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Biomedical subjects

R L Harris

Publications and source records attributed to R L Harris.

At least 55 records · Page 3Linked to original sources
PubMed1990

Evaluation of a hospital admission HIV antibody voluntary screening program.

Voluntary screening for the presence of human immunodeficiency virus (HIV) is recommended by the healthcare profession. The optimal settings to accomplish screening have not been established. We evaluated an admission HIV screening program in a large private hospital to assess advantages and disadvantages in this setting. In a three-month study period, 4,535 of 8,868 patients (51%) admitted to the hospital agreed to HIV testing. Serum specimens from 500 patients who refused testing were blindly, anonymously tested. The seroprevalence of the patients agreeing to (0.26%) and refusing (0.60%) testing was not statistically different (p = .12). There were 12 HIV cases discovered; ten (83%) of these were known to be in a high-risk group at the time of admission. Eighty-five percent of patients interviewed were in favor of this screening program. Difficulties associated with confidentiality or consent were not evident. Calculated charges of testing for each HIV case discovery was $14,550. There was no evidence that this screening program provided for a more effective infection control policy to prevent nosocomial HIV transmission. A hospital admission HIV screening program can be implemented, can meet with favorable patient opinion and can detect previously unknown HIV-positive patients. Hospitals are an efficient and practical setting for HIV testing. The benefit of this program appears to be greater for the patient than hospital or healthcare worker. Cost-benefit analyses will identify optimal candidates to be screened in different hospital populations.

Attitude to Health↗
PubMed1987

Candida osteomyelitis. Report of five cases and review of the literature.

Candida species have emerged as important pathogens in human infection. Although a variety of deep-seated candidal infections have been reported, Candida osteomyelitis has rarely been described. Five patients with Candida osteomyelitis are presented, and the 32 adult cases previously reported are reviewed. Candida osteomyelitis is noted as a simultaneous occurrence or late manifestation of hematogenously disseminated candidiasis. Osteomyelitis may not be prevented by a course of amphotericin B adequate to control the acute episode of disseminated candidiasis, particularly in immunosuppressed patients. Less commonly, Candida osteomyelitis presents as a postoperative wound infection. Like bacterial osteomyelitis, the most common presenting symptom is local pain. The insidious progression of infection, the nonspecificity of laboratory data, and the failure to recognize Candida as a potential pathogen may lead to diagnostic delay. Diagnosis can be made by either open biopsy or closed needle aspiration. Successful therapeutic regimens have employed combinations of antifungal therapy (most often amphotericin B) with surgical debridement when indicated. It is anticipated that osteomyelitis will become a more commonly recognized manifestation of hematogenously disseminated candidiasis.

Aged↗
PubMed1987

Manifestations of sepsis.

The clinical manifestations of sepsis may be flagrant or subtle. Awareness of the signs and symptoms of sepsis allows early recognition and prompt, appropriate management. The clinical presentation, relative frequency, and current pathophysiologic understanding of the manifestations of sepsis are reviewed. Special emphasis is placed on the cardiopulmonary manifestations, which are examined in a temporal sequence of preshock, early shock, and late shock states. While therapy for the underlying infection (such as antibiotics and drainage of abscesses) is often sufficient, therapy for the specific manifestations of sepsis may also be necessary. Guidelines for therapy for these manifestations of sepsis are given.

Bacterial Infections↗
PubMed1986

The timing of psychosocial transitions and changes in women's lives: an examination of women aged 45 to 60.

Sixty-four middle-class women from four cohorts aged 45, 50, 55, and 60 participated in a retrospective interview concerning psychosocial changes in their adult lives. Their responses provided self-report data relating to specific psychosocial changes, and judges who read the interview protocols provided independent ratings of major psychosocial transitions. The results indicated that major psychosocial transitions were more likely to be associated with phases of the family cycle than with chronological age; within the family cycle, transitions were more likely to occur during the preschool (28% of the women), launching (42% of the women), and postparental (33% of the women) phases than during the no children, school-age, or adolescent phases; transitions associated with the preschool and launching phases were characterized by dissatisfaction, personal disruption, marital unhappiness, and decreased personal development, whereas transitions associated with the postparental phase were characterized by personal mellowing and improved marital relations; and finally, numerous self-reported psychosocial changes were associated with family cycle phase, and a small number of changes was associated with chronological age.

Age Factors↗
PubMed1986

Successful management of Histoplasma capsulatum infection of an abdominal aortic aneurysm.

A 65-year-old woman with disseminated histoplasmosis underwent resection of an atherosclerotic abdominal aortic aneurysm. Yeast forms of Histoplasma capsulatum were present in the aneurysm. Surgical resection and revascularization with a Dacron graft followed by systemic amphotericin B therapy and chronic ketoconazole suppressive therapy have resulted in a patient without symptoms 15 months postoperatively. It is important to be aware of the potential for artherosclerotic aortic aneurysm involvement by H. capsulatum.

Aged↗
PubMed1985

Some health consequences of a natural disaster.

A survey of the health and psychosocial problems of all victims of the 1983 South Australian Ash Wednesday Bushfires was carried out 12 months after the disaster. A total of 1526 victims completed an extensive questionnaire that included the 28-item General Health Questionnaire and a self-reporting check-list of specific health problems. The data received indicated a significant increase in stress-related conditions, including hypertension, gastrointestinal disorders, diabetes, and mental illness, while the prevalence of nonstress-related conditions such as cancer or urological disease were not increased significantly. Health problems increased during the 12 months following the bushfire and diminished toward the end of that period, but a large number of difficulties remained. Certain disaster experiences, particularly the type of loss suffered, were found to be significantly related to health.

Adolescent↗
PubMed1985

The timing of psychosocial changes in women's lives: the years 25 to 45.

Sixty women, aged 30, 35, 40, and 45, participated in a retrospective interview concerning psychosocial changes in their adult lives. Subjects' responses provided self-report data concerning specific psychosocial changes, and judges who read the interview protocols provided independent ratings of major psychosocial transitions. The distributions of self-reported changes and rated transitions across both chronological age and family cycle phases were examined statistically. Rated transitions were found to be reliably related to chronological age but not to family cycle phase. Specifically, 78% of the subjects manifested a major transition commencing between ages 27 and 30. That transition was characterized initially by personal disruption, followed by reassessment and finally by increased psychological well-being. Both chronological age and family cycle phase were reliably related to a variety of self-reported changes. The implications for conceptions of adult developmental changes are discussed.

Adult↗
PubMed1985

Mortality among workers in the Florida phosphate industry. I. Industry-wide cause-specific mortality patterns.

A retrospective cohort mortality study was conducted on 17,601 white and 4,722 nonwhite male workers in the Florida phosphate mining and chemical processing industry. Concerns about potential risks from naturally-occurring sources of ionizing radiation and anecdotal reports of lung cancer among workers prompted this investigation. Historical follow-up was conducted for the years 1949 to 1978. In comparison with U.S. rates, small excess of mortality rates of lung cancer were observed for white (standardized mortality ratio [SMR] equals 1.22) and nonwhite workers (SMR = 1.24); however, these excesses disappeared when contrasts were made with prevailing rates in Florida. Emphysema mortality was also slightly elevated in comparison with U.S. rates; the SMRs were 1.48 and 1.73 for white and nonwhite workers, respectively. Neither disease was related to overall length of employment. Detailed analyses of mortality in relation to work assignments are presented in the companion article.

Adult↗
PubMed1985

Mortality among workers in the Florida phosphate industry. II. Cause-specific mortality relationships with work areas and exposures.

Small excesses of lung cancer and emphysema mortality had been detected among an historical cohort of 17,601 white and 4,722 nonwhite Florida phosphate industry workers. Internal mortality rate comparisons were made between worker subcohorts classified according to length of employment in 16 work areas and according to employment duration in jobs grouped by potential exposures to 10 agents, including alpha radiation. The only consistent associations seen were increased lung cancer mortality rates among long-term workers in plant-wide services and skilled crafts jobs. There was no evidence to support causal associations with exposures characteristic of the phosphate industry.

Adult↗
PubMed1984

Chronic active hepatitis in mice induced by 3-hydroxy-4-pyrone.

Chronic active hepatitis was selectively induced in mice by the feeding of a diet containing 3-hydroxy-4-pyrone (0.5% by weight) for periods of 6 weeks and longer. This model should be of particular value in elucidating the pathogenesis of drug-induced forms of chronic active hepatitis. Maltol (3-hydroxy-2-methyl-4-pyrone) did not produce any liver lesion.

Animals↗