Search PubMed⌕ Search

Biomedical subjects

T F Brewer

Publications and source records attributed to T F Brewer.

At least 37 records · Page 2Linked to original sources
PubMed1992

The problem of transfusion-associated acquired immunodeficiency syndrome in Africa: a quantitative approach.

BACKGROUND: Transfusion-associated AIDS accounts for 10% of all cases of AIDS in Africa. The risk of HIV-1 contamination in transfusions continues to exist, even in countries where blood products are screened, because of limitations in test sensitivity, human error, and the window period. Furthermore, 30 African countries do not screen all of their blood products because of resource limitations. METHODS: This study used decision analysis to compare the survival outcomes of severely anemic patients who are transfused with those of patients who are not transfused. Sensitivity analyses were performed. RESULTS: When 5% of the blood supply is HIV-1 contaminated, every patient with a 6.6% or greater risk of dying from anemia should be transfused. Detailed results are provided for a wide range of HIV-1 contamination rates. CONCLUSIONS: This study provides a method for developing and evaluating locality-specific transfusion guidelines. This method can be applied to other regions, including the United States, and to other diseases transmitted by blood products.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Prevalence of antibody to HIV-1 among entrants to US correctional facilities.

Prevalence of antibody to the human immunodeficiency virus type 1 (HIV-1) was assessed among 10,994 consecutive male and female entrants to 10 correctional systems in the United States. The HIV-1 seroprevalence for the 10 systems ranged from 2.1% to 7.6% for men and 2.5% to 14.7% for women; seroprevalence among women was higher than among men across nine of 10 systems. Using age 25 years to divide the population, HIV-1 prevalence among young women (5.2%) was significantly higher than among young men (2.3%), but similar to that in both older women (5.3%) and older men (5.6%). Overall, HIV-1 rates for nonwhites (4.8%) were higher than those for whites (2.5%). Although categories were identified across correctional systems, which may serve to focus prevention programs, variability in rates among correctional systems indicates that program planning must take local conditions into consideration.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Death in prison: changing mortality patterns among male prisoners in Maryland, 1979-87.

The leading causes of death (rate per 100,000 prisoner-years) in Maryland state prisons for the period 1979-87 were circulatory system disease (59), suicide (40), and homicide and legal intervention (30). Acquired immunodeficiency syndrome (AIDS) became the leading cause of death in 1987. Homicides declined after 1980; drug overdose deaths peaked in 1981 and later disappeared. Male inmates have 39 percent lower all-cause death rates than the general population of Maryland after adjustment for age and race.

Cause of Death↗
PubMed1989

Suicide mortality in the Maryland state prison system, 1979 through 1987.

Prisoners are reported to have a higher suicide rate than the community. We studied suicides in the Maryland prison system to determine the level of risk and risk factors for inmate suicide. There were 37 male inmate suicide deaths between 1979 and 1987 (39.6 suicides per 100,000 male inmates), which is significantly higher than the age- and race-adjusted male suicide rate in the general population of Maryland (22.0 per 100,000). Risk of male inmate suicide was increased for the following characteristics: white race (relative risk [RR], 2.0; 95% confidence interval [CI], 1.1 to 3.9), age 25 to 34 years (RR, 1.8; 95% CI, 1.0 to 3.4), major crime committed against person (RR, 3.4; 95% CI, 1.7 to 6.7), life sentence (RR, 4.7; 95% CI, 2.2 to 10.0), and classification to the major maximum security institution in the prison system (RR, 5.1; 95% CI, 2.7 to 9.8). The methods of suicide chosen by inmates were hanging (86%), cutting wound (5%), antidepressant overdose (5%), and fall from height (3%). We conclude that inmate suicide represents a significant correctional health and public health problem. Specific implications for prevention of inmate suicide are examined.

Black or African American↗
PubMed1989

Dental health of male inmates in a state prison system.

This study investigated the prevalence of decayed, missing, and filled teeth (DMFT) in a state prison system, using the opening of a new institution as an opportunity to examine a cross-section of the state male inmate population routinely. A representative sample of 178 male inmates was examined by a single dentist, and the results were linked to demographic information. This study found a mean DMFT of 10.5 for inmates aged 18-29, 17.1 for inmates aged 30-44, and 22.4 for inmates over age 44. In the 18-29 age group, white inmates had more filled teeth than blacks (P less than .005) and more missing teeth (P = .06). Missing teeth increased by 0.54 teeth/year of age (P less than .001) and DMFT increased by 0.66 teeth/year of age (P less than .001). The number of decayed teeth was explained using negative reciprocal time incarcerated (-1/T), and declined by 1.30 teeth between the sixth and 12th month of incarceration (P less than .01). This may have been due to a treatment effect, or by selective loss of the population with poorer teeth. Comparison with US employed adults standardized to the study population showed that inmates had more missing teeth at every age, and a greater percent of unmet dental needs.

Adolescent↗
PubMed1989

5-Hydroxytryptophan and carbidopa in spontaneously hypertensive rats.

Serial measurements of blood pressure, body weight, food and water intake, and salt and water excretion were compared in two groups of spontaneously hypertensive rats (SHR) over a 12-day period: control SHR (n = 11) and a group (n = 9) which received supplementary 5-hydroxytryptophan (5-HTP; 2 mg/ml) in its drinking water. During the final 4 days of study, both groups received additional oral carbidopa (50 mg/kg twice a day) to inhibit peripheral, but not brain aromatic L-amino-acid decarboxylase (LAAD), an enzyme necessary to the formation of 5-hydroxytryptamine (5-HT, serotonin) from 5-HTP. 5-Hydroxytryptophan increased urinary 5-HT and its metabolite 5-hydroxyindoleacetic acid (5-HIAA) markedly; following carbidopa, urinary 5-HT, and to a lesser degree urinary 5-HIAA, decreased, whereas brain 5-HT and 5-HIAA increased. Spontaneously hypertensive rats treated with 5-HTP plus carbidopa had significantly lower blood pressure levels, lower pulse rates, reductions in food and water intake, salt and water excretion, and a loss of body weight, when compared with the control SHR. These data indicate that enhanced brain formation of 5-HT can give rise to metabolic and circulatory responses with a resultant lowering of blood pressure.

5-Hydroxytryptophan↗
PubMed1989

Medical care behind bars: Maryland prison system.

The inmate population in the Maryland prison system has increased dramatically over the past 10 years due to changes in sentencing by the courts. At the same time, costs of inmate health care have increased markedly following court cases mandating adequate care, an amelioration of prior inadequate standards of care. The unique demographic and disease risk characteristics of inmates predispose them to a distinct set of health problems. The state is legally obligated to provide health care to individuals sentenced to confinement in state prisons. It is often the first care these individuals have received in many years.

Adolescent↗
PubMed1988

Transmission of HIV-1 within a statewide prison system.

To assess the incidence of infection with HIV-1 in the Maryland state prison system, inmates with excess sera stored from specified intake periods between April and June 1985 and 1986 were approached in May 1987 to volunteer for venipuncture. Of the 2286 inmates for whom intake specimens were stored, 1038 (45.4%) no longer incarcerated as of April 1987 were excluded from the study; another 319 missed the survey. Of the 929 eligible inmates approached for the study, 446 (48%) consented and 422 (94.6%) provided a specimen. Twenty-nine (6.6%) were confirmed seropositive at time of entry into prison, indicating that infection had occurred prior to incarceration. Baseline seropositives were more likely (P less than 0.05) to be non-violent offenders, committed in Baltimore City, and black. The 393 participants seronegative at baseline provided a total of 482 prison-years of potential exposure to infection. Two inmates seroconverted with baseline specimens seronegative on Western blot and follow-up sera confirmed positive; their duration of pre-incarceration detention was 69 and 146 days, respectively. No interruption of incarceration was recorded for these two inmates. The rate of infection in this prison sample, which does not include an average of 2 months of pre-incarceration detention for the study sample, was 0.41% per prison-year.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Formation of biogenic amines by isolated kidneys of spontaneously hypertensive rats.

Kidneys form dopamine (DA) from L-dopa and serotonin from L-5-hydroxytryptophan (L-5-HTP) via aromatic L-amino acid decarboxylase. We compared the ability of isolated perfused kidneys from adult (20-week-old) spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY) to form these biogenic amines. Renal vascular resistance (RVR) was greater in perfused kidneys from SHR (n = 10) than WKY (n = 8) (p less than 0.01). Slight decreases in RVR were observed during L-dopa infusion but these were unrelated to DA formation. L-Dopa infusion was associated with greater DA output in SHR than WKY in both the renal venous and urinary effluents although the latter did not achieve statistical significance. L-5-HTP increased RVR to a greater degree in SHR than WKY kidneys. This was associated with larger quantities of serotonin in the urinary and venous effluents and greater pressor responses to exogenous serotonin in SHR than WKY kidneys; however, either parameter alone was not significantly increased. Our findings do not support a deficiency of intrarenal DA formation as a pathogenic factor for hypertension in SHR. Biogenic amine formation is as great if not greater in SHR than WKY kidneys and appears to contribute largely to the greater increases in renal resistance seen in SHR kidneys on infusion of L-5-HTP. Enhanced renal serotonin formation may elevate blood pressure, whereas enhanced renal DA formation would favor blood pressure lowering, perhaps as a compensatory mechanism.

5-Hydroxytryptophan↗
PubMedDate not supplied

Gonorrhea prevalence in the Maryland state prisons.

During a 6-month period from July 1 through December 31, 1986, 2,598 consecutive men were screened for gonorrhea upon entry into the Maryland Division of Corrections. Twenty-eight men (1.1%) demonstrated positive cultures for gonorrhea with 27 of them (92%) asymptomatic. This prevalence is substantially lower than other rates reported from prisons and detention centers. Although the role of asymptomatic males as a reservoir for gonorrhea has been well delineated, standard recommendations for screening high-risk male populations such as prison inmates have not been established. These data suggest that screening in some correctional facilities may not be cost-effective given the low prevalence observed. In addition, contact tracing may be delayed by long holding periods in local detention facilities prior to transfer to the state prison system. These data underscore the need for additional analysis to determine the most effective program structure for screening in correctional facilities and detention centers.

Adult↗