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Biomedical subjects

J W Curran

Publications and source records attributed to J W Curran.

106 records · Page 6Linked to original sources
PubMedDate not supplied

The value of the cervical gram stain in the diagnosis and treatment of gonorrhea in women in a venereal disease clinic.

In a venereal disease clinic population of 8,537 women, 1,179 (70%) of 1,675 cases of gonorrhea were detected at the initial visit by the use of the cervical gram stain. The results of cervical cultures indicated that specificity of the gram stain was 97%. Use of the cervical gram stain, combined with epidemiologic treatment of potentially exposed patients, permitted treatment of 1,531 (91%) of 1,675 infected women at the initial clinic visit; this proportion represented an increase of 42% over treatment based solely upon epidemiologic grounds. Of the 124 patients who were not treated at the initial visit and who required treatment at a second visit, nine (7.3%) developed pelvic inflammatory disease during the interval between visits. Although a test of only moderate sensitivity, the cervical gram stain, used as an adjunct to the culture for Neisseria gonorrhoeae, provided the advantages of diagnosis at the initial visit and informed treatment, facilitated the case-finding process, and minimized treatment defaulter rates and the potential risks of sequelae and transmission of gonorrhea before results of cultures were known.

Anti-Bacterial Agents↗
PubMedDate not supplied

The current outbreak of Kaposi's sarcoma and opportunistic infections.

The data suggest that: The recent outbreak of KS and PCP is a single epidemic, that of immunosuppression among homosexual men and drug abusers. The public health significance of this epidemic is probably underestimated, and clinicians should be alert to more subtle indications of immunosuppression, such as nonfatal opportunistic infections, unexplained lymphadenopathy, or other tumors. Opportunities to clarify the relationships between the environment, immunology, cancer, and infections make this outbreak scientifically important. The sudden and highly focal occurrence of these illnesses among homosexual men and drug addicts suggests a potential for their prevention if risk factors or etiologic agent(s) can be identified. The staggering morbidity and mortality associated with this outbreak dictate immediate concerted efforts to identify risk factors.

Adolescent↗
PubMedDate not supplied

Communicating surveillance, epidemiologic, and laboratory information on HIV infection and AIDS.

As the epidemic of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS) has evolved over the past 10 years, the Centers for Disease Control (CDC) has been at the forefront of the scientific efforts that have characterized HIV-AIDS research. Because of CDC's central role in these efforts, the medical and public health communities have come to depend on the agency for prompt reporting of new developments related to the epidemiology of HIV infection and AIDS and for advice on risk management, prevention, and control. CDC disseminates this information through epidemiologic updates and prevention guidelines published in the periodical, Morbidity and Mortality Weekly Report, through articles in scientific journals and summary tabulations of AIDS case data and HIV seroprevalence data, and through interviews and presentations at scientific meetings. These formal information dissemination activities are supplemented with training and support efforts directed at health care providers, health department and laboratory personnel, educators, and centralized HIV-AIDS information resources. As questions are answered, controversies resolved, and new research applications explored, CDC will continue to provide the medical and public health communities with the most recent epidemiologic information and recommendations developed to help direct efforts in HIV prevention and risk reduction.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The family of HIV seroprevalence surveys: objectives, methods, and uses of sentinel surveillance for HIV in the United States.

During 1987-89, the Centers for Disease Control (CDC), in collaboration with State and local health departments, other Federal agencies, blood collection agencies, and medical research institutions, implemented a national sentinel surveillance system for human immunodeficiency virus (HIV) infection. This ongoing surveillance system, known as the CDC family of HIV seroprevalence surveys, uses standardized survey and HIV serologic testing procedures in a group of sentinel populations from geographically diverse metropolitan areas, States, and Territories of the United States. As of September 1989, sentinel surveillance for HIV infection was being conducted in 41 States, Puerto Rico, and 39 metropolitan areas, including the District of Columbia. Information from this system complements AIDS surveillance data to assist health officials to direct resources and develop strategies for HIV prevention and health-care programs.

AIDS Serodiagnosis↗
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Transfusion-associated acquired immunodeficiency syndrome in the United States.

By Aug 15, 1985, one hundred ninety-four cases of possible transfusion-associated acquired immunodeficiency syndrome (AIDS) had been reported to the Centers for Disease Control. Cases received their transfusions in 30 states. Infants account for 10% of the cases, suggesting an increased susceptibility to developing AIDS. Investigations one to six years after the transfusions have identified high-risk donors to 47 cases. Of 47 high-risk donors tested, 40 had a reactive serology for human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) antibody, including five with no risk for AIDS by history. The HTLV-III/LAV was isolated from 23 of 26 seroreactive high-risk donors, most of whom remained asymptomatic. Blood components that transmitted HTLV-III/LAV included red cells, platelets, plasma, and whole blood. The time from transfusion to diagnosis of AIDS ranged from four to 84 months. The risk of developing AIDS after a blood transfusion has been low and will be lowered further by using both self-deferral and antibody screening.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Review of death certificates to assess completeness of AIDS case reporting.

To assess the level of reporting of acquired immunodeficiency syndrome (AIDS) cases, the authors reviewed death certificates for periods of 3 months during July through December 1985 in each of four cities: Washington, DC, New York City, Boston, and Chicago. Since reporting began in 1981, these cities have reported 38 percent of all AIDS cases in the United States. Death certificates were selected and matched to the AIDS surveillance registries in each city, and medical records of those not on the AIDS registry were reviewed to determine if AIDS had been diagnosed. The estimated completeness of AIDS case reporting to AIDS surveillance systems was high in all four cities (ranging from 83 percent to 100 percent). The unreported cases were similar to reported cases with respect to sex, race, risk factor, and specific diagnosis. Of the causes of death examined, AIDS, Pneumocystis carinii pneumonia, and Kaposi's sarcoma were predictive of AIDS as defined by the CDC case definition. However, 77 of 588 deaths (13 percent) attributed to 1 of these 3 causes occurred in cases that were presumptively AIDS but did not meet the diagnostic requirements to be classified as AIDS for reporting purposes. A review of death certificates provides an easy and rapid means of evaluating surveillance efforts and can be a useful adjunct to other methods of surveillance for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Monitoring the levels and trends of HIV infection: the Public Health Service's HIV surveillance program.

A comprehensive, multifaceted approach to HIV surveillance is needed to provide the information necessary for public health management and policy. Because HIV infection is not readily or uniformly ascertained, survey methods and sentinel surveillance approaches must be used. At least some of the surveys must be blinded, that is, anonymous and unlinked to identifiable persons, to avoid the uninterpretable impact of self-selection bias that could lead to both significant underestimates and occasional overestimates of HIV prevalence. Other surveys must be nonblinded, with careful interviews of volunteer participants to evaluate risk factors for HIV infection. These various surveys must continue over time to evaluate trends in infection. A comprehensive family of complementary HIV surveys and studies and a national household-based HIV seroprevalence survey have been undertaken by the Public Health Service in collaboration with other Federal agencies, State and local health departments, blood collection agencies, and medical research institutions. These projects focus on accessible segments of the general population, childbearing women, persons at high risk for HIV, and persons in special settings such as prisons and colleges. This comprehensive surveillance approach will help monitor the levels and trends of HIV infection in the United States and help prioritize, target, and evaluate HIV prevention activities.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

An overview of the effectiveness and efficiency of HIV prevention programs.

Because of the enormity of the HIV-AIDS epidemic and the urgency for preventing transmission, HIV prevention programs are a high priority for careful and timely evaluations. Information on program effectiveness and efficiency is needed for decision-making about future HIV prevention priorities. General characteristics of successful HIV prevention programs, programs empirically evaluated and found to change (or not change) high-risk behaviors or in need of further empirical study, and economic evaluations of certain programs are described and summarized with attention limited to programs that have a behavioral basis. HIV prevention programs have an impact on averting or reducing risk behaviors, particularly when they are delivered with sufficient resources, intensity, and cultural competency and are based on a firm foundation of behavioral and social science theory and past research. Economic evaluations have found that some of these behaviorally based programs yield net economic benefits to society, and others are likely cost-effective (even if not cost-saving) relative to other health programs. Still, specific improvements should be made in certain HIV prevention programs.

Adolescent↗