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Biomedical subjects

W W Darrow

Publications and source records attributed to W W Darrow.

At least 55 records · Page 3Linked to original sources

The acquired immunodeficiency syndrome in a cohort of homosexual men. A six-year follow-up study.

A cohort of 6875 homosexual men, initially seen at the San Francisco City Clinic between 1978 and 1980, were studied to determine the incidence and prevalence of the acquired immunodeficiency syndrome, related conditions, and infection with the human T-lymphotropic virus, type III/lymphadenopathy-associated virus (HTLV-III/LAV). By December 1984, 2.4% of the men had the syndrome; mortality attributable to the syndrome in 1984 was 600/100 000. For each man with the syndrome in a representative sample of 474 cohort members seen in 1984, 7.5 men had generalized lymphadenopathy, 1.1 had other prodromal findings, and 0.8 had hematologic abnormalities. Prevalence of serum antibodies to HTLV-III/LAV, measured by an enzyme-linked immunosorbent assay, increased from 4.5% in 1978 to 67.4% in 1984. Of 31 persons who were seropositive and without the syndrome between 1978 and 1980, 2 developed the syndrome and 8 developed related conditions during a median follow-up of 61 months. Over a 6-year period, two thirds of cohort members were infected with HTLV-III/LAV and almost one third developed related conditions.

Acquired Immunodeficiency Syndrome↗

The acquired immunodeficiency syndrome in gay men.

The acquired immunodeficiency syndrome (AIDS) is a major health problem for gay men in the United States. About three fourths of all reported cases have occurred in this population, and the number is projected to double in the next year. In Manhattan and San Francisco, AIDS is now the leading cause of premature mortality in men aged 25 to 44 years who have never married. In a sample of a cohort of gay men enrolled in a San Francisco clinic, 2.7% of the men had the syndrome and 26% had related conditions in 1984. Antibody to human T-lymphotropic virus, type III/lymphadenopathy-associated virus was found in sera from 67% of the men, including 58% of asymptomatic men. Behavioral factors associated with an increased risk of AIDS include large numbers of sexual partners, receptive anal intercourse, and "fisting." The adoption of safer lifestyles is currently the basis of attempts to control the syndrome in gay men.

Acquired Immunodeficiency Syndrome↗

Cluster of cases of the acquired immune deficiency syndrome. Patients linked by sexual contact.

The possibility that homosexual men with the acquired immune deficiency syndrome (AIDS) had been sexual partners of each other was studied. Of the first 19 homosexual male AIDS patients reported from southern California, names of sexual partners were obtained for 13. Nine of the 13 patients had sexual contact with one or more AIDS patients within five years of the onset of symptoms. Four of the patients from southern California had contact with a non-Californian AIDS patient, who was also the sexual partner of four AIDS patients from New York City. Ultimately, 40 patients in 10 cities were linked by sexual contact. On the basis of six pairs of patients, a mean latency period of 10.5 months (range seven to 14 months) is estimated between sexual contact and symptom onset. The finding of a cluster of AIDS patients linked by sexual contact is consistent with the hypothesis that AIDS is caused by an infectious agent.

Acquired Immunodeficiency Syndrome↗

National case-control study of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men: Part 1. Epidemiologic results.

To identify risk factors for the occurrence of Kaposi's sarcoma and Pneumocystis carinii pneumonia in homosexual men, we conducted a case-control study in New York City, San Francisco, Los Angeles, and Atlanta. Fifty patients (cases) (39 with Kaposi's sarcoma, 8 with pneumocystis pneumonia, and 3 with both) and 120 matched homosexual male controls (from sexually transmitted disease clinics and private medical practices) participated in the study. The variable most strongly associated with illness was a larger number of male sex partners per year (median, 61 for patients; 27 and 25 for clinic and private practice controls, respectively). Compared with controls, cases were also more likely to have been exposed to feces during sex, have had syphilis and non-B hepatitis, have been treated for enteric parasites, and have used various illicit substances. Certain aspects of a lifestyle shared by a subgroup of the male homosexual population are associated with an increased risk of Kaposi's sarcoma and pneumocystis pneumonia.

Acquired Immunodeficiency Syndrome↗

The gay report on sexually transmitted diseases.

Most studies of sexually transmitted diseases in homosexual men have examined prevalence in clinic populations; for comparative purposes, we analyzed data from a survey of 4,329 gay men conducted in 1977. Among 4,212 respondents to the self-administered questionnaire, 66.8 per cent reported previous infection with pediculosis; 38.4 per cent, gonorrhea; 24.1 per cent, nonspecific urethritis; 18.1 per cent, venereal warts; 13.5 per cent, syphilis; 9.7 per cent, hepatitis; and 9.4 per cent, herpes. Number of different lifetime sexual partners best predicted histories of symphilis (r = .249), gonorrhea (r = .402), and the other diseases; frequency of checkups, years as a practicing homosexual, and furtive sexual activities were among the many other significant correlates of venereal infections. Respondents most often sought examinations from private physicians (39.4 per cent); those who visited gay clinics were examined most often and felt most positive about their medical care. Gay men who participated in the survey reported frequent infections with many of the same sexually transmitted diseases often seen in private medical practices, public VD clinics, and gay health centers. Since high rates of disease are related to large numbers of different partners, frequent exposures with anonymous contacts, and anal intercourse, we recommend frequent examinations for those whose life-styles include these characteristics.

Hepatitis B↗

Social and psychologic aspects of the sexually transmitted diseases: a different view.

A sociologic model is presented which interrelates four major variables: health providers, health consumers, the sociocultural environment, and social exchange. This model is proposed as an alternative to the prevailing medical model where the patient is pictured as a passive carrier who presents a problem to the competent physician to define, treat and control. In contrast to the epidemiologic model, the new model puts the health professional on the same level as the patient and demands that we take a critical look at our own values and behavior as well as that of the patient community. Studies are presented which indicate that in the United States there is much left to be desired in our performance as far as screening, diagnosis, treatment, reporting and follow-up of sexually transmitted diseases (STDs) are concerned. We have a tendency to dismiss the reasons for noncompliance of patients as "poor excuses" but we are probably even less compliant in doing what should be done to control STDs. Setting realistic goals and accepting the challenge of solving this problem are essential.

Adult↗

Gonococcal pelvic inflammatory disease: case-finding observations.

During a 20 month period, 110 women with gonococcal pelvic inflammatory disease an 165 women with uncomplicated gonorrhea were provided intensive case-finding services (interviewing of patients and tracing of contacts). Approximately three contacts per case were investigated, and 24.3% of the 859 male contacts were infected. Nearly two thirds (64.6%) of the infected contacts were asymptomatic. Active public health intervention was frequently necessary to persuade asymptomatic men to seek medical attention; removal of these men from the disease pool may serve to prevent reinfection of treated women and to diminish the transmission of gonorrhea.

Colorado↗

Repeated gonorrhea: an analysis of importance and risk factors.

This study was designed to assess the epidemiological importance of repeated infections due to Neisseria gonorrhoeae and to analyze variables potentially associated with repeated gonorrhea. The retrospective analysis was of 7,347 patients seen during one year, and the prospective study was of a stratified randomly selected sample of 429 patients. The 492 retrospectively identified repeaters constituted 0.06% of the county population and 6.7% of the clinic population. The 492 repeaters had 21.6% of the cases of gonorrhea reported from the county and 29.4% of the cases reported from the clinic. The repeaters tended to be younger than those without repeated infection (P less than 0.001), male (62%), black (81.7%), and residents of areas of lower socioeconomic status than those who were not repeaters (P less than 0.001). Most repeaters (73.5%) had not graduated from high school. Repeaters did not have significantly greater numbers of sex partners (P greater than 0.05) or greater exposure to prostitutes or clients than those who did not have repeated infections and less frequently had sexual contact while symptomatic. Intensive follow-up of the small number of high-risk repeaters and their contacts could result in a major reduction in the number of reported cases of gonorrhea.

Adolescent↗

Veneral infections in three ethnic groups in Sacramento.

Blacks treated in Sacramento County (CA) Clinics were most likely to have gonorrhea. Chicanos were slightly more likely to have nonspecific urethritis and other sexually transmitted diseases, and Whites were most likely to be uninfected. Whites tended to name greater numbers of different sexual partners, but differences among the three groups were not statistically significant. Black men more frequently reported to clinics with genitourinary symptoms and delayed significantly longer before seeking treatment. Future research should assess the relative contributions of sexual and health behaviors to the distributions of different sexually transmitted diseases in different groups.

Black or African American↗

Adoption of Thayer-Martin culture medium by physicians in office-based practice.

In the summer of 1972, 26.4% of 900 physicians surveyed in the United States reported that they had performed one or more endocervical cultures for gonorrhea during a week of study. Obstetrician-gynecologists (62.8%) were considerably more likely than others to employ this diagnostic technique. The use of Thayer-Martin cultures was associated with the number of women examined and type of laboratory used (public, private or hospital), but not region of practice (East, Midwest, South, of West), area of practice (urban, suburban, or rural), or month of interview (July, August, or September). Results of this survey are consistent with the diffusion of innovation model proposed by Rogers.

Adult↗