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An ongoing surveillance program was intensified during the 1979-1980 and the 1980-1981 influenza seasons to determine whether an increased risk of acquiring Guillain-Barré syndrome (GBS) within eight weeks after influenza vaccination existed for adults in the United States who received influenza vaccine, when compared with adult who had not been vaccinated recently. Five hundred twenty-eight cases of GBS with onset between Sept 1 and March 31, including seven following recent vaccination, were reported by participating neurologists in 1979-1980; 459 cases, including 12 following recent vaccination, were reported in 1980-1981. The relative risk of acquiring GBS following influenza vaccination--0.6 in 1979-1980 and 1.4 in 1980-1981--was not significantly different from 1.0 in either season. These results suggest that there was no increased risk of acquiring GBS associated with the influenza vaccines administered during these seasons and that the causative "trigger agent" in the A/New Jersey (swine) influenza vaccine administered in 1976 has not been present in subsequent influenza vaccine preparations.
Almost 500,000 Southeast Asian refugees have arrived in the United States since 1975. While these refugees have not presented substantial public health problems, they have important personal health problems frequently requiring medical attention. Medical care providers in this country need to be aware of disease patterns and prevalence among these refugees. As well, they need to be aware of the cultural and religious backgrounds and previous medical practices of this refugee population, particularly as these practice influence the refugees' ability to obtain and maintain medical services provided in this country. Historical, cultural, religious, ethical, and medical information is provided to help US health care facilities develop culturally appropriate medical care services for Southeast Asian refugees.
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Attitudes toward clinical research, the focus of recent and damaging media attention, were assessed through questionnaires completed anonymously by 104 patients with cancer, 84 cardiology patients, and 107 members of the general public. Responses differed neither by subgroup nor by demographic variables. Data are therefore reported on the total population of 295 subjects. Most respondents (71%) believed that patients should serve as research subjects. In support of this belief, the majority cited potential benefit ot others and the opportunity to increase scientific knowledge, but a different bias emerged when they were asked about their own potential participation. This study shows that diverse respondents view clinical trials as important, ethical, and as a means of attaining superior clinical care. Major importance is attributed to making contributions to medical knowledge and to helping future patients. Contrasts are noted in patients' views of their own treatments v treatments of "'hypothetical others."
No abstract available
Although human immunodeficiency virus type 1 (HIV-1) and HIV-2 share modes of transmission, their epidemiologic characteristics differ and international spread of HIV-2 has been very limited. Recently, the prevalence of infection with HIV-1 but not HIV-2 has increased rapidly in different West African countries, where HIV-2 was probably present earlier. Among 19,701 women of reproductive age tested in Abidjan, Ivory Coast, between 1988 and 1992, the prevalence of HIV-1 infection increased from 5.0% to 9.2%, while that of HIV-2 declined from 2.6% to 1.5%. Differences in viral load may be responsible: reported results of virus culture and polymerase chain reaction assays suggest that at high CD4+ T-lymphocyte counts viral load is lower in HIV-2-infected than in HIV-1-infected persons; the efficacy of heterosexual and perinatal transmission of HIV-2 is less efficient than that of HIV-1 at this stage. At low (< 0.20 x 10(9)/L [< 200/microL]) CD4+ T-lymphocyte counts, virus isolation is equally successful for both viruses, and the efficacy of heterosexual transmission is similar. Differences in HIV-1 and HIV-2 natural history are reflected in differences in viral load, that for HIV-2 being lower until immunodeficiency is severe. Differences in viral load throughout most of the natural history of infection appear to correlate with lower transmissibility of HIV-2 than HIV-1, and are the likeliest explanation for their markedly different global epidemiology.
To evaluate whether eye size and shape are different in children based on their parental history of myopia.
In 1991, the American Medical Association's Council on Scientific Affairs prepared a report (Report M) on the silicone gel breast implant controversy and the U.S. Food and Drug Administration regulatory history of breast implant devices through August 1991. The recommendations of Report M were adopted as amended by the AMA's House of Delegates at its 1991 Interim Meeting. This follow-up report (Report C) by the Council on Scientific Affairs covers the continuing FDA regulatory history through October 1992 and was adopted as amended at the 1992 Interim Meeting of the AMA's House of Delegates.
No abstract available
To assess transdermal nicotine use patterns and outcomes in a population of low-income older smokers.
No abstract available
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