gonorrhoea surveillance.

In a progressive surveillance programme designed to detect gonococcal infection in females, 113,063 women were screened for gonorrhoea in Memphis-Shelby County, Tennessee, during a 2-year period. The importance of including the urban community hospital in the surveillance programme is emphasized by the contribution of the City of Memphis Hospital where 53-3 per cent. of all positive cases of gonorrhoea were detected in only 34-2 per cent. of all tests done. The City of Memphis Hospital emergency room was an especially productive surveillance area, giving 29-0 per cent. of all positives with only 6-1 per cent. of all tests performed. The importance of taking routine cultures for gonococci from women presenting for prenatal care, delivery, or for genitourinary complaints in an urban hospital is stressed.

Female↗
PubMed1975

Female gonorrhea: its relation to abnormal uterine bleeding, urinary tract symptoms, and cervicitis.

Data are presented from an investigation of the assocation of presenting complaints with gonococcal infection in females seeking primary care in an urban emergency room. Over 27% of patients in the study had cultures positive for Neisseria gonorrhoeae (GC). The GC positivity rates which were significantly higher than expected were found in patients with abnormal uterine bleeding, urinary tract symptoms, and cervicitis, as well as acute PID. Clinical findings suggest an etiologic role for the gonococcus in the pathogenesis of these disorders. Where the incidence of gonorrhea is high, new approaches in the managment of patients with these presenting complaints are necessary in order to prevent the more serious complications of gonorrhea and further spread of the disease.

Female↗
PubMed1975

Human immunity to Neisseria gonorrhoeae: acquired serum opsonic antibodies.

Recent studies have demonstrated that virulent (Types 1 and 2) colonial variants of Neisseria gonorrhoeae are highly resistant to phagcytosis by normal human polymorphonuclear leukocytes. To pursue this observation, sera from prostitutes were compared with sera from Catholic nuns in terms of their ability to enhance phagocytosis of Type 1 gonococci. The phagocytic system consisted of a monolayer of normal human polymorphonuclear leukocytes and an inoculum of 107 to 108 colony-forming units of N. gonorrhoeae. In a representative test, the mean percentages of phagocytosis were: 13 nuns, 10 per cent; 32 prostitutes, 30 per cent (p less than 0.01). In a separate set of experiments, 5 (45 per cent) of 11 patients with acute gonococcal salpingitis had significant increases in serum opsonic activity between the acute and one month convalescent bleeding. A pool of prostitute sera retained detectable opsonic activity at dilutions as high as 1:320. The opsonic activity was heat-stable, demonstrable without complement, and resided in both the IgG and IgA fractions of serum. These studies demonstrate the presence of acquried opsonic antibody to N. gonorrhoeae in humans: the significance of such antibodies in proction against gonococcal disease requires further exploration.

Antibodies, Bacterial↗