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Biomedical subjects

N J Fiumara

Publications and source records attributed to N J Fiumara.

At least 19 recordsLinked to original sources

Facts about gonorrhea and dentistry.

This article reviews gonorrhea and discusses various misconceptions that have appeared in the dental literature and in verbal presentations about gonorrhea and dentistry. Facts are presented and some conclusions are offered for the dental profession.

Dentists

Prevalence of rubella antibodies in Massachusetts schoolchildren.

In 1982, 1,871 (79%) of 2,368 eligible 6th, 10th and 12th grade students in Massachusetts participated in a statewide serosurvey for rubella antibodies. Sera were screened at the Centers for Disease Control (CDC) by a reference hemagglutination inhibition assay at 1:8, equivalent to approximately 15 International Units (IU)/ml. Sera negative by the CDC hemagglutination inhibition assay were retested using an enzyme immunoassay, a passive hemagglutination assay, and a commercial hemagglutination inhibition test. The approximate screening levels were 10 IU/ml, 7.5 IU/ml, and 5 IU/ml, respectively. Overall seroprevalence levels varied from 76.4% screening at 15 IU to 93.1% including seropositives from any of the tests. Persons with a school record of vaccination had significantly higher seroprevalence levels than persons without records. However, only 78.3% of persons with a record had antibody greater than or equal to 15 IU compared with 60.0% without records; considering any detectable antibody, the comparison is 95.6% versus 71.4%. The low titers in vaccinees appeared to be due to a falloff of antibody with time since vaccination. Of students with a single vaccination noted in the record with exact dates, 92.3% who were vaccinated 0-4 years prior to the study had antibody at 15 IU compared with less than 78% of students with antibody who were vaccinated five or more years prior to the study. In contrast, using more sensitive assays, there was no significant decline in seroprevalence with time since vaccination. Revaccination studies and epidemiologic data suggest that almost all persons with detectable antibody whether above or below 15 IU/ml are immune to rubella. Thus, immunity levels in Massachusetts schoolchildren in the 6th, 10th, and 12th grades are probably in excess of 90%.

Adolescent

Reinfection with disseminated gonococcal disease.

A 20-year-old prostitute was admitted to hospital with joint pains and a macular and pustular rash on the fingers and feet on two occasions. Disseminated gonococcal infection was diagnosed and successfully treated.

Adult

The treatment of gonococcal proctitis. An evaluation of 173 patients treated with 4 g of spectinomycin.

A group of 1,533 homosexual males were examined in 1976 for gonorrhea at the Skin Clinic of the Boston Dispensary. This examination included a rectal culture. There were 213 males with positive rectal cultures: an infection rate of 13.7%. Of these, 173 were treated with 4 g of spectinomycin hydrochloride, intramuscularly, and 127 (73.4%) returned in one week for a posttreatment examination and culture. All who returned had a negative culture. Four grams of intramuscular spectinomycin hydrochloride appears to be effective in the treatment of gonococcal proctitis.

Adolescent

Clinical and microbiological investigation of men with urethritis.

Of 377 men attending clinics for the treatment of sexually transmitted disease, 104 had gonococcal urethritis, 72 had definite nongonococcal urethritis, 53 had possible nongonococcal urethritis, and 123 had no urethritis. A purulent urethral discharge was noted in 78% and 14% of patients with gonococcal urethritis and definite nongonococcal urethritis, respectively (P less than 0.001). In contrast, 4% and 64% of men with gonococcal urethritis and definite nongonococcal urethritis, respectively, had a clear urethral discharge (P less than 0.001). Black men with urethritis were more likely to have gonococcal infection, whereas white men were more likely to have nongonococcal urethritis. Homosexual and bisexual white men with urethritis were more likely to have gonorrhea, whereas heterosexual white men with urethritis were more likely to have nongonococcal urethritis. Heterosexual men were more likely than homosexual men to be colonized with Ureaplasma urealyticum. There were no differences in the rates of colonization with Mycoplasma hominis among heterosexual and homosexual men.

Adolescent

Keratonodular tonsillitis.

Reported is an unusual lesion on the right palatine tonsil in a man with latent primary syphilis. The lesion was white, nodular, firm, and asymptomatic, and histologically had a keratinized surface; it was not caused by primary syphilis or any other known or described entity. The term keratonodular tonsillitis has been coined to designate this lesion of unknown cause or significance.

Adult