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Biomedical subjects

R K Sikes

Publications and source records attributed to R K Sikes.

At least 37 records · Page 2Linked to original sources
PubMed1986

Transmission of hepatitis B with resultant restriction of surgical practice.

Five patients developed acute hepatitis B (HB) within four months after major operations by the same obstetric-gynecologic surgeon. Investigation documented that the surgeon was HB surface antigen and HB e antigen positive; all five patients had an HB subtype matching that of the surgeon and no other identifiable risk factors for HB viral infection. A seroprevalence study comparing exposed surgical and obstetric patients with a control group showed no significant additional subclinical HB transmission. The surgeon resumed his surgical practice but was required to obtain written informed consent from patients, to double-glove, and to employ appropriate surgical techniques to avoid self-injury. Seven months later, acute HB occurred in a patient two months after a cesarean section, resulting in exclusion of the surgeon from major operations. This is the fifth outbreak of nosocomial HB linked to an obstetric-gynecologic surgeon, and it reinforces the need for health care workers to receive preexposure prophylaxis with HB vaccine to prevent such occurrences.

Carrier State↗
PubMed1986

Primary invasive Haemophilus influenzae type b disease: a population-based assessment of risk factors.

We performed a population-based case-control study of risk factors for primary invasive Haemophilus influenzae type b (Hib) disease in metropolitan Atlanta from July 1, 1983, through June 30, 1984. Active surveillance identified 102 cases in children less than 5 years of age, 89 of whom lived in households with telephones. We used random digit dialing to select 530 controls who were postmatched to cases by age. Multivariate analysis showed a significant association between Hib disease and two independent exposure factors, household crowding (odds ratio (OR) 2.7, 95% confidence limits (CL) 1.3 to 5.6) and day-care attendance. For day-care attendance, relative risk was highest in 2- to 5-month-old infants (OR 17.7, 95% CL 5.8 to 54.4) and declined to 9.4 (4.3 to 20.9) at ages 6 to 11 months, 5.0 (2.7 to 9.3) at 12 to 23 months, 2.7 (1.3 to 5.5) at 24 to 35 months, and 1.4 (0.5 to 4.0) in 36- to 59-month-old children. Fifty percent of all invasive Hib disease that occurred during the study period was attributable to exposure to day-care; the attributable risk for household crowding was 18%. Dose-response effects were observed for hours per week of day-care attendance and extent of household crowding. Breast-feeding was protective for infants less than 6 months of age (OR 0.08, 95% CL 0.01 to 0.59). After controlling for socioeconomic and other confounding factors, we could demonstrate no effect of black race on cumulative risk of invasive Hib disease. Our study defines high-risk groups and provides a population-based model of the interrelationship between risk factors associated with invasive Hib disease.

Age Factors↗
PubMed1986

Motorcycle-associated fatalities in Georgia, 1980-1981.

In 1980-1981, 158 motorcycle-associated fatalities occurred in Georgia, accounting for an estimated 6,113 lost years of productive life. Death ratios were highest for men 20 to 29 years of age, and motorcycle-associated fatalities occurred most frequently during summer months, on weekends, and during afternoon and evening hours. Forty-six percent of motorcycle-associated fatalities did not involve another vehicle, and head injuries alone or in combination with other injuries were responsible for death in approximately half. Helmet use, an effective measure for preventing motorcycle-associated fatalities, is required in Georgia; additional injury prevention strategies are discussed.

Accidents, Traffic↗
PubMed1986

Infant mortality in a rural health district in Georgia, 1974 to 1981.

In 1979 the infant mortality rate (IMR) dropped nearly 50% in a rural health district in southeast Georgia, and this lower rate continued during the next two years. For infants born during 1979 to 1981, the IMR was 12.4 as compared with 21.6 for those born from 1974 to 1978. Using linked birth and infant death records to identify shifts in the components of infant mortality in this district, we found that the change in IMR primarily reflected a decrease in neonatal and postneonatal deaths among infants with birth weight greater than or equal to 2,500 gm, rather than a change in the distribution of birth weights. Although the IMR was approximately twofold higher in white than in black infants, a similar relative decline in mortality was observed in both racial groups. For infants weighing greater than or equal to 2,500 gm, approximately half of the lower death rate was due to fewer deaths caused by infections. The decline in mortality in this district was greater than declines in neighboring districts and accompanied efforts to improve services for medically indigent mothers and infants. The findings suggest that in areas with high infant mortality, initial efforts to lower mortality should focus on primary care programs rather than more specialized interventions.

Black or African American↗
PubMed1984

Nosocomial mycobacterial pseudoinfection in a Georgia hospital.

Nosocomial pseudoepidemics may be detected when clustering of pseudoinfections occur or when artificial clusters of real infection are observed. Nontuberculous mycobacteria were reportedly isolated from specimens obtained from seven patients at one hospital from October 1980 to January 1981. Because the patients' clinical illnesses were not uniformly consistent with mycobacterial disease, we hypothesized that pseudoinfections had occurred and searched for a common source of contamination. The investigation suggested that specimen contamination was associated with one microbiology laboratory technician: 6 of 22 (27%) specimens processed by that person were positive compared with 1 of 103 (1%) specimens processed by the other five technicians. However, a specific mechanism of contamination was not identified. Nosocomial pseudoepidemics associated with false infections should be suspected and investigated when clinical features and laboratory findings do not agree.

Adult↗
PubMed1984

Epidemic keratoconjunctivitis: report of an outbreak in an ophthalmology practice and recommendations for prevention.

In Fall 1981, an outbreak of acute infectious conjunctivitis with keratitis (EKC) occurred in patients who had visited a private ophthalmology clinic just prior to onset of illness. Among an estimated 2,200 patient visits to the office from August 10 to October 15, 1981 for problems unrelated to infectious conjunctivitis, 39 (1.8%) persons subsequently developed EKC. The median incubation period was 6.5 days (range, 1 to 14 days). A case-control study was done to identify risk factors associated with contracting EKC; patients with EKC were more likely than control patients to have been examined by one or the other of two of the four ophthalmologists at the clinic and to have undergone procedures such as tonometry or foreign body removal. Adenovirus was isolated from conjunctival swabs from four of five persons with conjunctivitis; three were type 8 and one was type 7. Recognition of the problem and improved handwashing practices were associated with terminating the outbreak. This outbreak illustrates the potential for transmission of adenovirus infection during the provision of eye care. Infection control practitioners should be familiar with measures for the prevention of such infections among ophthalmology patients.

Adenoviridae Infections↗
PubMed1984

Human infections with La Crosse virus in Georgia, 1982.

Eight cases of central nervous system infection due to La Crosse (California serogroup) virus were detected in Georgia children in 1982. The patients were residents of the state, without histories of travel away from the vicinities of their homes during the 30 days before the onset of their illnesses. All were hospitalized with a diagnosis of aseptic meningitis or encephalitis; none had sequelae. Onset dates were from May 1 to Aug 30. Distribution of cases within the state suggested that active transmission of La Crosse virus occurred at least in the southeast quadrant of the state. The epidemiology and natural cycle of La Crosse in the southeastern United States are briefly discussed.

Aedes↗
PubMed1984

Safety of prolonged administration of rimantadine hydrochloride in the prophylaxis of influenza A virus infections in nursing homes.

We evaluated the safety of rimantadine hydrochloride (RH) prophylaxis in a double-blind, placebo-controlled trial in three nursing homes during a community epidemic of influenza A (H3N2). Although daily monitoring of the 35 participants revealed an association between RH administration (100 mg twice a day) and the development of nausea and anxiety (P less than 0.05), these and other potential side effects were transient and were rarely considered to be clinically significant. Serum RH levels measured at the end of the trial (mean, 1,159 ng/ml) were nearly three times higher than those measured previously in younger individuals, suggesting that lower dosages may be indicated for the elderly.

Adamantane↗
PubMed1983

Human Campylobacter infection associated with certified raw milk.

Between May 27 and June 18, 1981, 50 individuals in 30 households in suburban Atlanta, Georgia, had a gastrointestinal illness caused by Campylobacter jejuni. Epidemiologic evidence strongly associated consumption of unpasteurized milk with illness. A culture survey confirmed fecal carriage of C. jejuni by cows in the implicated dairy and in a control dairy, but failed to document presence of the organism in the milk. The standard plate counts and leukocyte counts (two indicators of microbiologic quality of milk), facilities, and operating procedures at the implicated dairy were all within accepted levels for production of Grade A raw milk in Georgia. Inasmuch as the parameters used by regulatory officials to determine the wholesomeness of milk were not violated at the implicated dairy, the only means available to ensure the public's health would be proper pasteurization before consumption.

Adult↗