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Biomedical subjects

K E Nelson

Publications and source records attributed to K E Nelson.

258 records · Page 15Linked to original sources
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Bacterial infections and skin cleaning prior to injection among intravenous drug users.

In a survey of 1,057 active intravenous drug users in Baltimore, MD, who were recruited through extensive community outreach, 12 reported endocarditis and 113 reported subcutaneous abscesses in the 6 months before being interviewed. Of all the persons surveyed, 556 reported cleaning their skin prior to injection at any time and 173 reported cleaning their skin all the time in the 6 months before the interview. The frequency of subcutaneous abscesses was lower among those who reported skin cleaning all the time; a similar trend was noted for frequency of endocarditis. The relatively simple procedure of encouraging intravenous drug users to clean their skin prior to injection will not eliminate but might reduce the frequency of these serious and expensive infectious complications of intravenous drug use.

Abscess↗
PubMedDate not supplied

Human immunodeficiency virus infection in diabetic intravenous drug users.

OBJECTIVE: --To evaluate the association between diabetes and human immunodeficiency virus (HIV) seroprevalence in a population of intravenous (IV) drug users. DESIGN: --Cross-sectional survey in a cohort of IV drug users. SETTING: --Community-based study clinic. SUBJECTS: --The study included 2921 individuals with a history of IV drug use in the past 10 years; over 90% had injected drugs in the past year and 77% in the past month; only 15% were receiving drug treatment. OUTCOME MEASURES: --The HIV seroprevalence among IV drug users with and without a history of diabetes. RESULTS: --Those IV drug users with a history of diabetes had significantly lower HIV seroprevalence (9.8%) than nondiabetic IV drug users (24.3%; P = .03). Despite similar duration and intensity of drug use and sexual practices, diabetic IV drug users tended not to share injection paraphernalia and were less likely to attend shooting galleries than nondiabetic IV drug users. CONCLUSION: --Our data suggest that the apparent protective effect of diabetes against HIV infection in IV drug users is most likely due to their safer injection practices afforded by their ready access to sterile injection equipment.

Adult↗
PubMedDate not supplied

The cost of a preventable disease: estimated U.S. national medical expenditures for congenital syphilis, 1990.

Reported cases of congenital syphilis have increased rapidly in recent years. The purpose of this study was to estimate first-year medical care expenditures among 1990 incident cases of infants diagnosed with congenital syphilis. The authors used a synthetic estimation model to calculate expenditures for congenital syphilis as the number of treated cases multiplied by cost per case. The number of cases was derived from surveillance data adjusted for underreporting and presumptive (false-positive) treatment. Cost per case was based on expected hospital and physician charges applied to case treatment protocols appropriate to case severity. Base-case estimated first-year medical expenditure for 1990 treated cases (N = 4,400) in 1990 was +12.5 million. In sensitivity analysis, estimates ranged from +6.2 million to +47 million. Substantial reduction in congenital syphilis treatment costs could be achieved through targeted public health interventions consisting of prenatal maternal screening and contact tracing of males testing positive for syphilis. Physicians should be aggressive in presumptive treatment of newborns, since this usually prevents future disability but represents a small portion of total national expenditure for congenital syphilis. More precise data on severe cases resulting in long-term disability are needed to make reliable cost estimates.

Female↗
PubMedDate not supplied

Rhizomys sumatrensis and Cannomys badius, new natural animal hosts of Penicillium marneffei.

The incidence of Penicillium marneffei infection has increased substantially, especially in persons with HIV infection. Very little is known about the natural reservoirs or animal hosts of P. marneffei. This pathogenic fungus was first isolated from a species of bamboo rat (Rhizomys sinensis) in Vietnam and later from another rodent species, R. pruinosus. We studied a total of 75 captured bamboo rats; P. marneffei could be isolated from the internal organs of 13 of 14 (92.8%) of large bamboo rats, R. sumatrensis, and of 3 of 10 reddish-brown small bay bamboo rats, Cannomys badius (30%). All 51 greyish-black C. badius were negative on culture. Among R. sumatrensis, P. marneffei were frequently recovered from the lungs (85.7%), spleen (50%) and liver (28.6%). Of the 28 soil samples collected from the bamboo rat burrows and the 67 from the residential areas of patients with P. marneffei infection, P. marneffei was isolated from one soil sample collected from a burrow of R. sumatrensis. The mycological characteristics of P. marneffei isolates from bamboo rats and humans were very similar. Our data indicate that R. sumatrensis and C. badius may be important animal hosts of P. marneffei in northern Thailand.

Animals↗