Search PubMed⌕ Search

Biomedical subjects

R M Selik

Publications and source records attributed to R M Selik.

34 records · Page 2Linked to original sources
PubMed1988

Epidemiology of HIV infection and AIDS in the United States.

By the end of 1987, nearly 50,000 cases of acquired immunodeficiency syndrome (AIDS) had been reported since 1981, 20,745 in the past year alone. Black and Hispanic adults and children have reported rates 3 to 12 times as high as whites. This can be largely attributed to higher reported rates in black and Hispanic intravenous (IV) drug abusers, their sex partners, and infants. In 1986, reported AIDS deaths increased adult male and female mortality in the United States by an estimated 0.7 and 0.07%, respectively, with much greater increases in selected age groups or areas of the country. The greatest variation in infection with the human immunodeficiency virus (HIV) (0 to 70%) has been found in surveys of IV drug abusers, while surveys of homosexual men reveal infection rates of 20 to 50%. Infection with HIV ranged from 0 to 2.6% in limited sexually transmitted disease clinic surveys of heterosexual men and women without a history of IV drug abuse or known sexual contact with persons at increased risk. The modes of HIV transmission are now well understood, but a large amount of biologic variability in efficiency of transmission remains to be explained. The period between initial infection with HIV and the development of AIDS is variable, but the risk for disease progression increases with duration of infection.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Racial/ethnic differences in the risk of AIDS in the United States.

We analyzed the variation in the risk of AIDS in US Blacks, Hispanics, and other racial/ethnic groups relative to that in Whites (non-Hispanic) by geographic area and mode of acquiring HIV infection, based on data reported between June 1, 1981 and January 18, 1988 to the Centers for Disease Control and 1980 US census data. Relative risks (RRs) in Blacks and Hispanics were highest in the northeast region, and higher in suburbs than in central cities of metropolitan areas. RRs in Blacks and Hispanics were greatest for AIDS directly or indirectly associated with intravenous-drug abuse by heterosexuals (range: 5.7-26.9) and were also high for AIDS associated with male bisexuality (range: 2.5-4.8), suggesting that these behaviors may be more prevalent in Blacks and Hispanics than in Whites. Prevention strategies should take into account these racial/ethnic differences.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Opportunistic diseases reported in AIDS patients: frequencies, associations, and trends.

To look for associations and trends in the reported frequencies of particular opportunistic diseases in AIDS patients, we analyzed diseases in the 30,632 AIDS patients in the United States reported to the Centers for Disease Control (CDC) by 9 February 1987. Compared with all other AIDS patients, children were three times more likely to have cytomegalovirus disease, homosexual men were seven times more likely to have Kaposi's sarcoma, and Haitian-born patients were six, 14 and 13 times more likely to have toxoplasmosis, tuberculosis, and chronic enteric isosporiasis, respectively. The proportions of patients initially presenting with particular diseases have changed; from before 1983 to 1986, the proportion with Pneumocystis pneumonia climbed from 41.9 to 63.6% and the proportion with extrapulmonary cryptococcosis rose from 4.5 to 6.2%, while Kaposi's sarcoma fell from 30.9 to 14.2%, chronic herpes simplex declined from 4.2 to 2.1%, and toxoplasmosis of the brain dropped from 3.5 to 1.5%.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Acquired immune deficiency syndrome (AIDS) trends in the United States, 1978-1982.

This report summarizes results of surveillance for the acquired immune deficiency syndrome (AIDS) in the United States by the Centers for Disease Control through the first quarter of 1983. Surveillance has been predominantly passive, supplemented by active follow-up of requests to the Centers for Disease Control for pentamidine isethionate for treatment of Pneumocystis carinii pneumonia. The 1,299 reported cases showed trends of increasing incidence among all risk groups: homosexual men (72 percent), intravenous drug abusers (17 percent), persons of Haitian origin (5 percent), persons with hemophilia (1 percent), and others (6 percent). Cases were reported among residents of 35 states and the District of Columbia, with the majority from New York (49 percent) and California (22 percent). Of the 6 percent of patients without well-established risk factors for AIDS, many have suspected risk factors (e.g., blood transfusion or a sexual partner in a high-risk group).

Acquired Immunodeficiency Syndrome↗
PubMed1984

Heterosexual and homosexual patients with the acquired immunodeficiency syndrome. A comparison of surveillance, interview, and laboratory data.

Homosexual and heterosexual patients with the acquired immunodeficiency syndrome were compared by risk group. Race; diagnoses; history of sexually transmitted diseases, sexual behavior, and drug use; and socioeconomic indicators differed considerably among risk groups, suggesting different risk factors for acquisition of the syndrome. Patients in the homosexual, intravenous drug user, and Haitian risk groups differed in their serologic response to cytomegalovirus and syphilis testing, presumably due to lifestyle-related exposures. Differences in the rate of recovery of cytomegalovirus, serum levels of IgA and IgG, and antibody titers to Epstein-Barr virus were noted among patients with different diagnoses. We conclude that in studies of risk factors for the acquired immunodeficiency syndrome, patients should be analyzed by risk group and diagnoses.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Acquired immune deficiency syndrome in the United States: the first 1,000 cases.

Between June 1981 and February 1983, the Centers for Disease Control (Atlanta) received reports of 1,000 patients living in the United States who met a surveillance definition for the acquired immune deficiency syndrome (AIDS). Seventy-three percent of these patients were diagnosed after January 1, 1982. The 1,000 patients included 284 with Kaposi's sarcoma (KS), 497 with Pneumocystis carinii pneumonia (PCP), 83 with KS and PCP, and 136 with opportunistic infections other than PCP. The overall mortality has been 39.2%. Cases have been reported from 32 states and the District of Columbia; New York, California, New Jersey, and Florida account for 82.7% of the reports. All but 61 of the patients could be classified into one or more of the following groups: homosexual or bisexual men, intravenous drug abusers, Haitian natives, or patients with hemophilia. Epidemiologic trends in AIDS cases are consistent with the gradual extension of an infectious agent into new populations.

Acquired Immunodeficiency Syndrome↗
PubMed1981

Effects of restricted public funding for legal abortions: a second look.

At hospitals in three cities where public funding for legal abortions had been restricted, we reviewed the records of women with complications of all types of abortions. We compared the number of complications in the year before funding restriction with the number in the following year, during restriction. For complications of illegal and spontaneous abortions, we found no significant change in either the number or proportion of publicly funded hospitalizations. For complications of legal abortions, we found a decrease in both the number and proportion of publicly funded hospitalizations. For poor women, it appears that restriction of public funding for legal abortions has not markedly increased the number of illegal abortions, but has reduced the number of legal abortions, especially those at later gestational ages, which would have cost more and been at greater risk of complications.

Abortion, Legal↗
PubMed1981

Fatal septic abortion in the United States, 1975-1977.

In 1975 through 1977, 36 women in the United States died of septic abortion (12 legal, 15 spontaneous, 8 illegal, and 1 unclassified). The respective estimated death-to-case rates for septic abortion are 0.4 and 0.6 deaths per 100,000 legal and spontaneous abortions. Unmarried teenagers who undergo incomplete abortion at 16 weeks' gestation or more by intrauterine placement of a foreign body appear to have the highest risk of death from infection after legal abortion. Three of these risk factors (gestational age at the time of abortion, method, and completeness of abortion) can be influenced by medical personnel. Complete abortion by safe techniques early in pregnancy can help eliminate deaths from infection after legal abortion.

Abortion, Incomplete↗
PubMed1981

Behavioral factors contributing to abortion deaths: a new approach to mortality studies.

One hundred six women were reported to have died from abortions (55 legal, 10 illegal, and 41 spontaneous) in the United States from 1975 through 1977. In reviewing these deaths, the authors developed a new approach to mortality studies. A catalogue was compiled of behavioral factors (including actions by physicians, patients, communities, and institutions) that in the authors' judgment increased the risk of death from abortion. The proportion of abortion deaths to which each behavioral risk factor contributed was determined. Of the 199 different behavioral factors, 5 contributed to more than 10% of legal abortion deaths, 5 to more than 10% of illegal abortion deaths, and 3 to more than 10% of spontaneous abortion deaths. The most frequent factors involved were delay in obtaining a legal abortion until 13 weeks' gestation or later, incomplete abortion, and inappropriate choice of antibiotics for septic abortion. Assessing the proportion of abortion deaths to which each factor contributed can help identify which factors deserve priority in prevention.

Abortion, Legal↗
PubMedDate not supplied

Reducing classification errors in cohort studies: the approach and a practical application.

Classification errors of dependent variables can distort the results of observational studies. To reduce misclassification from our multicentre observational study of abortion complications, we extended the methodology of Lawrence and Greenwald for use in situations of unequal sample sizes and implemented both an office review and a field review. We reabstracted 424 reported complications and a random sample of 364 reported non-serious cases from 12 institutions participating in our study. In total, 30 per cent of the reported serious complications turned out to be misclassified: the office review detected 74 per cent of the total number of misclassifications with the remainder found in the field review. Because, with our particular data base, we estimated expending only 15 per cent of the total resources with our office effort, this represented the most cost-efficient approach to reducing classification errors. By eliminating the false positives from our study, we forced the specificity to 1.00 which produced both an unbiased estimate of the relative risk and an increase of 4 per cent to 63 per cent in the power of our study.

Abortion, Spontaneous↗
PubMedDate not supplied

Trends in transfusion-associated acquired immune deficiency syndrome in the United States, 1982 through 1991.

To evaluate the efficacy of measures for preventing the transmission of human immunodeficiency virus (HIV) by blood transfusion, trends in transfusion-associated cases of acquired immune deficiency syndrome (AIDS) reported through June 1992 were analyzed. By year of transfusion, cases rose from 56 in 1978 to 714 in 1984, dropped sharply to 288 in 1985 when screening of donated blood for HIV antibody began, and fell below 20 per year from 1986 through 1991. Reinvestigation of a sample of cases suggested that only one-fourth of those attributed in the trends analysis to post-1985 United States transfusions actually were due to that source. By year of AIDS diagnosis, cases climbed from 14 in 1982 to 824 in 1987 and subsequently remained relatively level. Of cases diagnosed in 1991 with known transfusion dates, almost all resulted from transfusions received before 1986. Cases in persons aged > or = 65 years at diagnosis fell steeply after 1987, while those in persons aged 45 to 64 years leveled and those in persons aged 25 to 44 years continued to increase; this caused the median age to decrease from 59 in 1986 to 47 in 1991. Thus, screening and other measures have almost completely prevented transmission, but, because of infections acquired before screening began, many cases continue to be diagnosed among increasingly younger persons.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Abortion facilities and the risk of death.

While the number of abortions performed annually in the United States has increased steadily since 1969, the proportion of abortions performed in hospitals has been declining since 1975. Between 1974 and 1977, 1,229,000 abortions were performed at 12 or fewer weeks' gestation in U.S. hospitals, while 2,730,000 were performed in free-standing clinics and doctors' offices. Over the same period, there were 19 deaths which resulted from in-hospital procedures, and 17 from abortions performed in nonhospital facilities. The crude death-to-case rate are 1.5 deaths per 100,000 procedures for hospital abortions, and 0.6 deaths per 100,000 abortions performed in nonhospital facilities. When these rates are adjusted for the presence of preexisting medical conditions and for the concurrent performance of sterilizations, the death-to-case rates for first-trimester abortions performed in both kinds of facilities were about 0.7.

Abortion, Legal↗