FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Hilborn, ED Mermin, JH Mshar, PA Hadler, JL Voetsch, A Wojtkunski, C Swartz, M Mshar, R Lambert-Fair, MA Farrar, JA Glynn, MK Slutsker, L AF Hilborn, ED Mermin, JH Mshar, PA Hadler, JL Voetsch, A Wojtkunski, C Swartz, M Mshar, R Lambert-Fair, MA Farrar, JA Glynn, MK Slutsker, L TI A multistate outbreak of Escherichia coli O157 : H7 infections associated with consumption of mesclun lettuce SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID MINNESOTA; EPIDEMIOLOGY; DIARRHEA; BEEF AB Background: An outbreak of Escherichia coli O157:H7 infections in Connecticut and Illinois during May 28 to June 27, 1996, was investigated to determine the source of infections. Methods: Independent case-control studies were performed in both states. Pulsed-field gel electrophoresis (PFGE) was performed on E coli O157:H7 isolates. A case-patient was defined as a Connecticut or northern Illinois resident with diarrhea whose stool culture yielded E coli O157:H7 of the outbreak-associated PFGE subtype. Controls were town-, age-, and sex-matched to case-patients. We traced implicated lettuce to the farm level and performed environmental investigations to identify unsafe lettuce production practices. Results: In Connecticut and Illinois, infection was associated with consumption of mesclun lettuce (Connecticut matched odds ratio [MOR], undefined; 95% confidence interval [CI], 3.4 to infinity; and Illinois MOR, undefined; 95% CI, 1.4 to infinity). We traced implicated lettuce to a single grower-processor. Cattle, a known E coli O157:H7 reservoir, were found near the lettuce fields. Escherichia coli (an indicator of fecal contamination) was cultured from wash water and finished lettuce. A trace-forward investigation identified 3 additional states that received implicated lettuce; E coli O157:H7 isolates from patients in 1 of these states matched the outbreak-associated PFGE subtype. Conclusions: This multistate outbreak off coli O157:H7 infections was associated with consumption of mesclun lettuce from a single producer. Molecular subtyping facilitated the epidemiological investigation. This investigation increased the knowledge about current production practices that may contribute to the contamination of lettuce by microbial pathogens. Lettuce production practices should be monitored for microbiological safety. C1 Ctr Dis Control & Prevent, Epidemiol Program Off, Atlanta, GA USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA USA. Connecticut Dept Publ Hlth, Hartford, CT USA. Yale Univ, Sch Publ Hlth, New Haven, CT USA. Illinois Dept Publ Hlth, Springfield, IL 62761 USA. Calif Dept Hlth Serv, Sacramento, CA USA. RP Hilborn, ED (reprint author), US EPA, Natl Hlth & Environm Effects Res Lab, Maildrop 58A, Res Triangle Pk, NC 27711 USA. RI Mermin, Jonathan/J-9847-2012 NR 35 TC 191 Z9 198 U1 2 U2 17 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD AUG 9 PY 1999 VL 159 IS 15 BP 1758 EP 1764 DI 10.1001/archinte.159.15.1758 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 224MR UT WOS:000081903300015 PM 10448779 ER PT J AU Dietz, WH Davis, R AF Dietz, WH Davis, R TI Lessons from a cyclist - Doctors should do more to promote physical activity SO BRITISH MEDICAL JOURNAL LA English DT Editorial Material ID EXERCISE; ADVICE C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Dietz, WH (reprint author), Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Mailstop K-24, Atlanta, GA 30341 USA. NR 10 TC 2 Z9 2 U1 0 U2 1 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0959-8138 J9 BRIT MED J JI Br. Med. J. PD AUG 7 PY 1999 VL 319 IS 7206 BP 334 EP 334 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 226CA UT WOS:000082001700005 PM 10435940 ER PT J AU Stevens, CA Moore, CA AF Stevens, CA Moore, CA TI Tibial hemimelia in Langer-Giedion syndrome - Possible gene location for tibial hemimelia at 8q SO AMERICAN JOURNAL OF MEDICAL GENETICS LA English DT Article; Proceedings Paper CT International Symposium on Mosaicism in Human Skin CY MAY 22-23, 1998 CL MARBURG, GERMANY DE Langer-Giedion syndrome; tricho-rhino-phalangeal syndrome; tibial hemimelia; ulnar deficiency ID SHORTEST REGION; DELETION; OVERLAP AB We report on a girl with Langer-Giedion syndrome or tricho-rhino-phalangeal syndrome, type II (TRPS II) with deletion on 8q, and the unusual findings of bilateral tibial hemimelia and unilateral absence of the ulna. An 8-year-old boy with TRPS II with bilateral tibial hemimelia was reported by Turleau et al. [1982: Hum. Genet. 62:183-187]. The critical region for TRPS II is 8q24.1. Although no genes involving limb development in the human have been identified in this region, two mouse syndromes are localized to the homologous chromosome region of 9A1-A4 which involve limb abnormalities. We propose that a gene involved in limb development is contiguous with the TRPS II gene which, when deleted, may cause tibial hemimelia. (C) 1999 Wiley-Liss, Inc. C1 TC Thompson Childrens Hosp, Dept Paediat, Chattanooga, TN 37403 USA. Univ Tennessee, Coll Med, Chattanooga Unit, Chattanooga, TN USA. Ctr Dis Control & Prevent, Div Birth Defects & Dev Disabil, Natl Ctr Environm Hlth, Atlanta, GA USA. RP Stevens, CA (reprint author), TC Thompson Childrens Hosp, Dept Paediat, 910 Blackford St, Chattanooga, TN 37403 USA. NR 14 TC 17 Z9 17 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0148-7299 J9 AM J MED GENET JI Am. J. Med. Genet. PD AUG 6 PY 1999 VL 85 IS 4 BP 409 EP 412 DI 10.1002/(SICI)1096-8628(19990806)85:4<409::AID-AJMG19>3.0.CO;2-6 PG 4 WC Genetics & Heredity SC Genetics & Heredity GA 216VK UT WOS:000081465000019 PM 10398269 ER PT J AU MacLennan, J Obaro, S Deeks, J Williams, D Pais, L Carlone, G Moxon, R Greenwood, B AF MacLennan, J Obaro, S Deeks, J Williams, D Pais, L Carlone, G Moxon, R Greenwood, B TI Immune response to revaccination with meningococcal A and C polysaccharides in Gambian children following repeated immunisation during early childhood SO VACCINE LA English DT Article DE meningococcus; polysaccharide vaccine; tolerance ID LINKED-IMMUNOSORBENT-ASSAY; PROTEIN CONJUGATE VACCINE; MENINGITIDIS SEROGROUP-A; ANTIBODY CONCENTRATIONS; INFANTS; IMMUNIZATION AB Forty-two Gambian children randomised to receive two doses of meningococcal A/C polysaccharide vaccine (MPS) in infancy and either MPS (n = 15), meningococcal A/C conjugate (n = 13) or inactivated polio vaccine (IPV n = 14) at 2 years, were revaccinated with MPS at 5 years of age along with 39 matched control children. Meningococcal A and C polysaccharide antibodies were analysed by ELISA and bactericidal assay (SBA) in sera taken before and 10 days after revaccination. The geometric mean group SEA titre in the MPS group following revaccination was about half that of the unvaccinated controls (0.51 95%CI: 0.28, 0.90) for group A and less than half that of the controls for group C (0.41, 95%CI: 0.16, 1.03 P = 0.06). The group C SEA response in the conjugate group was 14-fold higher than in the MPS group (P < 0.001), Multiple doses of meningococcal polysaccharide in childhood may therefore attenuate the SEA response to both group A and group C polysaccharides. In contrast, vaccination with meningococcal A/C conjugate after MPS in infancy gives immunological memory to N. meningitidis group C. (C) 1999 Published by Elsevier Science Ltd. All rights reserved. C1 John Radcliffe Hosp, Dept Paediat, Oxford Vaccine Grp, Oxford OX3 9DU, England. Ctr Stat Med, Oxford, England. Ctr Dis Control & Prevent, Atlanta, GA USA. Univ London London Sch Hyg & Trop Med, Dept Infect & Trop Dis, London WC1E 7HT, England. RP MacLennan, J (reprint author), John Radcliffe Hosp, Dept Paediat, Oxford Vaccine Grp, Oxford OX3 9DU, England. OI Deeks, Jonathan/0000-0002-8850-1971 NR 25 TC 79 Z9 82 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD AUG 6 PY 1999 VL 17 IS 23-24 BP 3086 EP 3093 DI 10.1016/S0264-410X(99)00139-5 PG 8 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 225KD UT WOS:000081957300018 PM 10462244 ER PT J AU Willett, WC Dietz, WH Colditz, GA AF Willett, WC Dietz, WH Colditz, GA TI Guidelines for healthy weight SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Review ID BODY-MASS-INDEX; CORONARY HEART-DISEASE; FAT DISTRIBUTION; DIABETES-MELLITUS; RISK-FACTORS; FOLLOW-UP; US ADULTS; WOMEN; MEN; MORTALITY C1 Brigham & Womens Hosp, Dept Med, Channing Lab, Boston, MA USA. Harvard Univ, Sch Med, Boston, MA USA. Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA. Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Willett, WC (reprint author), 655 Huntington Ave, Boston, MA 02115 USA. RI Colditz, Graham/A-3963-2009 OI Colditz, Graham/0000-0002-7307-0291 NR 43 TC 721 Z9 747 U1 5 U2 19 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD AUG 5 PY 1999 VL 341 IS 6 BP 427 EP 434 DI 10.1056/NEJM199908053410607 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 223UN UT WOS:000081860100007 PM 10432328 ER PT J AU Rogers, MF Shaffer, N AF Rogers, MF Shaffer, N TI Reducing the risk of maternal-infant transmission of HIV by attacking the virus SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID HUMAN-IMMUNODEFICIENCY-VIRUS C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Rogers, MF (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 14 TC 19 Z9 19 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD AUG 5 PY 1999 VL 341 IS 6 BP 441 EP 443 DI 10.1056/NEJM199908053410609 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 223UN UT WOS:000081860100009 PM 10432330 ER PT J AU Pelletier, AR Quinlan, KP Sacks, J Van Gilder, TJ Gilchrist, J Ahluwalia, HK AF Pelletier, AR Quinlan, KP Sacks, J Van Gilder, TJ Gilchrist, J Ahluwalia, HK TI Firearm use in G- and PG-rated movies SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Pelletier, AR (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 2 TC 6 Z9 6 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 4 PY 1999 VL 282 IS 5 BP 428 EP 428 DI 10.1001/jama.282.5.428 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 222KP UT WOS:000081784900014 PM 10442653 ER PT J AU Brener, ND Simon, TR Krug, EG Lowy, R AF Brener, ND Simon, TR Krug, EG Lowy, R TI Recent trends in violence-related behaviors among high school students in the United States SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID YOUTH AB Context Violence-related behaviors such as fighting and weapon carrying are associated with serious physical and psychosocial consequences for adolescents. Objective To measure trends in nonfatal violent behaviors among adolescents in the United States between 1991 and 1997. Design, Setting, and Participants Nationally representative data from the 1991, 1993, 1995, and 1997 Youth Risk Behavior Surveys were analyzed to describe the percentage of students in grades 9 through 12 who engaged in behaviors related to violence. Overall response rates for each of these years were 68%, 70%, 60%, and 69%, respectively. To assess the statistical significance of time trends for these variables, logistic regression analyses were conducted that controlled for sex, grade, and race or ethnicity and simultaneously assessed linear and higher-order effects. Main Outcome Measures Self-reported weapon carrying, physical fighting, fighting-related injuries, feeling unsafe, and damaged or stolen property. Results Between 1991 and 1997, the percentage of students in a physical fight decreased 14%, from 42.5% (95% confidence interval [CI], 40.1%-44.9%) to 36.6% (95% CI, 34.6%-38.6%); the percentage of students injured in a physical fight decreased 20%, from 4.4% (95% CI, 3.6%-5.2%) to 3.5% (95% CI, 2.9%-4.1%); and the percentage of students who carried a weapon decreased 30%, from 26.1% (95% CI, 23.8%-28.4%) to 18.3% (95% CI, 16.5%-20.1%). Between 1993 and 1997, the percentage of students who carried a gun decreased 25%, from 7.9% (95% CI, 6.6%-9.2%) to 5.9% (95% CI, 5.1%-6.7%); the percentage of students in a physical fight on school property decreased 9%, from 16.2% (95% CI, 15.0%-17.4%) to 14.8% (95% CI, 13.5%-16.1%); and the percentage of students who carried a weapon on school property decreased 28%, from 11.8% (95% CI, 10.4%-13.2%) to 8.5% (95% CI, 7.0%-10.0%). All of these changes represent significant linear decreases. Conclusions Declines in fighting and weapon carrying among US adolescents between 1991 and 1997 are encouraging and consistent with declines in homicide, nonfatal victimization, and school crime rates. Further research should explore why behaviors related to interpersonal violence are decreasing and what types of interventions are most effective. C1 Ctr Dis Control & Prevent, Div Adolescent & Sch Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Div Violence Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. RP Brener, ND (reprint author), Ctr Dis Control & Prevent, Div Adolescent & Sch Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Mailstop K-33,4770 Buford Hwy NE, Atlanta, GA 30341 USA. NR 23 TC 100 Z9 100 U1 2 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 4 PY 1999 VL 282 IS 5 BP 440 EP 446 DI 10.1001/jama.282.5.440 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 222KP UT WOS:000081784900020 PM 10442659 ER PT J AU Kirkland, KB Meriwether, RA MacKenzie, WR Binz, WC Allen, RJ Veenhuis, PE AF Kirkland, KB Meriwether, RA MacKenzie, WR Binz, WC Allen, RJ Veenhuis, PE TI Clinician judgment as a tool for targeting HIV counseling and testing in North Carolina state mental hospitals, 1994 SO AIDS PATIENT CARE AND STDS LA English DT Article ID PSYCHIATRIC-INPATIENTS; RISK BEHAVIORS; SEROPREVALENCE; INFECTION; AIDS; ILL AB HIV infection increasingly affects populations that may not appear at high risk based on the use of some traditional targeting strategies. To shed some light on how to more sensitively/effectively identify people who need routine HIV testing and counseling, the objective of this study is to determine the prevalence of HIV infection in North Carolina state mental hospitals and to evaluate clinician judgment as a tool for targeting HIV counseling and testing. The design used is a blinded seroprevalence study. The study population includes all patients admitted to North Carolina state mental hospitals between March Ist and May 31st, 1994. The main outcome measures are the HIV seroprevalence, demographic and diagnostic features, and clinician assessment of the likelihood of HIV infection. The results of the study find that of 2159 study subjects, 35 persons (1.6%) were infected with HIV; of these, 14 (40%) were not previously known to be infected. All 35 HIV infections occurred in persons aged 13-59 years. Within this age group, infection rates were significantly higher for Blacks, males, persons who had a diagnosis of organic brain disease, and persons who had multiple psychiatric diagnoses. However, testing strategies that targeted any of the higher risk groups were insensitive. The rate of HIV infection for persons judged by the admitting clinician to have a high or intermediate likelihood of HIV infection was 26.4 times higher than the rate for those judged to have a low likelihood of infection (2.1 vs. 0.1%, 95% confidence intervals: 3.5-201.3). Of the 14 previously undiagnosed HIV-infected persons, 13 were judged by clinicians to have a high or intermediate likelihood of HIV infection. Moreover, 1258 persons were correctly assessed to have a low likelihood of infection. Conclusions from this study are that an HIV counseling and testing strategy targeting persons (in this setting aged 13-59 years) who were judged by clinicians to have a high or intermediate likelihood of infection, would have identified more than 90% of previously undetected infections while substantially reducing the number of negative HIV tests performed. C1 Dept Environm Hlth & Nat Resources, Raleigh, NC USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Epidem Intelligence Serv, Atlanta, GA USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Div Field Epidemiol, Atlanta, GA USA. Dept Human Resources, Raleigh, NC USA. RP Kirkland, KB (reprint author), Duke Univ, Med Ctr, Dept Med, Box 3306, Durham, NC 27710 USA. RI Mac Kenzie, William /F-1528-2013 OI Mac Kenzie, William /0000-0001-7723-0339 NR 16 TC 3 Z9 3 U1 0 U2 1 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD AUG PY 1999 VL 13 IS 8 BP 473 EP 479 DI 10.1089/108729199318200 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 234ZW UT WOS:000082515100005 PM 10800526 ER PT J AU Thompson, MP Simon, TR Saltzman, LE Mercy, JA AF Thompson, MP Simon, TR Saltzman, LE Mercy, JA TI Epidemiology of injuries among women after physical assaults: The role of self-protective behaviors SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-for-Epidemiological-Research CY JUN 24-26, 1998 CL CHICAGO, ILLINOIS SP Soc Epidemiol Res DE crime victims; risk factors; women; wounds and injuries ID VICTIM RESISTANCE; VIOLENCE; RISK; RAPE AB Physical assaults against women result in more than 5,000 deaths and 1 million nonfatal injuries per year in the United States. Data from the National Crime Victimization Survey, 1992-1995, were used to test the association between injury risk and self-protective behaviors, while controlling for victim, offender, and crime-related characteristics. Unlike in prior studies, a self-protective behavior measure that accounted for the temporal sequencing of the occurrence of injuries and self-protective behaviors was used. The study also examined whether the effect of self-protective behaviors varied as a function of victim-offender relationship status. The sample included 3,206 incidents in which females were physically assaulted by a lone male offender within the previous 6 months. Multivariate results revealed that women who used self-protective measures were less likely to be injured than were women who did not use self-protective measures or who did so only after being injured. The effect of self-protective behaviors on risk of injury did not vary as a function of the victim-offender relationship. The inverse association found between self-protective behaviors and injury risk differs from those of previous studies. Owing to inconsistent findings across studies, caution should be used when making recommendations to women regarding whether or not they should use self-protective behaviors during a physical assault. C1 Ctr Dis Control & Prevent, Div Violence Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30341 USA. RP Thompson, MP (reprint author), Ctr Dis Control & Prevent, Div Violence Prevent, Natl Ctr Injury Prevent & Control, 4770 Buford Highway,MS K-60, Atlanta, GA 30341 USA. NR 15 TC 17 Z9 17 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 1 PY 1999 VL 150 IS 3 BP 235 EP 244 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 221AZ UT WOS:000081703200004 PM 10430227 ER PT J AU Ford, ES Sowell, A AF Ford, ES Sowell, A TI Serum alpha-tocopherol status in the United States population: Findings from the Third National Health and Nutrition Examination Survey SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE education; ethnic groups; health surveys; tocopherol ID LOW-DENSITY-LIPOPROTEIN; PLASMA VITAMIN-E; FOOD-FREQUENCY QUESTIONNAIRE; CORONARY-ARTERY DISEASE; FAT-SOLUBLE VITAMINS; BETA-CAROTENE; ANTIOXIDANT VITAMIN; HEART-DISEASE; CIGARETTE-SMOKING; OXIDATIVE STRESS AB Despite the role vitamin E may have in protecting against various chronic conditions, little is known about vitamin E status in the US population. Using data from the Third National Health and Nutrition Examination Survey (1988-1994), the authors examined the distribution and correlates of serum alpha-tocopherol among 16,295 US adults aged 18 or more years. The mean concentration of alpha-tocopherol was 26.8 mu mol/liter (geometric mean, 25.0 mu mol/liter). The 25th, 50th, and 75th percentiles were 19.6, 24.1, and 30.4 mu mol/liter, respectively. The mean alpha-tocopherol/cholesterol ratio was 5.1 (geometric mean, 4.9); the 25th, 50th, and 75th percentiles were 4.1, 4.7, and 5.5 (10(-3)), respectively. About 27% of the US population had a low alpha-tocopherol concentration (<20 mu mol/liter). After age standardization, 29% of the men, 28% of the women, 26% of the Whites (men, 27%, and women, 26%), 41% of the African Americans (men, 42%, and women, 40%), 28% of the Mexican Americans (men, 29%, and women, 27%), and 32% of the other participants (men, 36%, and women, 29%) had this low concentration. For all participants, age, educational attainment, serum cholesterol, and several serum vitamins and carotenoids were directly related to and high density lipoprotein cholesterol was inversely related to serum alpha-tocopherol concentration in multiple linear regression analysis. Men had a higher concentration than did women, and African Americans had the lowest concentration of any racial or ethnic group. These results show that important proportions of US adults have a low serum alpha-tocopherol concentration, which may increase their risk for chronic diseases in which low dietary intake or blood concentration of alpha-tocopherol have been implicated. C1 Ctr Dis Control & Prevent, Div Nutr, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Div Sci Lab, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Ford, ES (reprint author), Ctr Dis Control & Prevent, Div Nutr, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway,MS K26, Atlanta, GA 30341 USA. NR 75 TC 65 Z9 68 U1 0 U2 2 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 1 PY 1999 VL 150 IS 3 BP 290 EP 300 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 221AZ UT WOS:000081703200011 PM 10430234 ER PT J AU Vittinghoff, E Douglas, J Judson, F McKirnan, D MacQueen, K Buchbinder, SP AF Vittinghoff, E Douglas, J Judson, F McKirnan, D MacQueen, K Buchbinder, SP TI Per-contact risk of human immunodeficiency virus transmission between male sexual partners SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE HIV infections; transmission ID HOMOSEXUAL MEN; HIV TRANSMISSION; ORAL INTERCOURSE; INFECTION; SEROCONVERSION; AIDS; PROGRESSION; PROBABILITY; BEHAVIOR; HEALTH AB The risk of human immunodeficiency virus (HIV) transmission from various types of homosexual contact, including oral sex, is of biologic, epidemiologic, and public health importance. The per-contact risk of acquiring HIV infection from specific acts was estimated in a prospective cohort study of 2,189 high-risk homosexual and bisexual men, conducted in San Francisco, California; Denver, Colorado; and Chicago, Illinois, in 1992-1994. During 2,633 person-years of follow-up, 60 seroconversions were observed. The estimated per-contact risk of acquiring HIV from unprotected receptive anal intercourse (URA) was 0.82 percent (95% confidence interval: 0.24, 2.76 percent) when the partner was known to be HIV+ and 0.27 percent (95% confidence interval: 0.06, 0.49 percent) when partners of unknown serostatus were included. There was heterogeneity in per-contact risk, with nine seroconversions occurring after only one or two episodes of URA. The per-contact risk associated with unprotected insertive anal and receptive oral sex with HIV-positive or unknown serostatus partners was 0.06 and 0.04 percent, respectively. URA accounted for only 15 percent of all reported sexual activity by seroconverters. As lower-risk practices become more common, they may play a larger role in propagating the epidemic and should also be addressed by interventions targeting high-risk homosexual and bisexual men. C1 Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94105 USA. San Francisco Dept Publ Hlth, San Francisco, CA USA. Denver Dept Publ Hlth, Denver, CO USA. Univ Illinois, Chicago, IL USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Vittinghoff, E (reprint author), Univ Calif San Francisco, Dept Epidemiol & Biostat, 74 New Montgomery,Suite 600, San Francisco, CA 94105 USA. FU PHS HHS [R64/CCU12541-01] NR 26 TC 370 Z9 379 U1 1 U2 11 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 1 PY 1999 VL 150 IS 3 BP 306 EP 311 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 221AZ UT WOS:000081703200013 PM 10430236 ER PT J AU Botto, LD Mulinare, J AF Botto, LD Mulinare, J TI Maternal vitamin use, genetic variation of infant methylenetetrahydrofolate reductase, and risk for spina bifida SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Letter ID NEURAL-TUBE DEFECTS; ETIOLOGY C1 Ctr Dis Control & Prevent, Div Birth Defects & Dev Disabilities, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. RP Botto, LD (reprint author), Ctr Dis Control & Prevent, Div Birth Defects & Dev Disabilities, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. NR 7 TC 4 Z9 4 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 1 PY 1999 VL 150 IS 3 BP 323 EP 324 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 221AZ UT WOS:000081703200017 PM 10430239 ER PT J AU Garfein, RS Lyerla, R Jones, TS Nakashima, AK Monterroso, ER Vlahov, D AF Garfein, RS Lyerla, R Jones, TS Nakashima, AK Monterroso, ER Vlahov, D TI High rates of HIV infection among injection drug users participating in needle exchange programs in Montreal: Results of a cohort study SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Letter C1 Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. RP Garfein, RS (reprint author), Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 6 TC 3 Z9 3 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD AUG 1 PY 1999 VL 150 IS 3 BP 325 EP 325 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 221AZ UT WOS:000081703200019 PM 10430240 ER PT J AU Lentz, TJ Rice, CH Lockey, JE Succop, PA Lemasters, GK AF Lentz, TJ Rice, CH Lockey, JE Succop, PA Lemasters, GK TI Potential significance of airborne fiber dimensions measured in the US refractory ceramic fiber manufacturing industry SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE airborne fiber; electron microscopy; man-made vitreous fiber; occupational exposure; pleural plaque; refractory ceramic fiber; synthetic vitreous fiber ID CHRONIC INHALATION TOXICITY; MALE FISCHER-344 RATS; MADE VITREOUS FIBERS; PLEURAL PLAQUES; CHRYSOTILE ASBESTOS; LUNG; DEPOSITION; DISEASE; CLEARANCE; PULMONARY AB Background To determine dimensions of airborne fibers in the U.S. refractory ceramic fiber (RCF) manufacturing industry, fibers collected though personal air sampling for employees at RCF manufacturing and processing operations have been measured. Methods Data were derived from transmission electron microscopy analyses of 118 air samples collected over a 20-year period. Results Characteristics of sized fibers include: diameter measurements of < 0.19 to 1.0 mu m, of which 75% are less than 0.6 mu m; and length ranging from < 0.6 to > 20 mu m, with 68% of fibers between 2.4 and 20 mu m. Conclusions Exposures in RCF manufacturing include airborne fibers with dimensions (diameter < 0.1-0.4 mu m, length < 10 mu m) historically associated with biological effects in pleural tissues. Air sampling data and a review of studies relating fiber size to pleural effects in animals and humans support the belief that information on fiber dimensions is essential for studies with synthetic vitreous fibers. Am. J. Ind. Med. 36:286-298, 1999. (C) 1999 Wiley-Liss, Inc. C1 NIOSH, Educ & Informat Div, Cincinnati, OH 45226 USA. Univ Cincinnati, Coll Med, Dept Environm Hlth, Cincinnati, OH 45267 USA. RP Lentz, TJ (reprint author), NIOSH, Educ & Informat Div, 4676 Columbia Pkwy,MS C-32, Cincinnati, OH 45226 USA. EM tb17@cdc.gov FU CIT NIH HHS [T42-CCT-510420-02] NR 69 TC 5 Z9 5 U1 0 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD AUG PY 1999 VL 36 IS 2 BP 286 EP 298 PG 13 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 214GD UT WOS:000081319500008 PM 10398937 ER PT J AU Floyd, RL Decoufle, P Hungerford, DW AF Floyd, RL Decoufle, P Hungerford, DW TI Alcohol use prior to pregnancy recognition SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE alcohol drinking; pregnancy; National Center of Health Statistics; teratogens; prenatal; alcohol; prevalence; fetal alcohol syndrome ID PRENATAL ALCOHOL; CONSUMPTION; EXPOSURE; GROWTH; RISK AB Background: Frequent alcohol use during the first. 8 weeks of pregnancy can result in spontaneous abortion and dysmorphologic changes in the developing organ systems of the embryo, including the heart, kidneys, and brain. However, few population-based studies are available that describe the prevalence of frequent drinking (6 or more drinks per week) among women prior to and during early pregnancy (the periconceptional period), and the sociodemographic and behavioral factors that characterize these women. Such knowledge is fundamental to the design of targeted interventions for the prevention of fetal alcohol syndrome (FAS) and other prenatal alcohol-related disorders. Methods: This cross-sectional study used survey data collected by the National Center for Health Statistics as part of the 1988 National Maternal and Infant Health Survey (NMIHS). Weighted prevalence estimates were calculated using SUDAAN, and multivariate analyses were used to determine risk factors for frequent drinking. Results: Forty-five percent of all women surveyed reported consuming alcohol during the 3 months before finding out they were pregnant, and 5% reported consuming 6 or more drinks per week. Sixty percent of women who reported alcohol consumption also reported that they did not learn they were pregnant until after the fourth week of gestation. Risk factors for frequent drinking during the periconceptional period included 1 or more of the following: being unmarried, being a smoker, being white non-Hispanic, being 25 years of age or older, or being college educated. Conclusions: Half of all pregnant women in this study drank alcohol during the 3 months preceding pregnancy recognition,with 1 in 20 drinking at moderate to heavy levels. The majority did not know they were pregnant until after the fourth week of pregnancy, and many did not know until after the 6th week. Alcohol is a teratogen capable of producing a number of adverse reproductive and infant outcomes. Public health measures needed to reduce these potentially harmful exposures include alcohol assessment, education, and counseling for women of childbearing age, with referral sources for problem drinking, and family planning services for pregnancy postponement until problem drinking is resolved. C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Fetal Alcohol Syndrome Prevent Sect, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. RP Floyd, RL (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Fetal Alcohol Syndrome Prevent Sect, 4770 Buford Highway NE MS-F15, Atlanta, GA 30341 USA. NR 32 TC 158 Z9 161 U1 3 U2 14 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD AUG PY 1999 VL 17 IS 2 BP 101 EP 107 DI 10.1016/S0749-3797(99)00059-8 PG 7 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 224NC UT WOS:000081904300001 PM 10490051 ER PT J AU Miller, M Williams, WW Redd, SC AF Miller, M Williams, WW Redd, SC TI Measles among adults, United States, 1985-1995 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE measles; adult; United States; vaccination; immunization; CDC ID HEALTH-CARE WORKERS; NEUTRALIZATION TEST; MEDICAL SETTINGS; IMMUNITY; POPULATION; ANTIBODY; VACCINE; VIRUS; SUSCEPTIBILITY; TRANSMISSION AB Objective: To report the incidence and characteristics of adult measles cases in the United States and address the adequacy of current vaccination policies to eliminate measles transmission. Methods: Confirmed measles cases reported to the Centers for Disease Control and Prevention (CDC) from 1985 through 1995 were reviewed. Demographic data, exposure setting, and vaccination status of cases were analyzed and incidence rates calculated based on U.S. census data. Main Outcome Measures: Age-specific incidence rates of measles and exposure setting. Results: Of the 75,204 reported measles cases of known age, 16,006 (21.3%) occurred in adults (persons > 19 years of age). The incidence in persons < 19 years of age (7.8/100,000) was 9.6 times that of all adults. Of 11,520 adult measles cases for whom vaccination status was reported, 8,055 (69.9%) indicated no prior receipt of measles vaccine. Exposure setting tvas unknown for the majority of adult measles cases (8,475, 52.9%); most frequently reported were college or school (2840, 17.7%), home (1443, 9.0%), or a medical setting (1286, 8.0%). International travel was associated with 289 (1.8%) adult cases. From 1993 to 1995, incidence rates in all age groups were at record low levels, with adults contributing 29.5% (467/1584) of reported cases. Conclusion: Although adults accounted for a steadily increasing proportion of measles cases during the study period, incidence rates in all age groups have decreased. Most adults who had measles were susceptible because of lack of vaccination rather than vaccine failure. This analysis supports current strategies to ensure the immunity of school/college-aged populations, and health care workers. C1 WHO, Childrens Vaccine Initiat, CH-1211 Geneva 27, Switzerland. Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA USA. RP Miller, M (reprint author), WHO, Childrens Vaccine Initiat, 20 Ave Appia, CH-1211 Geneva 27, Switzerland. NR 43 TC 6 Z9 9 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD AUG PY 1999 VL 17 IS 2 BP 114 EP 119 DI 10.1016/S0749-3797(99)00058-6 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 224NC UT WOS:000081904300003 PM 10490053 ER PT J AU Kimball, AM Horwitch, CA O'Carroll, PW Arjoso, S Kunanusont, C Lin, YS Meyer, CM Schubert, LE Dunham, PL AF Kimball, AM Horwitch, CA O'Carroll, PW Arjoso, S Kunanusont, C Lin, YS Meyer, CM Schubert, LE Dunham, PL TI The Asian Pacific Economic Cooperation emerging infections network SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review DE epidemiology; medical informatics; telecommunications; infectious diseases ID PUBLIC-HEALTH AB Issue: The Asia Pacific Economic Cooperation (APEC) has undertaken an initiative in emerging infections. Project: The APEC Emerging Infections Network project uses collaborative telecommunications tools such as e-mail and a World Wide Web site to bridge the broad geographic expanse and diversity of APEC. Scientists and policymakers share information to effectively combat emerging infectious disease (EID) through surveillance, prevention, research, and control measures. Results: In the project's first year, site visits compiled information on Internet access in selected economies. Information sharing via electronic lists has been successful; feedback suggests that these strategies will become increasingly useful. The Emerging Infections Network (EINet) Web site includes project information, library access, surveillance data, prevention guidelines, and distance learning resources. A pilot effort to promote the secure electronic exchange of surveillance data demonstrated that informal communications may be both preferable and more feasible during the early stages of this project. Lesson Learned: Human net working is as important as technology-based networking in addressing emerging infections. Internet technology in some APEC economies is barely adequate, but is becoming more reliable and accessible. Numerous member economies are eager to be included in project activities. C1 Univ Washington, Hlth Serv, Seattle, WA 98195 USA. Puget Sound Hlth Care Syst, Seattle, WA USA. Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Atlanta, GA USA. Minist Hlth, Jakarta, Indonesia. Minist Publ Hlth, Bangkok, Thailand. Univ Washington, APEC Emerging Infect Network, Seattle, WA 98195 USA. RP Kimball, AM (reprint author), 1107 NE 45th St,Suite 427,Box 354809, Seattle, WA 98105 USA. NR 9 TC 3 Z9 3 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD AUG PY 1999 VL 17 IS 2 BP 156 EP 158 DI 10.1016/S0749-3797(99)00051-3 PG 3 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 224NC UT WOS:000081904300012 PM 10490062 ER PT J AU Koplan, JP Thacker, SB Lezin, NA AF Koplan, JP Thacker, SB Lezin, NA TI Epidemiology in the 21st century: Calculation, communication, and intervention SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID FUTURE C1 Ctr Dis Control & Prevent, Atlanta, GA USA. RP Koplan, JP (reprint author), Ctr Dis Control & Prevent, Atlanta, GA USA. NR 31 TC 12 Z9 12 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1153 EP 1155 DI 10.2105/AJPH.89.8.1153 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900002 PM 10432897 ER PT J AU Allison, DB Zannolli, R Narayan, KMV AF Allison, DB Zannolli, R Narayan, KMV TI The direct health care costs of obesity in the United States SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID BODY-MASS INDEX; MORTALITY; ASSOCIATION; OVERWEIGHT; WEIGHT; IMPACT; LIFE AB Objectives. Recent estimates suggest that obesity accounts for 5.7% of US total direct health care casts, but these estimates have not accounted for the increased death rate: among obese people. This article examines whether. the estimated direct health care costs attributable: to obesity are offset by the. increased mortality rate among obese individuals. Methods. Data on death rates, relative risks of death with obesity, and health care costs at different ages were used to estimate direct health care costs of obesity from 20 to 85 years of age - with and without accounting: for increased death rates associated with obesity Sensitivity analyses used different values of relative risk of death, given obesity, and allowed the relative costs due to obesity per unit of time to vary with age. Results. Direct health care casts from 20 to 85 years of age were estimated to be approximately 25% lower when differentia mortality was taken into account. Sensitivity analyses suggested that direct health care costs of obesity are unlikely to exceed. 4.32% or to be lower than 0.90%. Conclusions, Increased mortality among obese people should be accounted for in order not to overestimate health care costs. C1 Columbia Univ, St Lukes Roosevelt Hosp, Coll Phys & Surg, Obes Res Ctr, New York, NY 10025 USA. Univ Siena, Policlin LeScotte, Dept Pediat, I-53100 Siena, Italy. Ctr Dis Control & Prevent, Div Diabet Translat, Atlanta, GA USA. RP Allison, DB (reprint author), Columbia Univ, St Lukes Roosevelt Hosp, Coll Phys & Surg, Obes Res Ctr, 1090 Amsterdam Ave,14th Fl, New York, NY 10025 USA. RI Narayan, K.M. Venkat /J-9819-2012; OI Narayan, K.M. Venkat /0000-0001-8621-5405; Allison, David/0000-0003-3566-9399 FU NIDDK NIH HHS [P30DK26687, R01DK51716, R29DK47256] NR 24 TC 143 Z9 143 U1 0 U2 6 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1194 EP 1199 DI 10.2105/AJPH.89.8.1194 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900011 PM 10432905 ER PT J AU Saaddine, JB Narayan, KMV Engelgau, MM Aubert, RE Klein, R Beckles, GLA AF Saaddine, JB Narayan, KMV Engelgau, MM Aubert, RE Klein, R Beckles, GLA TI Prevalence of self-rated visual impairment among adults with diabetes SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID RISK FACTOR SURVEY; DAM HEALTH OUTCOMES; COST-EFFECTIVENESS; CATARACT-SURGERY; EYE CARE; SOCIOECONOMIC-FACTORS; POPULATION; DISEASE; VISION; ACUITY AB objectives. This study estimated the prevalence of self-rated visual impairment among US adults with. diabetes and identified correlates of impairment. Methods. Self-reported data from the 1995 Behavioral Risk Factor surveillance System survey of adults 18 years and older with diabetes were analyzed Correlates of visual impairment were examined by multiple logistic regression analysis. Results. The prevalence of self-rated visual impairment was 24.8%; (95% confidence interval [CI] = 22.3%, 27.3%). Among insulin users, multivariable-adjusted odds ratios were 4.9 (95% GI = 2.6, 9.2) for those who had not completed. high school and 1.8 (95% CI = 1.0, 2.8) for those who had completed high school compared with those with higher levels of education Ea Comparable estimates of odds ratios for non-users of insulin were 22 (95% CI:= 1.4, 3.4) and 1.3 (95% CI- 0.9, 2.0) respectively. Among nonusers the adjusted odds for minority adults were 2.4 (95% CI = 1.0, 3.7) times the odds for nonHispanic Whites. Conclusions. By these data, 1.6 million US adults with diabetes reported having some degree of visual impairment. Future research:li on the specific causes of visual impairment may help in estimating the avoidable public health burden. C1 Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Prudential Ctr Hlth Care Res, Atlanta, GA USA. Univ Wisconsin, Sch Med, Dept Ophthalmol & Visual Sci, Madison, WI USA. RP Saaddine, JB (reprint author), Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Mailstop K-10,4770 Buford Hwy NE, Atlanta, GA 30341 USA. RI Narayan, K.M. Venkat /J-9819-2012 OI Narayan, K.M. Venkat /0000-0001-8621-5405 NR 50 TC 16 Z9 17 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1200 EP 1205 DI 10.2105/AJPH.89.8.1200 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900012 PM 10432906 ER PT J AU Blumberg, SJ Bialostosky, K Hamilton, WL Briefel, RR AF Blumberg, SJ Bialostosky, K Hamilton, WL Briefel, RR TI The effectiveness of a short form of the household food security scale SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID HUNGER; INSECURITY AB Objectives. On the basis of an 18-item Household Food Security Scale, a short form was developed to assess financially based food insecurity and hunger in surveys of households with and without children. Methods. To maximize the probability that households would be correctly classified with respect to food insecurity and hunger, 6 items from the full scale were selected on the basis of April 1995 Current Population Survey data. Results. The short form classified 97.7% of households correctly and underestimated the prevalence of overall food insecurity and of hunger by 0.3 percentage points. Conclusions. The short form of the Household Food Security Scale is a brief but potentially useful tool for national surveys and some state/local applications. C1 Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Div Hlth Interview Stat, Hyattsville, MD 20782 USA. ABT Associates Inc, Cambridge, MA 02138 USA. RP Blumberg, SJ (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Div Hlth Interview Stat, 6525 Blecrest Rd,Room 850, Hyattsville, MD 20782 USA. NR 16 TC 164 Z9 171 U1 0 U2 10 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1231 EP 1234 DI 10.2105/AJPH.89.8.1231 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900018 PM 10432912 ER PT J AU Honein, MA Paulozzi, LJ AF Honein, MA Paulozzi, LJ TI Birth defects surveillance: Assessing the "gold standard" SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID CERTIFICATE; SYSTEMS AB Objectives. This study assessed the sensitivity of tbe Metropolitan Atlanta Congenital Defects Program (MACDP) by capitalizing on the delayed receipt of a data source. Methods. In 1997, we reviewed the medical records of potential eases from the 1995 birth certificates that had not previously been identified by the MACDP. Capture meth ods produced an estimate of total cases. Results. We identified 1149 infants with defects, including 20 exclusively from birth cv:certificates. The estimated sensitivity of the MACDP when data. fram birth certificates were included tvas 86.9% (95% confidence Interval [CI] = 80.6%, 91.9%) at 1 year after birth, increasing to 94.8% (95% CI= 90.3%, 97.5%) at 2 years after birth. Conclusions. The MACDP under-estimates defects by 13% at 1 year after birth and by 5% at 2 years after birth. C1 Ctr Dis Control & Prevent, Div Birth Defects & Pediat Genet, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30341 USA. RP Honein, MA (reprint author), Ctr Dis Control & Prevent, Div Birth Defects & Pediat Genet, Natl Ctr Environm Hlth, Mailstop F-45,4770 Buford Hwy, Atlanta, GA 30341 USA. NR 14 TC 61 Z9 61 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1238 EP 1240 DI 10.2105/AJPH.89.8.1238 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900020 PM 10432914 ER PT J AU Wortley, PM Lehman, JS Fleming, PL AF Wortley, PM Lehman, JS Fleming, PL TI Name-based reporting of HIV infection SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. RP Wortley, PM (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, 1600 Clifton Rd,Mailstop E-47, Atlanta, GA 30333 USA. NR 5 TC 1 Z9 1 U1 3 U2 3 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD AUG PY 1999 VL 89 IS 8 BP 1271 EP 1272 DI 10.2105/AJPH.89.8.1271-a PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 220CL UT WOS:000081646900031 PM 10432924 ER PT J AU Yang, CF Xiao, LH Tongren, JE Sullivan, J Lai, AA Collins, WE AF Yang, CF Xiao, LH Tongren, JE Sullivan, J Lai, AA Collins, WE TI Cytokine production in rhesus monkeys infected with Plasmodium coatneyi SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID HUMAN CEREBRAL MALARIA; TUMOR NECROSIS FACTOR; CILIARY NEUROTROPHIC FACTOR; FALCIPARUM-MALARIA; PARASITIZED ERYTHROCYTES; SEQUESTRATION; PATHOLOGY; PROTECTION; CEREBELLUM; PROFILES AB Plasmodium coatneyi infection in rhesus monkeys has been used as a model for studying human malaria. Cytokine production in this model, however, has so far not been examined. In this study, four rhesus monkeys were infected with P. coatneyi, with another four animals serving as uninfected controls. Blood samples were taken fur the determination of daily parasitemia, and cytokine and prostaglandin E2 (PGE(2),) levels at days 0, 3, 5, 7, and 10. All inoculated animals became infected, with synchronized appearance of ring-stage parasites. Infected monkeys had increased plasma levels of proinflammatory cytokines (interleukin-1 beta, interferon-gamma, and tumor necrosis factor-a) during the late stage of the infection. They also had increased production of ciliary neurotrophic factor. In conjunction with the production of proinflammatory cytokines, infected monkeys also had gradual increases in the production of PGE(2). A continued definition of the P. coatneyi/rhesus monkey animal model should be useful for the elucidation of the immunopathogenesis of human malaria. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. RP Yang, CF (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Mailstop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. RI Xiao, Lihua/B-1704-2013; Yang, Chunfu/G-6890-2013 OI Xiao, Lihua/0000-0001-8532-2727; NR 25 TC 15 Z9 15 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 226 EP 229 PG 4 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000010 PM 10463671 ER PT J AU Defraites, RF Gambel, JM Hoke, CH Sanchez, JL Withers, BG Karabatsos, N Shope, RE Tirrell, S Yoshida, I Takagi, M Meschievitz, CK Tsai, TF AF Defraites, RF Gambel, JM Hoke, CH Sanchez, JL Withers, BG Karabatsos, N Shope, RE Tirrell, S Yoshida, I Takagi, M Meschievitz, CK Tsai, TF TI Japanese encephalitis vaccine (inactivated, BIKEN) in US soldiers: Immunogenicity and safety of vaccine administered in two dosing regimens SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID ANTIBODY-RESPONSE; YELLOW-FEVER; NEUTRALIZATION AB The safety and immunogenicity of Japanese encephalitis (JE) vaccine (Nakayama strain, monovalent / BIKEN) was studied in 538 U.S. soldiers in 1990. Three doses of vaccine from three consecutively manufactured lots were given on days 0, 7, and either 14 or 30. Serum for antibody determination was drawn at months 0, 2, and 6. Japanese encephalitis plaque reduction neutralization tests were pel formed by three laboratories on each specimen. Five hundred twenty-eight (98%) participants completed the immunization series. All recipients without antibody before immunization developed neutralizing antibody against JE virus. There were no differences in geometric mean titer among the three test lots at months 2 and 6. Soldiers who received the third dose on day 30 had higher titers at both time points. Antibody to yellow fever had no significant effect on immune response to vaccine. Conclusions drawn from analysis of serologic data from the three labs were nearly identical. Symptoms were generally limited to mild local effects and were reduced in frequency with each subsequent does in the series (21% to 11%; P < 0.0001). Generalized symptoms were rare (e.g., fever = 5%) with no reported cases of anaphylaxis. C1 Walter Reed Army Inst Res, Div Prevent Med, Washington, DC 20307 USA. Walter Reed Army Inst Res, Div Communicable Dis & Immunol, Washington, DC 20307 USA. Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Ft Collins, CO 80522 USA. Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, Yale Arbovirus Res Unit,Connecticut Emerging Infe, New Haven, CT 06520 USA. Pasteur Merieux Connaught Inc, Swiftwater, PA 18370 USA. Osaka Univ, Kanoji Inst, Res Inst Microbial Dis, Osaka, Japan. RP Defraites, RF (reprint author), Walter Reed Army Inst Res, Div Prevent Med, Washington, DC 20307 USA. NR 21 TC 33 Z9 35 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 288 EP 293 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000020 PM 10463681 ER PT J AU Moore, A Richer, M Enrile, M Losio, E Roberts, J Levy, D AF Moore, A Richer, M Enrile, M Losio, E Roberts, J Levy, D TI Resurgence of sleeping sickness in Tambura County, Sudan SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID ZAIRE AB Endemic foci of human African trypanosomiasis are present in southern Sudan. In 1996 and 1997, trypanosomiasis increased sharply in Tambura County. To define the magnitude and geographic distribution of the outbreak, we conducted a prevalence survey using population-based cluster sampling in 16 villages: 1,358 participants answered questions about routine activities and tsetse fly contact and received serologic testing. Seroprevalence in the surveyed area was 19.4% (95% confidence interval = 16.9%, 21.8%). We confirmed infection in 65% of seropositive persons who received one parasitologic examination and in 95% of those who had serial examinations of lymph node fluid and blood. Activities related to the civil war, such as temporary migration, were not associated with seropositive status. Since the previous population screening in 1988, the trypanosomiasis prevalence increased two orders of magnitude, and the proportion of villages affected increased from 54% to 100%. Our results suggest that there may be 5,000 cases in Tambura County. The absence of trypanosomiasis control for nearly a decade is a factor in the resurgence of the disease. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Parasit Dis, Atlanta, GA 30341 USA. Int Med Corps, Nairobi, Kenya. CARE Int, Nairobi, Kenya. Sudanese Relief & Rehabil Agcy, Tambura, Sudan. RP Moore, A (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Parasit Dis, Mailstop F-22,4770 Buford Highway, Atlanta, GA 30341 USA. NR 8 TC 30 Z9 32 U1 0 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 315 EP 318 PG 4 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000025 PM 10463686 ER PT J AU Fulhorst, CF Bowen, MD Salas, RA Duno, G Utrera, A Ksiazek, TG de Manzione, NMC de Miller, E Vasquez, C Peters, CJ Tesh, RB AF Fulhorst, CF Bowen, MD Salas, RA Duno, G Utrera, A Ksiazek, TG de Manzione, NMC de Miller, E Vasquez, C Peters, CJ Tesh, RB TI Natural rodent host associations of Guanarito and Pirital viruses (family Arenaviridae) in central Venezuela SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID HEMORRHAGIC-FEVER; RESERVOIR AB The objective of this study was to elucidate the natural rodent host relationships of Guanarito and Pirital viruses (family Arenaviridae) in the plains of central Venezuela, Ninety-two arenavirus isolates from 607 animals, representing 10 different rodent species, were characterized to the level of serotype, The 92 isolates comprised 19 Guanarito virus strains and 73 Pirital virus strains. The 19 Guanarito virus isolates were from Zygodontomys brevicauda; 72 (98.6%) of the 73 Pirital virus isolates were from Sigmodon alstoni. These results indicate that the natural rodent associations of these 2 sympatric arenaviruses are highly specific and that Z. brevicauda and S, alstoni are the principal rodent hosts of Guanarito and Pirital viruses, respectively. C1 Univ Texas, Med Branch, Dept Pathol, Galveston, TX 77555 USA. Univ Texas, Med Branch, Ctr Trop Dis, Galveston, TX 77555 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Special Pathogens Branch, Atlanta, GA 30333 USA. Inst Nacl Higene Rafael Rangel, Caracas, Venezuela. Univ Nacl Expt Los Llanos Occidentales Ezequiel Z, Guanare, Portuguesa, Venezuela. Minist Sanidad & Asistencia Social, Reg Sanitaria Estado Portuguesa, Guanare, Portuguesa, Venezuela. RP Fulhorst, CF (reprint author), Univ Texas, Med Branch, Dept Pathol, 301 Univ Blvd, Galveston, TX 77555 USA. FU NIAID NIH HHS [AI-33983, AI-39800, AI-41435] NR 13 TC 41 Z9 43 U1 0 U2 3 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 325 EP 330 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000027 PM 10463688 ER PT J AU Ellis, BA Rotz, LD Leake, JAD Samalvides, F Bernable, J Ventura, G Padilla, C Villaseca, P Beati, L Regnery, R Childs, JE Olson, JG Carrillo, CP AF Ellis, BA Rotz, LD Leake, JAD Samalvides, F Bernable, J Ventura, G Padilla, C Villaseca, P Beati, L Regnery, R Childs, JE Olson, JG Carrillo, CP TI An outbreak of acute bartonellosis (Oroya fever) in the Urubamba region of Peru, 1998 SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID ECUADOR AB During May 1998, we conducted a case-control study of 357 participants from 60 households during an outbreak of acute bartonellosis in the Urubamba Valley, Peru, a region not previously considered endemic for this disease. Blood and insect specimens were collected and environmental assessments were done. Case-patients (n = 22) were defined by fever, anemia, and intra-erythrocytic coccobacilli seen in thin smears. Most case-patients were children (median age = 6.5 years). Case-patients more frequently reported sand fly bites than individuals of neighboring households (odds ratio [OR] = 5.8, 95% confidence interval [CI] = 1.2-39.2), or members from randomly selected households greater than or equal to 5 km away (OR = 8.5, 95% CI = 1.7-57.9). Barronella bacilliformis isolated from blood was confirmed by nucleotide sequencing (citrate synthase [gltA], 338 basepairs). Using bacterial isolation (n = 141) as the standard, sensitivity, specificity, and positive predictive value of thin smears were 36%, 96%, and 44%, respectively. Patients with clinical syndromes compatible with bartonellosis should be treated with appropriate antibiotics regardless of thin-smear results. C1 Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Meningitis & Special Pathogens Branch, Atlanta, GA 30333 USA. Inst Nacl Salud, Lima, Peru. Minist Salud Urubamba Santa Rosa Wanchaq, Ctr Salud Urubamba, Cuzco, Peru. RP Ellis, BA (reprint author), Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Mailstop G-13,1600 Clifton Rd, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 18 TC 36 Z9 47 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 344 EP 349 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000031 PM 10463692 ER PT J AU Ripoll, CM Remondegui, CE Ordonez, G Arazamendi, R Fusaro, H Hyman, MJ Paddock, CD Zaki, SR Olson, JG Santos-Buch, CA AF Ripoll, CM Remondegui, CE Ordonez, G Arazamendi, R Fusaro, H Hyman, MJ Paddock, CD Zaki, SR Olson, JG Santos-Buch, CA TI Evidence of rickettsial spotted fever and ehrlichial infections in a subtropical territory of Jujuy, Argentina SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB Between November 1993 and March 1994, a cluster 6 pediatric patients with acute febrile illnesses associated with rashes was identified in Jujuy Province, Argentina. Immunohistochemical staining of tissues confirmed spotted fever group rickettsial infection in a patient with fatal diseas, and testing of serum of a patient convalescing from the illness by using an indirect immunofluorescence assay (IFA) demonstrated antibodies reactive with spotted fever group rickettsiae. A serosurvey was conducted among 16 households in proximity to the index case. Of 105 healthy subjects evaluated by IFA, 19 (18%) demonstrated antibodies reactive with rickettsiae or ehrlichiae: 4 had antibodies reactive with Rickettsia rickettsii, 15 with Ehrlichia chaffeensis, and 1 with R, typhi. Ambylomma cajennense, a known vector of R. rickettsii in South America, was collected from pets and horses in the area. These results are the first to document rickettsial spotted fever and ehrlichial infections in Argentina. C1 Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Infect Dis Pathol Activ, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Hosp San Roque, San Salvador Jujuy Serv Infectol, Dept Chagas & Patol Reg, Area Epidemiol,Minist Bienestar Social, Jujuy, Argentina. Hosp Ninos Dr hector Quintana, Jujuy, Argentina. Cornell Univ Med Coll, Dept Med, Div Int Med & Infect Dis, New York, NY 10021 USA. RP Olson, JG (reprint author), Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Mailstop G-13,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 17 TC 77 Z9 90 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD AUG PY 1999 VL 61 IS 2 BP 350 EP 354 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 227VQ UT WOS:000082101000032 PM 10463693 ER PT J AU Keim, M Kaufmann, AF AF Keim, M Kaufmann, AF TI Principles for emergency response to bioterrorism SO ANNALS OF EMERGENCY MEDICINE LA English DT Article AB The recent occurrence of a series of anthrax-related hoaxes illustrates the need to educate emergency services personnel about how to best ensure patient and worker safety in the case of suspected exposure to biological threat agents. There are very few data to support the methods being used or the variation in current care. Emergency physicians, first responders, and hazardous materials response teams need a standardized approach to the management of patients who may have been exposed to biological threat agents. Currently recommended hospital infection control procedures seem appropriate for the level of risk involved with aerosolized biological threat agents. Such recommendations include standard and transmission-based precautions. These groups need a working knowledge of the isolation and infection control measures recommended for the treatment of patients exposed to those biological threat agents at outlined in the Centers for Disease Control and Prevention Guideline for Isolation Precautions in Hospitals. C1 Ctr Dis Control & Prevent, Emergency Preparedness & Response Branch, Atlanta, GA 30041 USA. RP Keim, M (reprint author), Ctr Dis Control & Prevent, Emergency Preparedness & Response Branch, 4770 Buford Highway MS-F38, Atlanta, GA 30041 USA. NR 21 TC 43 Z9 44 U1 1 U2 2 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD AUG PY 1999 VL 34 IS 2 BP 177 EP 182 DI 10.1016/S0196-0644(99)70227-1 PG 6 WC Emergency Medicine SC Emergency Medicine GA 221JA UT WOS:000081722900009 PM 10424919 ER PT J AU Brennan, RJ Waeckerle, JF Sharp, TW Lillibridge, SR AF Brennan, RJ Waeckerle, JF Sharp, TW Lillibridge, SR TI Chemical warfare agents: Emergency medical and emergency public health issues SO ANNALS OF EMERGENCY MEDICINE LA English DT Article ID NERVE AGENTS; TOKYO SUBWAY; TERRORISM; WEAPONS; GAS; EPIDEMIOLOGY; DISASTER; ATTACK AB The threat of exposure to chemical warfare agents has traditionally been considered a military issue. Several recent events have demonstrated that civilians may also be exposed to these agents. The intentional or unintentional release of a chemical warfare agent in a civilian community has the potential to create thousands of casualties, thereby overwhelming local health and medical resources. The resources of US communities to respond to chemical incidents have been designed primarily for industrial agents, but must be expanded and developed regarding incident management, agent detection, protection of emergency personnel, and clinical care. We present an overview of the risk that chemical warfare agents presently pose to civilian populations and a discussion of the emergency medical and emergency public health issues related to preparedness and response. C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA USA. RP Brennan, RJ (reprint author), Int Rescue Comm, 122 E 42nd St, New York, NY 10168 USA. NR 76 TC 58 Z9 60 U1 1 U2 6 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD AUG PY 1999 VL 34 IS 2 BP 191 EP 204 DI 10.1016/S0196-0644(99)70229-5 PG 14 WC Emergency Medicine SC Emergency Medicine GA 221JA UT WOS:000081722900011 PM 10424921 ER PT J AU Talan, DA Moran, GJ Pinner, RW AF Talan, DA Moran, GJ Pinner, RW CA Ctr Dis Control Prevention TI Bioterrorism alleging use of anthrax and interim guidelines for management - United States, 1998 (Reprinted from MMWR Morb Mortal Wkly Rep, vol 48, pg 69-74, 1999) SO ANNALS OF EMERGENCY MEDICINE LA English DT Reprint C1 Olive View UCLA Med Ctr, Sylmar, CA 91342 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Talan, DA (reprint author), Olive View UCLA Med Ctr, 14445 Olive View Dr, Sylmar, CA 91342 USA. NR 1 TC 3 Z9 3 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD AUG PY 1999 VL 34 IS 2 BP 229 EP 231 PG 3 WC Emergency Medicine SC Emergency Medicine GA 221JA UT WOS:000081722900019 ER PT J AU Moorman, AC Holmberg, SD Marlowe, SI Von Bargen, JC Yangco, BG Palella, FJ Ward, DJ Loveless, MO Fuhrer, J Joseph, P Alexander, W Aschman, DJ AF Moorman, AC Holmberg, SD Marlowe, SI Von Bargen, JC Yangco, BG Palella, FJ Ward, DJ Loveless, MO Fuhrer, J Joseph, P Alexander, W Aschman, DJ CA HOPS Investigators TI Changing conditions and treatments in a dynamic cohort of ambulatory HIV patients: The HIV outpatient study (HOPS) SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE AIDS; epidemiology; health care utilization; HIV; opportunistic infection ID HUMAN-IMMUNODEFICIENCY-VIRUS; BACTERIAL PNEUMONIA; DECLINING MORBIDITY; MEDICAL CONDITIONS; CIGARETTE-SMOKING; INFECTED PATIENTS; HOMOSEXUAL MEN; AIDS; DISEASE; SPECTRUM AB PURPOSE: Most HIV-infected persons are now treated as ambulatory patients, Obtaining continually updated data about these patients' changing conditions, therapies, and reimbursement is essential to health care provision and planning. The systematic tracking of patient medical and laboratory information in an ongoing commercial data collection program (The Health Research Network) allows clinicians to better understand health outcomes, practice patterns, and epidemiologic trends for their patients. METHODS: To evaluate trends in conditions and therapies of ambulatory HIV-infected patients, we analyzed such data electronically and prospectively collected in the HIV Outpatient Study (HOPS) from 1992 through 1996 from 1876 patients seen in 11,755 clinic visits to ten HIV clinical practices. RESULTS: Patients were as likely to be diagnosed with Mycobacterium avium complex ([MAC] 5.4 cases per 100 person-years) or wasting syndrome (7.8 cases per 100 person-years), as Pneumocystis carinii pneumonia ([PCP]; 7.6 cases per 100 person-years) or Kaposi sarcoma ([KS]; 6.9 cases per 100 person-years). A nested analysis showed that HIV-iniected cigarette smokers were at substantially greater risk of pneumonia (relative hazard [RH] = 2.3), bronchitis (RH = 1.7) and hairy leukoplakia (RH = 1.9) than nonsmokers. By 1996, 35 (56%) of 62 patients with PP, 9 (30%) of 30 patients with other pneumonias, 28 (90%) of 31 patients with KS, 35 (73%) of 48 patients with MAC, and 24 (63%) of 38 patients with cytomegalovirus retinitis were treated without hospitalization. CONCLUSIONS: The HOPS provides continually updated information on the changing characteristics, conditions, and therapy of ambulatory HIV-infected patients. (C) 1999 Elsevier Science Inc. C1 Ctr Dis Control & Prevent, Off Commun, Natl Ctr HIV STD & TB Prevent Ctr, Atlanta, GA 30033 USA. W Paces Ferry Med Clin, Atlanta, GA USA. Infect Dis Res Inst, Tampa, FL USA. Northwestern Univ, Sch Med, Chicago, IL USA. Oregon State Hlth Sci Univ, Portland, OR USA. Stony Brook Univ Hosp, Stony Brook, NY USA. Southside Healthcare Inc, Atlanta, GA USA. Apache Med Syst Inc, Hlth Res Network, Chicago, IL USA. Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Natl Ctr HIV STD & TB Prevent Ctr, Atlanta, GA 30033 USA. Hlth Res Network, Mclean, VA USA. SUNY Stony Brook, Stony Brook, NY 11794 USA. Columbia Rose Med Ctr, Denver, CO USA. Oregon Hlth Sci Univ, Portland, OR 97201 USA. Adult Immunol Clin, Oakland, CA USA. Fairmont Hosp, Oakland, CA USA. RP Moorman, AC (reprint author), Ctr Dis Control & Prevent, Off Commun, Natl Ctr HIV STD & TB Prevent Ctr, Mailstop E-06, Atlanta, GA 30033 USA. FU PHS HHS [UC64/CCU509689-03] NR 27 TC 49 Z9 49 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD AUG PY 1999 VL 9 IS 6 BP 349 EP 357 DI 10.1016/S1047-2797(99)00005-8 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 229GZ UT WOS:000082186300004 PM 10475534 ER PT J AU Xiao, LH Morgan, UM Limor, J Escalante, A Arrowood, M Shulaw, W Thompson, RCA Fayer, R Lal, AA AF Xiao, LH Morgan, UM Limor, J Escalante, A Arrowood, M Shulaw, W Thompson, RCA Fayer, R Lal, AA TI Genetic diversity within Cryptosporidium parvum and related Cryptosporidium species SO APPLIED AND ENVIRONMENTAL MICROBIOLOGY LA English DT Article ID FRAGMENT-LENGTH-POLYMORPHISM; PCR-RFLP ANALYSIS; CLETHRIONOMYS-GLAREOLUS; DISCONTINUOUS SUCROSE; TRANSMISSION; HOSTS; MICE; POPULATIONS; INFECTIVITY; PREVALENCE AB To assess the genetic diversity in Cryptosporidium parvum,,ve have sequenced the small subunit (SSU) rRNA gene of seven Cryptosporidium spp., various isolates of C. parvum from eight hosts, and a Cryptosporidium isolate from a desert monitor. Phylogenetic analysis of the SSU rRNA sequences confirmed the multispecies nature of the genus Cryptosporidium, with at least four distinct species (C. parvum, C. baileyi, C, muris, and C. serpentis). Other species previously defined by biologic characteristics, including C. wrairi, C. meleagridis, and C. felis, and the desert monitor isolate, clustered together or within C. parvum. Extensive genetic diversities were present among C. parvum isolates from humans, calves, pigs, dogs, mice, ferrets, marsupials, and a monkey. In general, specific genotypes were associated with specific host species. A PCR-restriction fragment length polymorphism technique previously developed by us could differentiate most Cryptosporidium spp. and C. parvum genotypes, but sequence analysis of the PCR product was needed to differentiate C.,wrairi and C. meleagridis from some of the C. parvum genotypes. These results indicate a need for revision in the taxonomy and assessment of the zoonotic potential of some animal C. parvum isolates. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Publ Hlth Serv, US Dept HHS, Atlanta, GA 30341 USA. Murdoch Univ, State Agr Biotechnol Ctr, Murdoch, WA 6150, Australia. Inst Venezolano Invest Cient, Ctr Ecol, Caracas, Venezuela. Ohio State Univ, Coll Vet Med, Dept Vet Prevent Med, Columbus, OH 43219 USA. ARS, Immunol & Dis Resistance Lab, USDA, Beltsville, MD 20705 USA. RP Xiao, LH (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Publ Hlth Serv, US Dept HHS, Mail Stop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. EM lax0@cdc.gov RI Xiao, Lihua/B-1704-2013 OI Xiao, Lihua/0000-0001-8532-2727 FU PHS HHS [DW75937730-01-0] NR 47 TC 328 Z9 355 U1 2 U2 16 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0099-2240 J9 APPL ENVIRON MICROB JI Appl. Environ. Microbiol. PD AUG PY 1999 VL 65 IS 8 BP 3386 EP 3391 PG 6 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA 223WR UT WOS:000081865000019 PM 10427023 ER PT J AU Zhuang, ZQ Stobbe, TJ Hsiao, HW Collins, JW Hobbs, GR AF Zhuang, ZQ Stobbe, TJ Hsiao, HW Collins, JW Hobbs, GR TI Biomechanical evaluation of assistive devices for transferring residents SO APPLIED ERGONOMICS LA English DT Article DE patient-handling devices; biomechanical evaluation; back injury ID BACK-PAIN; TASKS; RISK; WORKERS; NURSES AB This is the first of two articles to report a biomechanical evaluation and psychophysical assessment of nine battery-powered lifts, a sliding board, a walking belt, and a baseline manual method for transferring nursing home residents from a bed to a chair. The objectives of the biomechanical evaluation were: (1) to investigate the effects of transfer method and resident weight on the biomechanical stress to nursing assistants performing the transferring task, and (2) to identify resident-transferring methods that could reduce the biomechanical stress to the nursing assistants. Nine nursing assistants served as test subjects; two elderly persons participated as residents. A four-camera motion analysis system, two force platforms, and a three-dimensional biomechanical model were used to measure biomechanical load. The results indicate that transfer method and resident weight affect a nursing assistant's low-back loading. The basket-sling and overhead lift devices significantly reduced the nursing assistants' back-compressive forces during the preparation phase of a resident transfer. In addition, the use of basket-sling, overhead, and stand-up lifts removed about two-thirds of the exposure to low-back stress (lifting activities per transfer) as compared to the baseline manual method. Thus, the use of these devices reduces biomechanical stress, and thereby will decrease the occurrence of resident-handling-related low-back injuries. Furthermore, lifting device maneuvering forces were found to be significantly different and a number of design/use problems were identified with various assistive devices. The second article will detail the psychophysical assessment of the same resident-transferring methods. Published by Elsevier Science Ltd. C1 NIOSH, US Dept Hlth Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent, Morgantown, WV 26505 USA. W Virginia Univ, Dept Ind & Management Syst Engn, Morgantown, WV 26506 USA. W Virginia Univ, Dept Stat & Comp Sci, Morgantown, WV 26506 USA. RP Zhuang, ZQ (reprint author), NIOSH, US Dept Hlth Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent, 1095 Willowdale Rd, Morgantown, WV 26505 USA. RI Zhuang, Ziqing/K-5462-2012 NR 24 TC 64 Z9 66 U1 2 U2 17 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0003-6870 J9 APPL ERGON JI Appl. Ergon. PD AUG PY 1999 VL 30 IS 4 BP 285 EP 294 DI 10.1016/S0003-6870(98)00035-0 PG 10 WC Engineering, Industrial; Ergonomics; Psychology, Applied SC Engineering; Psychology GA 201YE UT WOS:000080624200001 PM 10416841 ER PT J AU Waters, TR AF Waters, TR TI Accuracy of measurements for the revised NIOSH lifting equation. Applied Ergonomics 29(6) 433-438. Author's reply SO APPLIED ERGONOMICS LA English DT Letter C1 NIOSH, US Dept Hlth & Human Serv, Cincinnati, OH 45226 USA. RP Waters, TR (reprint author), NIOSH, US Dept Hlth & Human Serv, 4676 Columbia Pkwy,MS-C24, Cincinnati, OH 45226 USA. NR 0 TC 0 Z9 0 U1 1 U2 3 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0003-6870 J9 APPL ERGON JI Appl. Ergon. PD AUG PY 1999 VL 30 IS 4 BP 371 EP 371 PG 1 WC Engineering, Industrial; Ergonomics; Psychology, Applied SC Engineering; Psychology GA 201YE UT WOS:000080624200011 ER PT J AU Jones, BA Valenstein, PN Steindel, SJ AF Jones, BA Valenstein, PN Steindel, SJ TI Gynecologic cytology turnaround time - A College of American Pathologists Q-Probes study of 371 laboratories SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article ID TIMELINESS; INSTITUTIONS; PERFORMANCE; EMERGENCY; HOSPITALS; GRADE AB Objectives.-To determine the turnaround time for gynecologic cytology in a large sample of laboratories and to identify laboratory and specimen characteristics associated with better and worse performance. Design and Setting-Prospective evaluation of gynecologic cytology turnaround times in 371 laboratories. Main Outcome Measure.-Gynecologic cytology case turnaround time. Results.-Three hundred seventy-one laboratories submitted information regarding laboratory characteristics and processes, and turnaround times of 66 042 gynecologic cytology cases. Half of the participating laboratories had mean turnaround times of 6 calendar days or less and were able to complete 90% of their cases within 8 calendar days. Ten percent of participants had mean turnaround times greater than 13 days and required 19 or more days to report 90% of their cases. Longer turnaround times were associated with the use of reference laboratories for all or part of the evaluation; contacting the physician's office for additional information; using cytotechnology students, residents, or fellows in the evaluation; and providing service on the weekend. Conclusion.-Practice patterns contribute to the long turnaround times for gynecologic cytology found in some laboratories and may be improved by local site-specific process analysis. C1 St Johns Hosp & Med Ctr, Dept Pathol, Detroit, MI 48236 USA. St Joseph Mercy Hlth Syst, Dept Pathol, Ann Arbor, MI USA. Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Div Lab Syst, Atlanta, GA USA. RP Jones, BA (reprint author), St Johns Hosp & Med Ctr, Dept Pathol, 22101 Moross Rd, Detroit, MI 48236 USA. NR 20 TC 13 Z9 13 U1 0 U2 0 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD AUG PY 1999 VL 123 IS 8 BP 682 EP 686 PG 5 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA 227CL UT WOS:000082060700008 PM 10420223 ER PT J AU LeBaron, CW Mercer, JT Massoudi, MS Dini, E Stevenson, J Fischer, WM Loy, H Quick, LS Warming, JC Tormey, P DesVignes-Kendrick, M AF LeBaron, CW Mercer, JT Massoudi, MS Dini, E Stevenson, J Fischer, WM Loy, H Quick, LS Warming, JC Tormey, P DesVignes-Kendrick, M TI Changes in clinic vaccination coverage after institution of measurement and feedback in 4 states and 2 cities SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID IMMUNIZATION; CHILDREN; IMPACT AB Background: Since 1995, states and jurisdictions receiving federal immunization funds have been required to perform annual measurements of vaccination coverage in their public clinics, based on data from Georgia where clinic coverage increased after the institution of a measurement and feedback intervention. Objective: To determine if clinic vaccination coverage improved in localities that used the Georgia intervention model. Design: Retrospective examination of clinic vaccination coverage data. Participants: Children aged 19 to 35 months enrolled in clinics in localities that had applied the intervention for 4 years or longer. Intervention: The Georgia intervention model: assessment of clinic vaccination coverage, feedback of the information to the clinic, incentives to clinics, and promotion of exchange of information among clinics (AFIX). Main Outcome Measure: Change in median clinic coverage rates, based on the primary (4-3-1) vaccine series, with comparison to results of the National Immunization Survey. Results: Four states and 2 cities that had applied the AFIX intervention for 4 years or longer were identified. The number of clinic records reviewed annually was 4639 to 18 000 in 73 to 116 clinics for states, and 714 to 5276 in 8 to 25 clinics for cities. Median clinic coverage rose in all localities: Missouri, 44% (1992) to 93% (1997); Louisiana, 61% (1992) to 83% (1997); Colorado, 55% (1993) to 75% (1997); Iowa, 71% (1994) to 89% (1997); Boston, Mass, 41% (1994) to 79% (1997); and Houston, Tex, 28% (1994) to 84% (1997). The increase in clinic coverage exceeded that of the general population in 5 localities and was identical in the sixth. The average annual, coverage rise attributable to the intervention was +5 percentage points per year (Georgia, +6 per year). The average crude direct program cost was $49 533 per locality per year. Conclusion: The Georgia intervention model (AFIX) can be reproduced elsewhere and is associated with improvements in clinic vaccination coverage. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA 30333 USA. Missouri Dept Hlth, Jefferson, MO USA. Louisiana Dept Hlth & Hosp, New Orleans, LA USA. Colorado Dept Publ Hlth & Environ, Denver, CO USA. Iowa Dept Publ Hlth, Des Moines, IA 50319 USA. Boston Publ Hlth Commiss, Boston, MA USA. Houston Dept Hlth & Human Serv, Houston, TX USA. RP LeBaron, CW (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA 30333 USA. NR 22 TC 26 Z9 26 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD AUG PY 1999 VL 153 IS 8 BP 879 EP 886 PG 8 WC Pediatrics SC Pediatrics GA 222LZ UT WOS:000081788200017 PM 10437765 ER PT J AU Fagot-Campagna, A Burrows, NR Williamson, DF AF Fagot-Campagna, A Burrows, NR Williamson, DF TI The public health epidemiology of type 2 diabetes in children and adolescents: a case study of American Indian adolescents in the Southwestern United States SO CLINICA CHIMICA ACTA LA English DT Article; Proceedings Paper CT International Conference on Enzymes, Receptors and Drugs in Obesity and Atherosclerosis CY MAY 07-09, 1998 CL TORONTO, CANADA DE epidemiology; public health; type 2 diabetes; children; adolescents; obesity ID PIMA-INDIANS; RISK-FACTORS; GLYCEMIC CONTROL; LIFE-STYLE; MELLITUS; PREVALENCE; OBESITY; DISEASE; INTERVENTIONS; PREVENTION AB Type 2 diabetes among children and adolescents is a newly recognized disease in the United States. Because obesity and physical inactivity are increasing in children and adolescents, the prevalence of pediatric type 2 diabetes may increase and eventually become an important cause of adult morbidity and mortality. Data on type 2 diabetes in adolescents aged 15-19 years were compared between two sources: systematic population screening of the Gila River Indian Community by the National Institutes of Health (NM), and reported cases by the Indian Health Service (MS) from clinics in the Southwestern US. The current NM estimate of prevalence of type 2 diabetes was much higher than the Ms estimate (5.1% vs. 0.46%). Both data sources, however, suggest a secular increase in prevalence between 1986 and 1996-97. These data are used to discuss the principles, applications, and challenges for accurate epidemiologic assessment of type 2 diabetes in children and adolescents. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Fagot-Campagna, A (reprint author), Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway,NE MS-K68, Atlanta, GA 30341 USA. NR 51 TC 38 Z9 42 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0009-8981 J9 CLIN CHIM ACTA JI Clin. Chim. Acta PD AUG PY 1999 VL 286 IS 1-2 BP 81 EP 95 DI 10.1016/S0009-8981(99)00095-9 PG 15 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 239UR UT WOS:000082788500007 PM 10511286 ER PT J AU Pfeiffer, CM Huff, DL Smith, SJ Miller, DT Gunter, EW AF Pfeiffer, CM Huff, DL Smith, SJ Miller, DT Gunter, EW TI Comparison of plasma total homocysteine measurements in 14 laboratories: An international study SO CLINICAL CHEMISTRY LA English DT Article ID VASCULAR-DISEASE; RISK FACTOR; SERUM; HOMOCYST(E)INE; COBALAMIN; THIOLS; ACID AB Background: Information on interlaboratory variation and especially on methodological differences for plasma total homocysteine is lacking. Methods: We studied 14 laboratories that used eight different method types: HPLC with electrochemical detection (HPLC-ED); HPLC with fluorescence detection (HPLC-FD) further subdivided by type of reducing/derivatizing agent; gas chromatography/mass spectrometry (GC/MS); enzyme immunoassay (EIA); and fluorescence polarization immunoassay (FPIA). Three of these laboratories used two methods. The laboratories participated in a 2-day analysis of 46 plasma samples, 4 additional plasma samples with added homocystine, and 3 plasma quality-control (QC) pools. Results were analyzed for imprecision, recovery, and methodological differences. Results: The mean among-laboratory and among-run within-laboratory imprecision (CV) was 9.3% and 5.6% for plasma samples, 8.8% and 4.9% for samples with added homocystine, and 7.6% and 4.2% for the QC pools, respectively. Difference plots showed values systematically higher than GC/MS for HPLC-ED, HPLC-FD using sodium borohydride/monobromobimane (however, for only one laboratory), and EIA, and lower values for HPLC-FD using trialkylphosphine/4-(aminosulfonyl)-7-fluoro-2,1,3-benzoxadiazole, The two HPLC-FD methods using tris(2-carboxyethyl) phosphine/ammonium 7-fluoro-2,1,3-benzoxadiazole-4-sulfonate (SBD-F) or tributyl phosphine/SBD-F, and the FPIA method showed no detectable systematic difference from GC/MS. Conclusions: Among-laboratory variations within one method can exceed among-method variations. Some of the methods tested could be used interchangeably, but there is an urgent need to improve analytical imprecision and to decrease differences among methods. (C) 1999 American Association for Clinical Chemistry. C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Pfeiffer, CM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, 4770 Buford Hwy NE,MS F-18, Atlanta, GA 30341 USA. NR 24 TC 64 Z9 66 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD AUG PY 1999 VL 45 IS 8 BP 1261 EP 1268 PN 1 PG 8 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 224FV UT WOS:000081887500020 PM 10430793 ER PT J AU Chace, DH Adam, BW Smith, SJ Alexander, JR Hillman, SL Hannon, WH AF Chace, DH Adam, BW Smith, SJ Alexander, JR Hillman, SL Hannon, WH TI Validation of accuracy-based amino acid reference materials in dried-blood spots by tandem mass spectrometry for newborn screening assays SO CLINICAL CHEMISTRY LA English DT Article ID CANDIDATE DEFINITIVE METHOD; RAPID DIAGNOSIS; HUMAN-SERUM; PHENYLALANINE; PHENYLKETONURIA; CHROMATOGRAPHY; TYROSINE AB Background: Advances in technology and the earlier release of newborns from hospitals have pressed the demand for accurate calibration and improved interlaboratory performance for newborn screening tests. As a first step toward standardization of newborn screening aminoacidopathy tests, we have produced six-pool sets of multianalyte dried-blood-spot amino acid reference materials (AARMs) containing predetermined quantities of five amino acids. We describe here the production of the AARMs, validation of their amino acid contents, and characterization of their homogeneity and their stability in storage. Methods: To each of six portions of a pool of washed erythrocytes suspended in serum we added Phe (0-200 mg/L), Leu (0-200 mg/L), Met (0-125 mg/L), Tyr (0-125 mg/L), and Val (0-125 mg/L). Six-pool sets (1300) were prepared, dried, and packaged. We used isotope-dilution mass spectrometry to estimate the endogenous amino acid concentrations of the AARMs and validate their final amino acid concentrations. We used additional tandem mass spectrometry analyses to examine the homogeneity of amino acid distribution in each AARM, and HPLC analyses to evaluate the stability of the amino acid contents of the AARMs. Results: The absolute mean biases across the analytic range for five amino acids were 2.8-9.4%. One-way ANOVAs of the homogeneity results predicted no statistically significant differences in amino acid concentrations within the blood spots or within the pools (P >0.05). Regression slopes (0 +/- 0.01) for amino acid concentrations vs storage times and their P values (>0.05) showed no evidence of amino acid degradation at ambient temperatures, 4 degrees C, or -20 degrees C during the intervals tested. Conclusion: The validation, homogeneity, and stability of these blood spots support their use as a candidate national reference material for calibration of assays that measure amino acids in dried-blood spots. (C) 1999 American Association for Clinical Chemistry. C1 Ctr Dis Control & Prevent, Newborn Screening Qual Assurance Program, Atlanta, GA 30341 USA. Neo Gen Screening, Pittsburgh, PA 15220 USA. Duke Univ, Med Ctr, Mass Spect Facil, Res Triangle Pk, NC 27709 USA. RP Hannon, WH (reprint author), Ctr Dis Control & Prevent, Newborn Screening Qual Assurance Program, Atlanta, GA 30341 USA. NR 21 TC 59 Z9 61 U1 1 U2 8 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD AUG PY 1999 VL 45 IS 8 BP 1269 EP 1277 PN 1 PG 9 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 224FV UT WOS:000081887500021 PM 10430794 ER PT J AU Fridkin, SK Steward, CD Edwards, JR Pryor, ER McGowan, JE Archibald, LK Gaynes, RP Tenover, FC AF Fridkin, SK Steward, CD Edwards, JR Pryor, ER McGowan, JE Archibald, LK Gaynes, RP Tenover, FC CA Project Intensive Care Antimicrobial Resistance TI Surveillance of antimicrobial use and antimicrobial resistance in United States hospitals: Project ICARE phase 2 SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Symposium on Surveillance and Control of Pathogens of Epidemiologic Importance CY APR 03-04, 1998 CL ORLANDO, FLORIDA SP Rhone Poulenc Rorer Pharmaceut ID STAPHYLOCOCCUS-AUREUS; INFECTIONS; SYSTEM AB The search for the means to understand and control the emergence and spread of antimicrobial resistance has become a public health priority. Project ICARE (Intensive Care Antimicrobial Resistance Epidemiology) has established laboratory-based surveillance for antimicrobial resistance and antimicrobial use at a subset of hospitals participating in the National Nosocomial Infection Surveillance system. These data illustrate that for most antimicrobial-resistant organisms studied, rates of resistance were highest in the intensive care unit (ICU) areas and lowest in the outpatient areas. A notable exception was ciprofloxacin- or ofloxacin-resistant Pseudomonas aeruginosa, for which resistance rates were highest in the outpatient areas. For most of the antimicrobial agents associated with this resistance, the rate of use was highest in the ICU areas, in parallel to the pattern seen for resistance. These comparative data on use and resistance among similar areas (i.e., ICU or other inpatient areas) can be used as a benchmark by participating hospitals to focus their efforts at addressing antimicrobial resistance. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA. RP Fridkin, SK (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Mailstop E-55,1600 Clifton Rd, Atlanta, GA 30333 USA. RI mcgowan jr, john/G-5404-2011 NR 20 TC 322 Z9 333 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 245 EP 252 DI 10.1086/520193 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900004 PM 10476720 ER PT J AU Rangel-Frausto, MS Wiblin, T Blumberg, HM Saiman, L Patterson, J Rinaldi, M Pfaller, M Edwards, JE Jarvis, W Dawson, J Wenzel, RP AF Rangel-Frausto, MS Wiblin, T Blumberg, HM Saiman, L Patterson, J Rinaldi, M Pfaller, M Edwards, JE Jarvis, W Dawson, J Wenzel, RP CA NEMIS Study Grp TI National Epidemiology of Mycoses Survey (NEMIS): Variations in rates of bloodstream infections due to Candida species in seven surgical intensive care units and six neonatal intensive care units SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Symposium on Surveillance and Control of Pathogens of Epidemiologic Importance CY APR 03-04, 1998 CL ORLANDO, FLORIDA SP Rhone Poulenc Rorer Pharmaceut ID HOSPITAL-ACQUIRED CANDIDEMIA; BLOOD-STREAM INFECTION; ANTIFUNGAL SUSCEPTIBILITY; NOSOCOMIAL INFECTIONS; RISK-FACTORS; SURVEILLANCE; MORTALITY; OUTBREAK; FUNGEMIA; SEVERITY AB Candida species are the fourth most frequent cause of nosocomial bloodstream infections, and 25%-50% occur in critical care units. During an 18-month prospective study period, all patients admitted for greater than or equal to 72 hours to the surgical (SICUs) or neonatal intensive care units (NICUs) at each of the participant institutions were followed daily, Among 4,276 patients admitted to the seven SICUs in six centers, there were 42 nosocomial bloodstream infections due to Candida species (9.8/1,000 admissions; 0.99/1,000 patient-days). Of 2,847 babies admitted to the six NICUs, 35 acquired a nosocomial bloodstream infection due to Candida species (12.3/1,000 admissions; 0.64/1,000 patient-days). The following were the most commonly isolated Candida species causing bloodstream infections in the SICU: Candida albicans, 48%; Candida glabrata, 24%; Candida tropicalis, 19%; Candida parapsilosis, 7%; Candida species not otherwise specified, 2%. In the NICU the distribution was as follows: C. albicans, 63%; C. glabrata, 6%; C, parapsilosis, 29%; other, 3%, Of the patients, 30%-50% developed incidental stool colonization, 23% of SICU patients developed incidental urine colonization, and one-third of SICU health care workers' hands were positive for Candida species. C1 Virginia Commonwealth Univ, Med Coll Virginia, Dept Internal Med, Richmond, VA 23298 USA. Univ Iowa, Div Gen Internal Med, Dept Internal Med, Iowa City, IA USA. Univ Iowa, Div Microbiol, Dept Pathol, Iowa City, IA USA. Univ Iowa, Dept Prevent Med, Iowa City, IA USA. Emory Univ, Dept Med, Div Infect Dis, Sch Med, Atlanta, GA 30322 USA. Grady Mem Hosp, Dept Epidemiol, Atlanta, GA USA. Ctr Dis Control & Prevent, Hosp Infect Program, Atlanta, GA USA. Columbia Univ, Dept Pediat, Div Infect Dis, New York, NY 10027 USA. Univ Texas, Dept Internal Med, Div Infect Dis, San Antonio, TX 78285 USA. Univ Calif Los Angeles, Harbor Med Ctr, Dept Internal Med, Div Infect Dis, Los Angeles, CA 90024 USA. RP Wenzel, RP (reprint author), Virginia Commonwealth Univ, Med Coll Virginia, Dept Internal Med, 1001 E Broad St 405,POB 980663, Richmond, VA 23298 USA. NR 25 TC 282 Z9 296 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 253 EP 258 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900005 PM 10476721 ER PT J AU Romero-Steiner, S Musher, DM Cetron, MS Pais, LB Groover, JE Fiore, AE Plikaytis, BD Carlone, GM AF Romero-Steiner, S Musher, DM Cetron, MS Pais, LB Groover, JE Fiore, AE Plikaytis, BD Carlone, GM TI Reduction in functional antibody activity against Streptococcus pneumoniae in vaccinated elderly individuals highly correlates with decreased IgG antibody avidity SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 97th Annual Meeting of the American-Society-for-Microbiology CY MAY 02-08, 1997 CL MIAMI, FLORIDA SP Amer Soc Microbiol ID PNEUMOCOCCAL POLYSACCHARIDE VACCINE; LINKED-IMMUNOSORBENT-ASSAY; RESPONSES; ADULTS; PERSISTENCE; EFFICACY; ELISA; YOUNG; MICE; AGE AB The pneumococcal polysaccharide vaccine is recommended as a means of preventing invasive disease in the elderly. We compared responses to the 23-valent polysaccharide vaccine in 46 previously unvaccinated, healthy, institutionalized elderly persons (mean age, 85.5 years) with those in 12 healthy younger adults (mean age, 37 years) by measuring prevaccination and postvaccination serum IgG antibody concentrations (by ELISA), functional antibody activity (by opsonophagocytosis), IgG antibody avidity, and passive protection in mice. Postvaccination IgG antibody concentrations for two serotypes (6B and 19F) of the five studied (4, 6B, 14, 19F, and 23F) were significantly lower in elderly than in younger adults; however, opsonophagocytic activity was significantly reduced for all serotypes in the elderly. Sera with reduced opsonophagocytic activity (titer, <64) correlated with low IgG antibody avidity and protected mice poorly against pneumococcal challenge. In elderly persons receiving polysaccharide vaccination, there was a significant reduction in the functionality of postvaccination antibodies, and this appeared to increase with advanced age. C1 Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Vet Adm Med Ctr, Med Serv, Dept Infect Dis, Houston, TX 77211 USA. RP Carlone, GM (reprint author), Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Bldg 1,Room 1260,Mailstop A-36, Atlanta, GA 30333 USA. OI Romero-Steiner, Sandra/0000-0003-4128-7768 NR 34 TC 179 Z9 183 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 281 EP 288 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900011 PM 10476727 ER PT J AU Friedman, MS Roels, T Koehler, JE Feldman, L Bibb, WF Blake, P AF Friedman, MS Roels, T Koehler, JE Feldman, L Bibb, WF Blake, P TI Escherichia coli O157 : H7 outbreak associated with an improperly chlorinated swimming pool SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID HEMOLYTIC-UREMIC-SYNDROME; HEMORRHAGIC COLITIS; INFECTIONS; LIPOPOLYSACCHARIDE; DIARRHEA; TRANSMISSION; ANTIBODIES; MINNESOTA; 0157-H7; WATER AB A cluster of gastrointestinal illnesses, including one case of hemolytic-uremic syndrome and one culture-confirmed Escherichia coli O157:H7 infection, followed a trailer park pool party. We interviewed a cohort of party attendees and park residents. A primary case was defined as the first gastrointestinal illness within a household between 5 July and 20 July in which the titer of IgG antibody to E. coli O157 (if determined) was elevated. Of 51 party attendees and trailer park residents, 18 developed a gastrointestinal illness, including 10 who met the definition of a primary case. Swimming in the pool significantly increased the risk of primary illness (relative risk = 6.3; 959% confidence interval = 1.8-18.9). No other exposure was significantly associated with primary illness, after pool exposure was controlled for. The implicated pool had little to no chlorine added during the period of 4-10 July. This outbreak provides new evidence of the importance of proper pool maintenance in controlling the spread off. coli O157:H7. C1 Georgia Div Publ Hlth, Epidem Intelligence Serv, Notifiable Dis Unit, Atlanta, GA USA. Georgia Div Publ Hlth, Epidemiol Sect, Epidemiol & Prevent Branch, Atlanta, GA USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Natl Ctr Infect Dis, Atlanta, GA USA. Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Prevent Med & Immunol Lab, Lab Sect,Div Bacterial & Mycot Dis, Atlanta, GA USA. Georgia Div Publ Hlth, Valdosta, GA USA. RP Friedman, MS (reprint author), Indian Hlth Serv, Zuni Hlth Ctr, POB 467, Zuni, NM 87327 USA. EM jaisal@nm.net NR 29 TC 47 Z9 49 U1 0 U2 3 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 EI 1537-6591 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 298 EP 303 DI 10.1086/520204 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900015 PM 10476731 ER PT J AU Schantz, PM AF Schantz, PM TI Editorial response: Treatment of cystic echinococcosis - Improving but still limited SO CLINICAL INFECTIOUS DISEASES LA English DT Editorial Material ID MULTICENTER CLINICAL-TRIALS; HYDATID-DISEASE; ALBENDAZOLE C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. RP Schantz, PM (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Mailstop F22,4770 Buford High, Atlanta, GA 30341 USA. NR 15 TC 10 Z9 11 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 310 EP 311 DI 10.1086/520206 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900017 PM 10476733 ER PT J AU File, TM Plouffe, JF Breiman, RF Skelton, SK AF File, TM Plouffe, JF Breiman, RF Skelton, SK TI Clinical characteristics of Chlamydia pneumoniae infection as the sole cause of community-acquired pneumonia SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 18-20, 1996 CL NEW ORLEANS, LOUISIANA SP Infectious Dis Soc Amer ID TWAR AB The clinical characteristics of 26 patients with community-acquired pneumonia due to Chlamydia pneumoniae as the only identified pathogen who required hospitalization were evaluated. Most patients (18) had reinfection based on serological results. The mean age of the patients was 55 years (38 years, patients with primary infection; 63 years, patients with reinfection), and the gender representation was equal. Generally, illness was mild and associated with limited temperature elevation and nonspecific symptoms. The presence of comorbid illnesses and the requirement of supplemental oxygen therapy were the most common criteria for hospital admission. C1 NE Ohio Univ, Coll Med, Summa Hlth Syst, Akron, OH USA. Ohio State Univ, Columbus, OH 43210 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP File, TM (reprint author), 75 Arch St,Suite 105, Akron, OH 44304 USA. NR 6 TC 23 Z9 23 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 426 EP 428 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900037 PM 10476753 ER PT J AU Dowell, SF Smith, T Leversedge, K Snitzer, J AF Dowell, SF Smith, T Leversedge, K Snitzer, J TI Failure of treatment of pneumonia associated with highly resistant pneumococci in a child SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 36th Annual Meeting of the Infectious-Diseases-Society-of-America CY NOV 12-15, 1998 CL DENVER, COLORADO SP Infectious Dis Soc Amer ID PENICILLIN-RESISTANT; CEPHALOSPORIN; BACTEREMIA; MENINGITIS; THERAPY; DISEASE C1 Ctr Dis Control & Prevent, Resp Dis Branch, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Pediat Associates, Thomaston, GA USA. Emory Univ, Sch Med, Atlanta, GA USA. RP Dowell, SF (reprint author), Ctr Dis Control & Prevent, Resp Dis Branch, Natl Ctr Infect Dis, Mailstop C-23,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 8 TC 42 Z9 44 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 462 EP 463 DI 10.1086/588389 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900057 PM 10476773 ER PT J AU Krause, G Kroeger, A AF Krause, G Kroeger, A TI Topical paromomycin/methylbenzethonium chloride plus parenteral meglumine antimonate as treatment of American cutaneous leishmaniasis: Controlled study SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID PAROMOMYCIN METHYLBENZETHONIUM CHLORIDE C1 Univ Liverpool, Liverpool Sch Trop Med, Int Hlth Div, Liverpool L3 5QA, Merseyside, England. RP Krause, G (reprint author), Ctr Dis Control & Prevent, Dept Hlth, Bur Epidemiol, 2020 Capital Circle SE,BIN A-12, Tallahassee, FL 32399 USA. OI Krause, Gerard/0000-0003-3328-8808 NR 6 TC 3 Z9 3 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG PY 1999 VL 29 IS 2 BP 466 EP 466 DI 10.1086/520249 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 227YE UT WOS:000082106900060 PM 10476776 ER PT J AU Richards, CL Jarvis, WR AF Richards, CL Jarvis, WR TI Lessons from recent nosocomial epidemics SO CURRENT OPINION IN INFECTIOUS DISEASES LA English DT Review ID INTENSIVE-CARE UNIT; PSEUDOMONAS-AERUGINOSA OUTBREAK; RESISTANT STAPHYLOCOCCUS-AUREUS; SPECTRUM BETA-LACTAMASE; LEGIONNAIRES-DISEASE; EXTENDED-SPECTRUM; MYCOBACTERIUM-ABSCESSUS; SERRATIA-MARCESCENS; TAP-WATER; INFECTIONS AB This review describes important examples of recent nosocomial infection epidemics. Current trends suggest that emerging problems in nosocomial infections include increased nosocomial epidemics in out-of-hospital settings, contamination of medical devices and products, and antimicrobial resistance. Increased attention should be focused on outbreak investigations in these areas. (C) 1999 Lippincott Williams & Wilkins. C1 Ctr Dis Control & Prevent, Invest & Prevent Branch, Hosp Infect Program, Atlanta, GA 30333 USA. RP Richards, CL (reprint author), Ctr Dis Control & Prevent, Invest & Prevent Branch, Hosp Infect Program, Mailstop E55,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 61 TC 2 Z9 3 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0951-7375 J9 CURR OPIN INFECT DIS JI Curr. Opin. Infect. Dis. PD AUG PY 1999 VL 12 IS 4 BP 327 EP 334 PG 8 WC Infectious Diseases SC Infectious Diseases GA 228GG UT WOS:000082128300003 PM 17035794 ER PT J AU Abbas, ZG Lutale, J Gill, GV Jarvis, WR Archibald, LK AF Abbas, ZG Lutale, J Gill, GV Jarvis, WR Archibald, LK TI Hand sepsis in an adult, Tanzanian, diabetic population. SO DIABETOLOGIA LA English DT Meeting Abstract C1 Muhimbili Univ, Coll Hlth Sci, Dar Es Salaam, Tanzania. Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England. CDC, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD AUG PY 1999 VL 42 SU 1 MA 1181 BP A312 EP A312 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225CC UT WOS:000081937601179 ER PT J AU Langlois, JA Norton, R Campbell, AJ Leveille, S AF Langlois, JA Norton, R Campbell, AJ Leveille, S TI Characteristics and behaviours associated with difficulty in performing activities of daily living among older New Zealand women SO DISABILITY AND REHABILITATION LA English DT Article ID BODY-MASS INDEX; PHYSICAL-ACTIVITY; MAINTAINING MOBILITY; GRIP STRENGTH; RISK-FACTORS; LATE-LIFE; NHANES-I; DISABILITY; DECLINE; ADULTS AB Purpose: The objective of this cross-sectional study was to determine the prevalence of self-reported difficulty in perfoming activities of daily living (ADLs) and the associated characteristics and behaviours among older women in Auckland, New Zealand. Methods: A sample of 569 community dwelling women aged 65 years and older were studied. Logistic regression was used to calculate odds ratios and 95% confidence intervals for the association of participant characteristics and behaviours with reported difficulty in performing greater than or equal to 1 of five basic ADLs. Results: An age adjusted prevalence of 4.6% was found for reported ADL difficulty. Age greater than or equal to 85 years (odds ratio [OR] 5.9; 95% confidence interval [CI] 1.1-30.2), history of stroke (OR 9.8, 95% CI 4.1-23.3), history of greater than or equal to 1 fall in the past year (OR 3.4; 95% CI 1.6-7.4), low body mass index (OR 2.8; 95% CI 1.2-6.4), and low grip strength (OR 2.6; 95% CI 1.2-5.5) were significantly and independently associated with ADL difficulty. Among women with ADL difficulty, the prevalence of adaptive equipment use was high (> 90%). Conclusions: Several characteristics, medical conditions, and behaviours, some of which may be preventable, are associated with physical disability in older New Zealand women. Studies like this are an important step toward the development of interventions to reduce or delay disability and improve health and quality of life. C1 Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. Univ Auckland, Injury Prevent Res Ctr, Auckland 1, New Zealand. Univ Otago, Sch Med, Dunedin, New Zealand. NIA, Bethesda, MD 20892 USA. RP Langlois, JA (reprint author), Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. NR 41 TC 4 Z9 4 U1 0 U2 3 PU TAYLOR & FRANCIS LTD PI LONDON PA ONE GUNPOWDER SQUARE, LONDON EC4A 3DE, ENGLAND SN 0963-8288 J9 DISABIL REHABIL JI Disabil. Rehabil. PD AUG PY 1999 VL 21 IS 8 BP 365 EP 371 PG 7 WC Rehabilitation SC Rehabilitation GA 238UD UT WOS:000082729900002 PM 10503977 ER PT J AU Sterling, DA Roegner, KC Lewis, RD Luke, DA Wilder, LC Burchette, SM AF Sterling, DA Roegner, KC Lewis, RD Luke, DA Wilder, LC Burchette, SM TI Evaluation of four sampling methods for determining exposure of children to lead-contaminated household dust SO ENVIRONMENTAL RESEARCH LA English DT Article DE lead; dust sampling methods; exposure assessment; wipe sampling; vacuum sampling; blood lead; sample location ID BLOOD LEAD; URBAN CHILDREN; HAND DUST; ENVIRONMENT; CHILDHOOD; VACUUM AB Childhood exposure to lead has been demonstrated to result in health effects and lead-contaminated household dust is a primary exposure source. There is a need to establish reliable methods for sampling surfaces to determine levels of lead contamination, Three vacuums (HVS3, GS80, and MVM) and one wipe method were evaluated for the collection of household floor dust under field sampling conditions within a Superfund site and demographically similar control area, Side-by-side floor samples were taken from three locations within 41 randomly selected households between August and September 1995: a child's bedroom, primary play area, and primary entrance. Analysis was pel formed to assess the relative collection performance of each sampler, spatial distribution of lead within a household, and correlation of lead loading with observed blood lead level, and to determine if discrete- or composites samples were more predictive of blood lead levels, Approximately 90% of the floor surfaces were carpeted, The rank order of sampling methods from greatest to lowest collection efficiency was HVS3 > GS80 > wipe > MVM, The HVS3 had the highest level of precision (CV = 0.05), with the GS80 and wipe precisions 0.48 and 0.053, respectively, Lead loadings for samples collected in bedrooms and living areas and composite samples using the HVS3 and wipe methods were significantly correlated with blood lead levels. Correlations between blood lead levels and composite samples were stronger for the HVS3 (R-2 = 0.33, P = 0.003) and wipe (R-2 = 0.25, P = 0.002) methods than the respective discrete samples. Regression analysis indicated that a blood lead level of 10 mu g/dl corresponds to a carpet wipe sample geometric mean of 68 mu g/ft(2). For ongoing public health purposes, such as screening and clearance testing, use of the wipe sampling method is the most appropriate. This investigation supports findings by others that the present HUD risk levels for lead in floor wipe samples may not be adequate for reducing children's blood lead levels below 10 mu g/dl. (C) 1999 Academic Press. C1 St Louis Univ, Sch Publ Hlth, Div Environm & Occupat Hlth, St Louis, MO 63108 USA. Agcy Tox Subst & Dis Registry, Div Hlth Assessment & Consultat, Atlanta, GA USA. US EPA, Environm Response Team, Edison, NJ USA. RP Sterling, DA (reprint author), St Louis Univ, Sch Publ Hlth, Div Environm & Occupat Hlth, 3663 Lindell Blvd, St Louis, MO 63108 USA. OI Luke, Douglas/0000-0003-1332-8569 NR 42 TC 34 Z9 34 U1 1 U2 10 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0013-9351 J9 ENVIRON RES JI Environ. Res. PD AUG PY 1999 VL 81 IS 2 BP 130 EP 141 DI 10.1006/enrs.1999.3962 PG 12 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 221QQ UT WOS:000081738100006 PM 10433844 ER PT J AU Mounts, AW Holman, RC Clarke, MJ Bresee, JS Glass, RI AF Mounts, AW Holman, RC Clarke, MJ Bresee, JS Glass, RI TI Trends in hospitalizations associated with gastroenteritis among adults in the United States, 1979-1995 SO EPIDEMIOLOGY AND INFECTION LA English DT Article ID DIARRHEAL DISEASE; ROTAVIRUS; CHILDREN AB Gastroenteritis (GE) is among the most common illnesses of humans but the burden of disease, its epidemiology, and the distribution of pathogens in adults have not been fully examined. This information is needed to plan prevention strategies particularly for high-risk groups. This study is a retrospective analysis of data from the National Hospital Discharge Survey for the years 1979 through 1995 which describes the disease burden and epidemiology of hospitalizations associated with GE among adults in the United States. Diarrhoea was listed as a diagnosis on an average of 452000 hospital discharges per year representing 1.5 % of all hospitalizations among adults. The annual number of GE hospitalizations has decreased by 20 % from approximately 500000 in 1979 to 400000 in 1995. The aetiology of 78 % of cases coded as GE was undetermined. Until the aetiology of disease can be better established, specific strategies for prevention cannot be developed. C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis,CDC, Atlanta, GA 30333 USA. US Dept HHS, Publ Hlth Serv, CDC,Program Off, Ctr Dis Control & Prevent,Epidem Intelligence Ser, Atlanta, GA 30333 USA. CDC, DVRD, Off Director, Atlanta, GA 30333 USA. RP Mounts, AW (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis,CDC, MS G-04, Atlanta, GA 30333 USA. NR 18 TC 41 Z9 45 U1 0 U2 0 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD AUG PY 1999 VL 123 IS 1 BP 1 EP 8 DI 10.1017/S0950268899002587 PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 232TK UT WOS:000082385900001 PM 10487635 ER PT J AU Dalton, CB Mintz, ED Wells, JG Bopp, CA Tauxe, RV AF Dalton, CB Mintz, ED Wells, JG Bopp, CA Tauxe, RV TI Outbreaks of enterotoxigenic Escherichia coli infection in American adults: a clinical and epidemiologic profile SO EPIDEMIOLOGY AND INFECTION LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 17-22, 1995 CL SAN FRANCISCO, CALIFORNIA SP Amer Soc Microbiol ID STABLE ENTERO-TOXIN; LINKED IMMUNOSORBENT-ASSAY; HEAT-LABILE ENTEROTOXINS; TRAVELERS DIARRHEA; UNITED-STATES; CHOLERA-TOXIN; GASTROENTERITIS; DISEASE; CHILDREN; ILLNESS AB Because enterotoxigenic Escherichia coli (ETEC) is not identified by routine stool culture methods, ETEC outbreaks may go unrecognized, and opportunities for treatment and prevention may be missed. To improve recognition of adult ETEC outbreaks, we compared them with reported outbreaks of viral gastroenteritis. During 1975-95, we identified 14 ETEC outbreaks in the United States and 7 on cruise ships, caused by 17 different serotypes and affecting 5683 persons. Median symptom prevalences were: diarrhoea 99 %, abdominal cramps 82 %, nausea 49 %, fever 22 %, vomiting 14 %. The median incubation period was 42 h, and for 8 of 10 outbreaks, the mean or median duration of illness was > 72 h (range 24-264). For 17 (81 %) ETEC outbreaks, but for only 2 (8 %) viral outbreaks, the prevalence of diarrhoea was greater than or equal to 2.5 times the prevalence of vomiting. ETEC outbreaks may be differentiated from viral gastroenteritis outbreaks by a diarrhoea-to-vomiting prevalence ratio of greater than or equal to 2.5 and a longer duration of illness. C1 NSW Dept Hlth, Hunter Publ Hlth Unit, Wallsend, NSW 2287, Australia. Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Div Bacterial & Mycot Dis,Publ Hlth Serv, Natl Ctr Infect Dis,US Dept HHS, Atlanta, GA 30333 USA. RP Dalton, CB (reprint author), NSW Dept Hlth, Hunter Publ Hlth Unit, POB 466, Wallsend, NSW 2287, Australia. NR 37 TC 41 Z9 41 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD AUG PY 1999 VL 123 IS 1 BP 9 EP 16 DI 10.1017/S0950268899002526 PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 232TK UT WOS:000082385900002 PM 10487636 ER PT J AU Ben Abderrazak, S Oury, B Lal, AA Bosseno, MF Force-Barge, P Dujardin, JP Fandeur, T Molez, JF Kjellberg, F Ayala, FJ Tibayrenc, M AF Ben Abderrazak, S Oury, B Lal, AA Bosseno, MF Force-Barge, P Dujardin, JP Fandeur, T Molez, JF Kjellberg, F Ayala, FJ Tibayrenc, M TI Plasmodium falciparum: Population genetic analysis by multilocus enzyme electrophoresis and other molecular markers SO EXPERIMENTAL PARASITOLOGY LA English DT Article DE strain typing; epidemiological; tracking; clonal evolution; self-fertilization; population structure; discrete typing unit ID ANTIGENIC DIVERSITY; PARASITIC PROTOZOA; TRANSMISSION DYNAMICS; SURFACE-ANTIGEN; MALARIA; PROTEINS; STRAIN AB Population genetic analysis by multilocus enzyme electrophoresis and other molecular markers. Experimental Parasitology 92, 232-238. The population structure of Plasmodium falcipartum, the agent of malignant malaria, is uncertain. We have analyzed multilocus enzyme electrophoresis (MLEE) polymorphisms at 7-12 gene loci in each of four populations (two populations in Burkina Faso, one in Sudan, one in Congo), plus one "cosmopolitan" sample consisting of parasite cultures from 15 distant localities in four different continents. We have also performed random amplified polymorphic DNA analysis (RAPD) and restriction fragment length polymorphism (RFLP) and characterized gene variation at four antigen genes in the Congo population. All genetic assays show abundant genetic variability in all populations analyzed. With the isoenzyme assays, strong linkage disequilibrium is apparent in at least two local populations, the Congo population and one population from Burkina Faso, as well as in the cosmopolitan sample, and less definitely in the other Burkina Faso population. However, no linkage disequilibrium is detected in the Congo population with the molecular assays. We failed to detect any nonrandom association between the different kinds of genetic markers; that is, MLEE with RAPD or RFLP, RAPD with RFLP, and so on. Although isoenzyme data show statistical departures from panmictic expectations, these results suggest that in the areas under survey, P. falciparum populations do not undergo predominant clonal evolution and show no clear-cut subdivisions, unlike Trypanosoma cruzi, Leishmania sp., and other major parasitic species. We discuss the epidemiological and taxonomical significance of these results. (C) 1999 Academic Press. C1 IRD, UMR CNRS IRD 9926, CEPM, F-34032 Montpellier 01, France. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Parasit Dis, Mol Vaccine Sect, Chamblee, GA 30341 USA. Inst Pasteur, F-97301 Cayenne, French Guiana. Ctr IRD, Lab Paludol, Dakar, Senegal. CNRS, Ctr Ecol Fonct & Evolut, F-34033 Montpellier, France. Univ Calif Irvine, Dept Ecol & Evolutionary Biol, Irvine, CA 92697 USA. RP Tibayrenc, M (reprint author), IRD, UMR CNRS IRD 9926, CEPM, BP 5045, F-34032 Montpellier 01, France. EM michel.tibayrenc@cepm.mpl.ird.fr FU NIGMS NIH HHS [GM42397] NR 32 TC 14 Z9 15 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0014-4894 EI 1090-2449 J9 EXP PARASITOL JI Exp. Parasitol. PD AUG PY 1999 VL 92 IS 4 BP 232 EP 238 DI 10.1006/expr.1999.4424 PG 7 WC Parasitology SC Parasitology GA 223ZJ UT WOS:000081871200002 PM 10425151 ER PT J AU Davis, RR Cheever, ML Krieg, EF Erway, LC AF Davis, RR Cheever, ML Krieg, EF Erway, LC TI Quantitative measure of genetic differences in susceptibility to noise-induced hearing loss in two strains of mice SO HEARING RESEARCH LA English DT Article DE noise-induced; age-related; hearing loss; mice ID ACOUSTIC TRAUMA; C57BL/6J MICE; AGE; GENOTYPE; EXPOSURE; DAMAGE; MOUSE AB The CBA/CaJ (CB) and C57BL/6J (B6) inbred strains of mice were exposed for 1 h to noise intensities between 98 and 119 dB SPL, Previous studies indicated that the B6 mice exhibited permanent threshold shifts (PTS) after 1 h exposure to 110 dB, whereas the CB mice did not exhibit any PTS. These differences in susceptibility to noise-induced hearing loss (NIHL) appear to be due to a gene for age-related hearing loss (AHL). The current study was designed to determine dose-response curves for NIHL over the ranges of intensities of noise that would characterize the B6 and CB inbred strains of mice. Because of the considerable differences in sensitivity to NIHL, the noise exposures for the two strains overlapped only at 110 and 113 dB. Nevertheless, the two strains exhibited two different dose-response curves, offset and with different slopes. We postulate that the B6 strain of mice exhibits a more linear increase for PTS from 98-113 dB, consistent with incremental effects on some metabolic physiological mechanism(s); the abrupt transition in NIHL between 113 and 116 dB for the CB mice is consistent with an ototraumatic structural injury. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Ctr Dis Control & Prevent, Bioacoust & Occupat Vibrat Sect, Phys Agents Effects Branch, Natl Inst Occupat Safety & Hlth, Cincinnati, OH 45226 USA. Univ Cincinnati, Dept Biol Sci, Cincinnati, OH 45221 USA. Ctr Dis Control & Prevent, Div Biomed & Behav Sci, Natl Inst Occupat Safety & Hlth, Cincinnati, OH 45226 USA. RP Davis, RR (reprint author), Ctr Dis Control & Prevent, Bioacoust & Occupat Vibrat Sect, Phys Agents Effects Branch, Natl Inst Occupat Safety & Hlth, Mailstop C-27,4676 Columbia Pkwy, Cincinnati, OH 45226 USA. RI Davis, Rickie/A-3186-2008; OI Davis, Rickie/0000-0002-9264-2021 NR 20 TC 18 Z9 21 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-5955 J9 HEARING RES JI Hear. Res. PD AUG PY 1999 VL 134 IS 1-2 BP 9 EP 15 DI 10.1016/S0378-5955(99)00060-X PG 7 WC Audiology & Speech-Language Pathology; Neurosciences; Otorhinolaryngology SC Audiology & Speech-Language Pathology; Neurosciences & Neurology; Otorhinolaryngology GA 223BY UT WOS:000081820900002 PM 10452371 ER PT J AU Caimano, MJ Bourell, KW Bannister, TD Cox, DL Radolf, JD AF Caimano, MJ Bourell, KW Bannister, TD Cox, DL Radolf, JD TI The Treponema denticola major sheath protein is predominantly periplasmic and has only limited surface exposure SO INFECTION AND IMMUNITY LA English DT Article ID FRACTURE ELECTRON-MICROSCOPY; OUTER-MEMBRANE PROTEINS; PALLIDUM SUBSP PALLIDUM; BORRELIA-BURGDORFERI; FREEZE-FRACTURE; LYME-DISEASE; SYPHILIS SPIROCHETE; CELL-MEMBRANES; BETA-STRANDS; IDENTIFICATION AB The recent discovery that the Treponema pallidum genome encodes 12 orthologs of the Treponema denticola major sheath protein (Msp) prompted us to reexamine the cellular location and topology of the T, denticola polypeptide. Experiments initially were conducted to ascertain whether Msp forms an array on or within the T. denticola outer membrane. Transmission electron microscopy (EM) of negatively stained and ultrathin-sectioned organisms failed to identify a typical surface layer, whereas freeze-fracture EM revealed that the T. denticola outer membrane contains heterogeneous transmembrane proteins but no array. In contrast, a lattice-like structure was observed in vesicles released from mildly sonicated treponemes; combined EM and biochemical analyses demonstrated that this structure was the peptidoglycan sacculus. Immunoelectron microscopy (IEM) subsequently was performed to localize Msp in T. denticola. Examination of negatively stained whole mounts identified substantial amounts of Msp in sonicated organisms. IEM of ultrathin-sectioned, intact treponemes also demonstrated that the preponderance of antigen was unassociated with the outer membrane. Lastly, immunofluorescence analysis of treponemes embedded in agarose gel microdroplets revealed that only minor portions of Msp are surface exposed. Taken as a whole, our findings challenge the widely held belief that Msp forms an array within the T. denticola outer membrane and demonstrate, instead, that it is predominantly periplasmic with only limited surface exposure. These findings also have implications for our evolving understanding of the contribution(s) of Msp/Tpr orthologs to treponemal physiology and disease pathogenesis. C1 Univ Texas, SW Med Ctr, Dept Internal Med, Dallas, TX 75235 USA. Univ Texas, SW Med Ctr, Dept Biochem, Dallas, TX 75235 USA. Univ Texas, SW Med Ctr, Dept Microbiol, Dallas, TX 75235 USA. Ctr Dis Control & Prevent, Div STD Lab Res, Atlanta, GA 30333 USA. RP Radolf, JD (reprint author), Univ Connecticut, Ctr Hlth, Ctr Microbial Pathogenesis, 263 Farmington Ave, Farmington, CT 06030 USA. FU NIAID NIH HHS [AI-07520, T32 AI007520, R01 AI026756, AI-26756, R37 AI026756] NR 59 TC 31 Z9 32 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD AUG PY 1999 VL 67 IS 8 BP 4072 EP 4083 PG 12 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 219ZA UT WOS:000081637400050 PM 10417176 ER PT J AU Burwen, DR Margo, CE McNeil, MM Brown, JM Tapelband, G Jenkins, RB Jarvis, WR AF Burwen, DR Margo, CE McNeil, MM Brown, JM Tapelband, G Jenkins, RB Jarvis, WR TI A pseudoepidemic of postoperative scleritis due to misdiagnosis SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID CATARACT-SURGERY; NECROTIZING SCLEROKERATITIS; CONTAMINATION; BRONCHOSCOPE AB OBJECTIVE: To describe a pseudoepidemic of infectious scleritis following eye surgery. METHODS: Retrospective cohort study with selected procedural and laboratory investigations. RESULTS: Twenty-one patients with postoperative scleritis were identified during a 2-month outbreak. Neither an infectious etiology nor a causative pre-, intra-, or postoperative exposure was found. The clinical findings, when carefully reviewed, were consistent with poor surgical-wound closure. CONCLUSIONS: The art of clinical diagnosis involves the subjective interpretation of clinical history, physical findings, and laboratory results. A repeated error in the interpretation of clinical findings can simulate an outbreak of disease. Clinicians may be reluctant to concede misdiagnosis. C1 Watson Clin, Lakeland, FL 33805 USA. Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Publ Hlth Serv,Us Dept Hlth & Human Serv, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Publ Hlth Serv,Us Dept Hlth & Human Serv, Atlanta, GA USA. N Florida S Georgia Vet Hlth Syst, Gainesville, FL USA. RP Margo, CE (reprint author), Watson Clin, 1600 Lakeland Hills Blvd, Lakeland, FL 33805 USA. NR 22 TC 1 Z9 1 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD AUG PY 1999 VL 20 IS 8 BP 539 EP 542 DI 10.1086/501666 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 227LK UT WOS:000082081700008 PM 10466553 ER PT J AU Cieslak, PR Strausbaugh, LJ Fleming, DW Ling, JM AF Cieslak, PR Strausbaugh, LJ Fleming, DW Ling, JM TI Vancomycin in Oregon: Who's using it and why SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID RESISTANT ENTEROCOCCUS-FAECIUM; ADVISORY-COMMITTEE GUIDELINES; UNIVERSITY MEDICAL-CENTER; RESTRICTION POLICY; MICROORGANISMS; EMERGENCE; PHYSICIAN; CRITERIA; IMPACT; USAGE AB OBJECTIVE: To determine the proportion of vancomycin orders that are appropriate according to national guidelines and to identify targets for educational messages. DESIGN: Population-based study of vancomycin use in Oregon during a 3-week period. Survey of pharmacists, prospective nagging of vancomycin orders, and data abstraction from patient charts using standardized forms. SETTING: Nonpsychiatric hospitals in Oregon. RESULTS: Four (6%) of the 66 Oregon hospitals had pharmacy restrictions on initial vancomycin orders. Sixty-four (97%) of the hospitals participated in the study of indications for use; 293 vancomycin orders were reported; 3.8 courses were initiated per 1,000 patient-days. Indications for use were determined for 266 (91%); of these, 159 (60%) were deemed appropriate. Of uses for prophylaxis, empirical treatment of suspected gram-positive infection, and treatment of documented grampositive infection, 57%, 56%, and 65%, respectively, were appropriate. Of hospitals with <250, 251-475, and >475 licensed beds, 65%, 58%, and 57% of vancomycin orders were appropriate. No single medical specialty accounted for >16% of inappropriate vancomycin use. CONCLUSIONS: Vancomycin was used inappropriately by physicians of many different specialties, in hospitals of all sizes, and in sundry clinical situations. The problem of inappropriate vancomycin use does not lend itself to solution by educational strategies targeted at specific subgroups; restrictions by hospital pharmacies may be required. C1 Oregon Hlth Div, Portland, OR 97232 USA. Ctr Dis Control & Prevent, Div Appl Publ Hlth Training, State Branch, Prevent Med Residency Epidemiol Program Off, Atlanta, GA USA. Oregon Hlth Sci Univ, Vet Affairs Med Ctr, Portland, OR 97201 USA. Assoc Profess Infect Control & Epidemiol, Portland, OR USA. RP Cieslak, PR (reprint author), Oregon Hlth Div, 800 NE Oregon St,Suite 772, Portland, OR 97232 USA. NR 21 TC 14 Z9 14 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD AUG PY 1999 VL 20 IS 8 BP 557 EP 560 DI 10.1086/501669 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 227LK UT WOS:000082081700013 PM 10466557 ER PT J AU Larkin, JA Kanowitz, SJ Quiroz, ES AF Larkin, JA Kanowitz, SJ Quiroz, ES TI Spontaneously draining abdominal wound: Case report and differential diagnosis SO INFECTIOUS DISEASES IN CLINICAL PRACTICE LA English DT Article ID CROHNS-DISEASE; FISTULA; ACTINOMYCOSIS; ABSCESS C1 Univ S Florida, Coll Med, Dept Med, Div Infect Dis, Tampa, FL 33612 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Larkin, JA (reprint author), Tampa Gen Hosp, Ctr Infect Dis, Tampa, FL 33601 USA. NR 27 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1056-9103 J9 INFECT DIS CLIN PRAC JI Infect. Dis. Clin. Pract. PD AUG PY 1999 VL 8 IS 6 BP 310 EP 312 DI 10.1097/00019048-199908000-00012 PG 3 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 220XE UT WOS:000081693000012 ER PT J AU Trees, DL Sandul, AL Peto-Mesola, V Aplasca, MR Leng, HB Whittington, WL Knapp, JS AF Trees, DL Sandul, AL Peto-Mesola, V Aplasca, MR Leng, HB Whittington, WL Knapp, JS TI Alterations within the quinolone resistance-determining regions of GyrA and ParC of Neisseria gonorrhoeae isolated in the Far East and the United States SO INTERNATIONAL JOURNAL OF ANTIMICROBIAL AGENTS LA English DT Article DE Neisseria gonorrhoea; ciprofloxacin; antimicrobial resistance; GyrA/ParC alterations ID TOPOISOMERASE-IV; POINT MUTATIONS; DNA GYRASE; GENE; SUSCEPTIBILITY; FLUOROQUINOLONES; IDENTIFICATION; STRAINS AB The genetic mutations within the quinolone resistance-determining regions (QRDRs) of gyrA and parC of 234 Neisseria gonorrhoeae strains isolated in the Far East and the United States, which exhibited either clinically significant ciprofloxacin resistance (CipR) or intermediate ciprofloxacin resistance (CipI) were characterized. A number of GyrA/ParC amino acid alteration patterns were identified, the most prevalent alteration pattern among CipR isolates being GyrA-91,95/ParC-Asp-86- > Asn (91,95/Asp-86- > Asn). Isolates containing 91,95/Asp-86- > Asn belonged to a number of A/S classes, penicillin/tetracycline resistance phenotypes, and plasmid profiles. These results strongly suggest that the continuing emergence of ciprofloxacin-resistant gonococci is not due to the spread of a single or a few strains but to numerous factors such as spread of existing strains, importation of new strains and, possibly, de novo development of ciprofloxacin resistance in previously susceptible strains. (C) 1999 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div AIDS STD & TB Lab Res, Atlanta, GA 30333 USA. Cebu Inst Med, Dept Microbiol & Parasitol, Cebu City, Philippines. Univ Philippines, Philippine Gen Hosp, Manila, Philippines. Minist Hlth, Phnon Penh, Cambodia. Univ Washington, Dept Med, Neisseria Reference Lab, Seattle, WA USA. RP Trees, DL (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div AIDS STD & TB Lab Res, Atlanta, GA 30333 USA. NR 23 TC 37 Z9 37 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0924-8579 J9 INT J ANTIMICROB AG JI Int. J. Antimicrob. Agents PD AUG PY 1999 VL 12 IS 4 BP 325 EP 332 DI 10.1016/S0924-8579(99)00081-3 PG 8 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 233YF UT WOS:000082454200008 PM 10493609 ER PT J AU Ford, ES AF Ford, ES TI Serum magnesium and ischaemic heart disease: findings from a national sample of US adults SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE cohort studies; coronary disease; magnesium; mortality; risk factors ID DIETARY MAGNESIUM; DRINKING-WATER; MYOCARDIAL-INFARCTION; RISK-FACTORS; BLOOD; ASSOCIATIONS; INFORMATION; METABOLISM; MORTALITY; SMOKING AB Background Animal and human data suggest that magnesium may play an important role in ischaemic heart disease. Few prospective epidemiological studies have related serum magnesium concentrations to mortality from ischaemic heart disease (IHD) or all-causes. Methods Data from the National Health and Nutrition Examination Survey Epidemiologic Followup Study were used to examine the association between serum magnesium concentration, measured between 1971-1975, and mortality from IHD or all-causes in a national sample of 25-74-year-old participants followed for about 19 years. Results The analytical samples for IHD and all-cause-mortality included 12 340 and 12 952 participants, respectively (1005 MD deaths, 2637 IHD deaths or hospitalizations, 4282 total deaths). Hazard ratios for IHD mortality from proportional hazards analysis comparing the second (1.59-<1.68 mEq/l), third (1.68-<1.77 mEq/l), and fourth (greater than or equal to 1.77 mEq/l) quartiles of serum magnesium concentration with the lowest quartile were 0.79 (95% CI : 0.58-1.08), 0.66 (95% CI : 0.47-0.93), 0.69 (95% CI : 0.52-0.90), respectively. For all-cause mortality hazards ratios were 0.82 (95% CI : 0.72-0.93), 0.84 (95% CI : 0.73-0.96), 0.85 (95% CI : 0.75-0.95). No significant interactions between serum magnesium concentration and age, sex, race, and education were observed. Conclusion Serum magnesium concentrations were inversely associated with mortality from IHD and all-cause mortality. C1 Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, Atlanta, GA 30341 USA. RP Ford, ES (reprint author), Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, 4770 Buford Highway,MS K26, Atlanta, GA 30341 USA. NR 38 TC 50 Z9 51 U1 1 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD AUG PY 1999 VL 28 IS 4 BP 645 EP 651 DI 10.1093/ije/28.4.645 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 232AR UT WOS:000082344000008 PM 10480691 ER PT J AU Hutin, YJF Harpaz, R Drobeniuc, J Melnic, A Ray, C Favorov, M Iarovoi, P Shapiro, CN Woodruff, BA AF Hutin, YJF Harpaz, R Drobeniuc, J Melnic, A Ray, C Favorov, M Iarovoi, P Shapiro, CN Woodruff, BA TI Injections given in healthcare settings as a major source of acute hepatitis B in Moldova SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE case-control studies; cross-infection; hepatitis B; infection control; injection adverse effects; Moldova; risk factors; sterilization ID RISK FACTOR; IMMUNE GLOBULIN; HIV-INFECTION; FINAL REPORT; VIRUS; TRANSMISSION; POLIOMYELITIS; CHILDREN; PAKISTAN; EXPOSURE AB Background Reported rates of acute hepatitis B are high in many former Soviet Union republics and modes of transmission are not well defined. Methods Two case-control studies were undertaken in Moldova to identify risk factors for acute hepatitis B in people aged 2-15 years (children) and greater than or equal to 15 years (adults). Serologically confirmed acute hepatitis B cases occurring between 1 January 1994 and 30 August 30 1995, were matched on age, sex, and district of residence to three potential controls who were tested for hepatitis B markers to exclude the immune. Stratified odds ratios (SOR) were calculated using bivariate and multivariate methods. Results In multivariate analysis, compared with the 175 controls, the 70 adult cases (mean age 25 years, 66% male) were more likely to report receiving injections in the 6 months before illness during a dental visit (SOR = 21; 95% CI: 3.7-120), a hospital visit (SOR = 35; 95% CI : 7.2-170), or a visit to the polyclinic (SOR = 13; 95% CI:2.4-74). Among children, receiving injections during a hospital visit (SOR = 5.2; 95% CI: 1.2-23) was the only exposure reported significantly more often by the 19 cases (mean age 8 years, 68% male) compared with the 81 controls. Conclusion These results, along with reported unsafe injection practices in Moldova, suggest that injections are a major source of hepatitis B virus transmission and highlight the importance of proper infection-control procedures in preventing transmission of blood-borne infections. C1 Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. Natl Ctr Sci & Appl Hyg & Epidemiol, Kishinev, Moldova. RP Hutin, YJF (reprint author), Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, MS G37, Atlanta, GA 30333 USA. EM yah5@cdc.gov NR 25 TC 42 Z9 42 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 EI 1464-3685 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD AUG PY 1999 VL 28 IS 4 BP 782 EP 786 DI 10.1093/ije/28.4.782 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 232AR UT WOS:000082344000028 PM 10480711 ER PT J AU Cruz, ME Schantz, PM Cruz, I Espinosa, P Preux, PM Cruz, A Benitez, W Tsang, VCW Fermoso, J Dumas, M AF Cruz, ME Schantz, PM Cruz, I Espinosa, P Preux, PM Cruz, A Benitez, W Tsang, VCW Fermoso, J Dumas, M TI Epilepsy and neurocysticercosis in an Andean community SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE epilepsy; neurocysticercosis; developing countries; neuroepidemiology ID LINKED IMMUNOELECTROTRANSFER BLOT; TAENIA-SOLIUM TAENIASIS; CEREBRAL CYSTICERCOSIS; CLINICAL-EVALUATION; MAJOR CAUSE; PRAZIQUANTEL; ALBENDAZOLE; PREVALENCE; ECUADOR; MEXICO AB Background Taenia solium neurocysticercosis (NCC) has been documented as one of the major causes of epilepsy in developing countries. However, methodological limitations have hindered the evaluation of the epidemiological relationship between cysticercosis and epilepsy at the community level. Methods We used the WHO protocol for epidemiological evaluation of neurological disorders to conduct a door-re-door survey among 2723 residents of San Pablo del Lago, an Ecuadorean rural community in which T. solium taeniasis/cysticercosis was known to be endemic. The WHO protocol was complemented by neuroimaging and immunological tests to confirm the diagnosis of this infection. Results In all 31 people suffering from active epilepsy were detected (prevalence 11.4 per 1000, 95% CI: 7.7-15.4); 26 agreed to undergo a computer tomography (CT) examination, and 28 agreed ro have blood drawn for serodiagnosis. Fourteen of the 26 (53.8%) had CT changes compatible with NCC and six of the 28 (21.4%) tested positive in the enzyme-linked immunoelectro-transfer blot (EITB) assay. In a seizure-free random sample of this population, 17 of 118 (144 per 1000) subjects examined by CT and 10 out of 96 (104 per 1000) examined by EITB had evidence of this infection. The differences between the epilepsy group and the random sample of the population were statistically significant (OR = 6.93, 95% CI:2.7-17.5, P < 0.001) for CT diagnosis, but not for EITB results (OR = 2.75, 95% CI:0.8-7.1, P > 0.12, NS). Conclusions These findings confirm that T. solium NCC is a significant cause of epilepsy at the community level in Andean villages of Ecuador. It is important to initiate effective public health interventions to eliminate this infection, which may be responsible for at least half of the cases of reported epilepsy in Ecuador. C1 Cent Univ, Sch Med, Inst Trop Neurol, Unit Neurosci, Quito, Ecuador. Cent Univ, Sch Vet Med, Quito, Ecuador. Ctr Dis Control & Prevent, Div Parasit Dis, NCID, Atlanta, GA USA. Inst Epidemiol & Trop Neurol, Limoges, France. Sch Med, Dept Biostat & Med Informat, Limoges, France. Univ Salamanca, Sch Med, E-37008 Salamanca, Spain. RP Cruz, ME (reprint author), Inst Neurociencias, Av Amazonas 4430, Quito, Ecuador. RI PREUX, Pierre-Marie/B-8393-2014 OI PREUX, Pierre-Marie/0000-0002-2171-2977 NR 37 TC 52 Z9 53 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD AUG PY 1999 VL 28 IS 4 BP 799 EP 803 DI 10.1093/ije/28.4.799 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 232AR UT WOS:000082344000031 PM 10480714 ER PT J AU Binkin, NJ Vernon, AA Simone, PM McCray, E Miller, BI Schieffelbein, CW Castro, KG AF Binkin, NJ Vernon, AA Simone, PM McCray, E Miller, BI Schieffelbein, CW Castro, KG TI Tuberculosis prevention and control activities in the United States: an overview of the organization of tuberculosis services SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Review DE tuberculosis; program; United States; TB control ID HUMAN-IMMUNODEFICIENCY-VIRUS; DRUG-RESISTANT TUBERCULOSIS; NEW-YORK-CITY; MYCOBACTERIUM-TUBERCULOSIS; PRISON; CARE; SURVEILLANCE; PERSPECTIVE; INFECTION; HEPATITIS AB After a 20% increase in tuberculosis (TB) cases between 1986 and 1992, TB cases in the United States have declined from 1993 through 1997, an average of 5 to 7 per cent per year. In this paper, we review trends and the current epidemiology of TB in the US, present a brief history of TB control efforts in the country, and present the key strategies for TB control in the US. We describe the current organizational structure of TB services in the US, the role of the private sector in TB control, and how TB control is funded. Finally we discuss the mechanisms by which TB policy is developed. The US model represents a categorical disease program that combines a centralized role of the national government in development of policy, funding, and in the maintenance of national surveillance, and a decentralized role of state and local jurisdictions, which adapt and implement national guidelines and which are responsible for day-to-day program activities. Given the relative success of this combined approach, other countries facing the challenge of maintaining an effective TB control program in the face of increased decentralization of health services may find this description useful. C1 Ctr Dis Control & Prevent, Div TB Eliminat, Atlanta, GA 30333 USA. RP Binkin, NJ (reprint author), Ctr Dis Control & Prevent, Div TB Eliminat, Mailstop E-10, Atlanta, GA 30333 USA. NR 78 TC 23 Z9 25 U1 1 U2 3 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD AUG PY 1999 VL 3 IS 8 BP 663 EP 674 PG 12 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 224CY UT WOS:000081880300004 PM 10460098 ER PT J AU Klein, RS Flanigan, T Schuman, P Smith, D Vlahov, D AF Klein, RS Flanigan, T Schuman, P Smith, D Vlahov, D CA HER Study Grp TI The effect of immunodeficiency on cutaneous delayed-type hypersensitivity testing in HIV-infected women without anergy: implications for tuberculin testing SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE skin tests; delayed type hypersensitivity testing; tuberculin testing; HIV; women ID INTRAVENOUS-DRUG-USERS; SKIN-TEST ANERGY; VIRUS-INFECTION; ASSOCIATION; RISK AB SETTING: A collaborative study in four urban medical centers in the United States. OBJECTIVE: To determine the effect of human immunodeficiency virus (HIV) infection and immunodeficiency on delayed type hypersensitivity (DTH) responses and the implications for interpretation of tuberculin reactions in non-anergic women with or at risk for HIV infection. DESIGN: Demographic and behavioral information, HIV antibody testing, CD4+ lymphocyte counts, and cutaneous responses to DTH testing with mumps, Candida, tetanus toroid, and tuberculin (purified protein derivative-PPD) antigens were obtained in 1184 women. RESULTS: Reactions to one or more of the four antigens occurred in 436 HIV-seropositive and 356 high-risk seronegative women. Among non-anergic women, HIV-seropositives were less likely (P less than or equal to 0.05) to react to mumps (62% vs 81%), tetanus (72% vs 84%), and PPD (13% vs 19%). Induration in HIV-seropositive reactors was associated with CD4+ cell level for mumps (P = 0.004) and tetanus (P < 0.001), but not for Candida or PPD, HIV-seropositive reactors with CD4+ cell counts >500/mm(3) did not have significantly smaller reactions than HIV-seronegatives for any antigen tested. PPD sizes were similar among HIV-seropositive reactors with CD4+ cell counts >500/mm(3) (12.4 +/- 7.4 mm) and HIV-seronegative reactors (12.0 +/- 8.3 mm); induration greater than or equal to 10 mm was seen in 16/173 (9.2%) seropositive women with CD4+ cell counts >500/mm3 and 41/356 (11.5%) seronegative women, respectively (P = 0.5). CONCLUSION: Among HIV-infected women able to react to a DTH antigen, induration in response to that antigen was relatively intact at CD4+ counts >500/mm3. This suggests that degree of immunodeficiency should be considered when interpreting PPD reactions in HIV-infected persons. C1 Montefiore Med Ctr, Dept Med, Div Infect Dis, Bronx, NY 10467 USA. Montefiore Med Ctr, Dept Epidemiol & Social Med, Bronx, NY 10467 USA. Albert Einstein Coll Med, Bronx, NY 10467 USA. Miriam Hosp, Dept Med, Div Infect Dis, Providence, RI 02906 USA. Brown Univ, Sch Med, Providence, RI 02912 USA. Wayne State Univ, Sch Med, Dept Med, Div Infect Dis, Detroit, MI 48201 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Baltimore, MD USA. RP Klein, RS (reprint author), Montefiore Med Ctr, Dept Med, Div Infect Dis, 111 E 210th St, Bronx, NY 10467 USA. FU PHS HHS [U64/CCU106795, U64/CCU206798, U64/CCU306802] NR 26 TC 5 Z9 5 U1 0 U2 0 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD AUG PY 1999 VL 3 IS 8 BP 681 EP 688 PG 8 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 224CY UT WOS:000081880300006 PM 10460100 ER PT J AU Louisirirotchanakul, S Beddows, S Cheingsong, R Shaffer, N Mastro, TD Likanonsakul, S Wasi, C Taylor, GP Weber, JN AF Louisirirotchanakul, S Beddows, S Cheingsong, R Shaffer, N Mastro, TD Likanonsakul, S Wasi, C Taylor, GP Weber, JN TI Role of maternal humoral immunity in vertical transmission of HIV-1 subtype E in Thailand SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT Conference on Global Strategies for the Prevention of HIV Transmission from Mothers to Infants CY SEP 03-06, 1997 CL WASHINGTON, D.C. DE HIV-1; antibody; vertical transmission; binding and neutralizing; subtypes B and E; hemodilution ID HUMAN-IMMUNODEFICIENCY-VIRUS; HETERODUPLEX MOBILITY ASSAY; ENVELOPE GLYCOPROTEIN; CHILD TRANSMISSION; ENZYME-IMMUNOASSAY; ANTIBODY-BINDING; V3 LOOP; TYPE-1; NEUTRALIZATION; GP120 AB The significance of the maternal humoral immune response in relation to vertical transmission of HIV-I was investigated in 123 mothers infected with subtype E from Thailand. Antibody binding titers to HIV-1 env domains (monomeric gp120, the CD4/gp120 binding site [BS], V3 loop, and gp41) and antibody-mediated neutralization of primary and T-cell line-adapted (TCLA) subtypes B and E HIV-1 isolates were investigated. No correlation between maternal anti HIV-1 antibodies at delivery and vertical transmission of HIV-1 subtype E was found. However, a trend to higher titer antibody-mediated cross-neutralization of a heterologous subtype B TCLA isolate, HIV-1(MN), was observed in nontransmitting mothers postpartum. The HIV-1-specific antibody titers in these infected mothers increased significantly from delivery to 6 months postpartum (p < .05), but this was only partially attributable to hemodilution and an additional factor or factors appear to affect humoral immunity to HIV-1 during late pregnancy. C1 St Marys Hosp, Imperial Coll, Sch Med,Dept Genitourinary Med & Communicable Dis, Jefferiss Res Trust Labs, London W2 1NY, England. HIV AIDS Collaborat, Nonthaburi, Thailand. Ctr Dis Control & Prevent, Atlanta, GA USA. Bamrasnaradura Infect Dis Hosp, Dept Communicable Dis Control, Minist Publ Hlth, Nonthaburi, Thailand. Mahidol Univ, Dept Microbiol, Fac Med, Siriraj Hosp, Bangkok 10700, Thailand. RP Weber, JN (reprint author), St Marys Hosp, Imperial Coll, Sch Med,Dept Genitourinary Med & Communicable Dis, Jefferiss Res Trust Labs, Praed St, London W2 1NY, England. FU Wellcome Trust NR 38 TC 12 Z9 12 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD AUG 1 PY 1999 VL 21 IS 4 BP 259 EP 265 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 219NU UT WOS:000081614000001 PM 10428102 ER PT J AU Kilmarx, PH Palanuvej, T Limpakarnjanarat, K Chitvarakorn, A St Louis, ME Mastro, TD AF Kilmarx, PH Palanuvej, T Limpakarnjanarat, K Chitvarakorn, A St Louis, ME Mastro, TD TI Seroprevalence of HIV among female sex workers in Bangkok: Evidence of ongoing infection risk after the "100% condom program" was implemented SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE Thailand; female sex workers; surveillance; HIV-1; syphilis ID AIDS EPIDEMIC; THAILAND; PREVALENCE; WOMEN; MEN AB Background: After implementation in 1991 of a nationwide campaign to promote condom use during commercial sex, HIV-1 seroprevalence among young men began to decrease in 1994. However, it is unknown to what degree female sex workers (FSWs) have been protected from infection. Methods: FSWs attending a government clinic in Bangkok in 1997 and 1998 were interviewed, counseled, and tested for evidence of prior syphilis by Treponema pallidum hemagglutination assay (TPHA) and for HIV-1 antibodies. Results: Among the 500 participants, women who began sex work more recently reported less risky sex behavior when they were first potentially exposed to HIV infection, and TPHA reactivity rates were lower among these women. However, their HIV infection rates were higher. HIV seroprevalence was 5.5% among 91 women who began sex work before 1989, 8.0% among 87 women who began during 1990 to 1993, and 12.5% among 322 women who had begun since 1994. Conclusions: Although condom use is critical to HIV prevention, women in this study who began sex work after the condom promotion campaign was implemented were still at high risk for HIV infection. Additional measures are needed to prevent HIV infection among the many young women who initiate or continue to engage in commercial sex. C1 Minist Publ Hlth, HIV AIDS Collaborat, Nonthaburi 11000, Thailand. Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA USA. Minist Publ Hlth, Dept Communicable Dis Control, Venereal Dis Div, Bangkok, Thailand. RP Kilmarx, PH (reprint author), Minist Publ Hlth, HIV AIDS Collaborat, DMS 6 Bldg,Tivanon Rd, Nonthaburi 11000, Thailand. NR 15 TC 34 Z9 34 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD AUG 1 PY 1999 VL 21 IS 4 BP 313 EP 316 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 219NU UT WOS:000081614000009 PM 10428110 ER PT J AU Tansuphasawadikul, S Amornkul, PN Tanchanpong, C Limpakarnjanarat, K Kaewkungwal, J Likanonsakul, S Eampokalap, B Naiwatanakul, T Kitayaporn, D Young, NL Hu, DJ Mastro, TD AF Tansuphasawadikul, S Amornkul, PN Tanchanpong, C Limpakarnjanarat, K Kaewkungwal, J Likanonsakul, S Eampokalap, B Naiwatanakul, T Kitayaporn, D Young, NL Hu, DJ Mastro, TD TI Clinical presentation of hospitalized adult patients with HIV infection and AIDS in Bangkok, Thailand SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE Thailand; Asia; injection drug users; sexual transmission; clinical spectrum; tuberculosis; cryptococcosis; AIDS ID IMMUNODEFICIENCY-VIRUS INFECTION; PENICILLIUM-MARNEFFEI INFECTION; DEFINING CONDITIONS; CUBIC MILLIMETER; SOUTHEAST-ASIA; TUBERCULOSIS; RISK; ZIDOVUDINE; AFRICA; TRIAL AB Objective: To characterize the clinical spectrum of disease and immune status of adult HIV-1-infected patients in Bangkok. Design: Cross-sectional survey of hospital admissions. Methods: From November 1993 through June 1996, demographic, clinical, and laboratory data were collected from HIV-infected inpatients (greater than or equal to 14 years old) at an infectious diseases hospital. Results: Of 16,717 persons admitted, 3112(18.6%) were HIV-seropositive, 2261 of whom were admitted for the first time. Of 2261, 1926 (85.2%) were male, 1942 (85.9%) had been infected heterosexually or by means not related to drug use, 319 (14.1%) were injection drug users (IDUs), and 1553 (68.7%) had AIDS. The most common AIDS-defining conditions were extrapulmonary cryptococcosis (EPC; 38.4%), tuberculosis (TB; 37.4%), and wasting syndrome (NS; 8.1%). IDUs were more likely (p < .05) to have TB or WS but less likely (p < .05) to have EPC or Pneumocystis carinii pneumonia than patients with no history of injection drug use. Lymphocyte counts were measured for 2047 (90.5%) patients; 81.8% had less than or equal to 1500 lymphocytes/mu l. Conclusion: These HIV-infected patients were admitted with severe immunosuppression. Cryptococcosis and TB are major problems and differ in prevalence among IDUs and persons infected sexually. Clinical and immunologic information is critical in improving the lives of HIV-infected persons in Asia through prevention, treatment, and prophylaxis. C1 Minist Publ Hlth, HIV AIDS Collaborat, Nonthaburi 11000, Thailand. Bamrasnaradura Infect Dis Hosp, Dept Communicable Dis Control, Minist Publ Hlth, Nonthaburi, Thailand. Ctr Dis Control & Prevent, Int Activ Branch, Div HIV AIDS Prevent, Atlanta, GA USA. Mahidol Univ, Fac Trop Med, Bangkok, Thailand. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. RP Limpakarnjanarat, K (reprint author), Minist Publ Hlth, HIV AIDS Collaborat, DMS 6 Bldg,Tivanon Rd, Nonthaburi 11000, Thailand. NR 35 TC 43 Z9 50 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD AUG 1 PY 1999 VL 21 IS 4 BP 326 EP 332 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 219NU UT WOS:000081614000011 PM 10428112 ER PT J AU Buchbinder, SP Holmberg, SD Scheer, S Colfax, G O'Malley, P Vittinghoff, E AF Buchbinder, SP Holmberg, SD Scheer, S Colfax, G O'Malley, P Vittinghoff, E TI Combination antiretroviral therapy and incidence of AIDS-related malignancies SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT 2nd National Aids Malignancy Conference CY APR 06-08, 1998 CL NATL INST HLTH, BETHESDA, MARYLAND SP NIH, NCI HO NATL INST HLTH DE HIV incidence; AIDS incidence; Kaposi's sarcoma; lymphoma; combination antiretroviral therapy; HAART ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; SARCOMA-ASSOCIATED HERPESVIRUS; SYNDROME-RELATED LYMPHOMA; HOMOSEXUAL BISEXUAL MEN; KAPOSIS-SARCOMA; SAN-FRANCISCO; PROTEASE INHIBITOR; REGRESSION; ACTIVATION; INFECTION AB We evaluated recent trends in the incidence of AIDS-related malignancies using Cox proportional hazards analysis in 622 men with well-characterized dates of HIV seroconversion in the San Francisco City Clinic cohort. By the end of 1996. 182 men had been diagnosed with Kaposi's sarcoma (KS), and 45 men had been diagnosed with lymphoma. The incidence of KS dropped from 3.5 to 0 per 100 person-years between 1993 through 1995 and 1996 (p = .07), whereas lymphoma incidence remained stable between these periods (1.4-1.8, p = .2). Combination antiretroviral therapy increased from 13% to 23% in 1993 through 1995 to 49% in 1996 and 79% in 1997. The decline in KS cannot be explained by earlier declines in HIV incidence, and concurrent increases in antiretroviral therapy suggests that control of viral replication may lead to a direct or indirect effect on KS pathogenesis. Failure to see such a trend for AIDS-related lymphoma may reflect inadequate follow-up time after widespread use of therapy or a need to treat earlier in the course of HIV infection to prevent HIV-associated lymphomagenesis. C1 San Francisco Dept Publ Hlth, HIV Res Sect, San Francisco, CA 94101 USA. Ctr Dis Control & Prevent, Div HIV AIDS, Atlanta, GA 30333 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Buchbinder, SP (reprint author), 25 Van Ness,Suite 500, San Francisco, CA 94102 USA. FU PHS HHS [R64/CCU912541] NR 30 TC 57 Z9 58 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD AUG 1 PY 1999 VL 21 SU 1 BP S23 EP S26 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 220KH UT WOS:000081663800005 PM 10430214 ER PT J AU Jones, JL Hanson, DL Dworkin, MS Ward, JW Jaffe, HW AF Jones, JL Hanson, DL Dworkin, MS Ward, JW Jaffe, HW CA Adult Adolescent Spectrum HIV Dis Project Grp TI Effect of antiretroviral therapy on recent trends in selected cancers among HIV-infected persons SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article; Proceedings Paper CT 2nd National Aids Malignancy Conference CY APR 06-08, 1998 CL NATL INST HLTH, BETHESDA, MARYLAND SP NIH, NCI HO NATL INST HLTH DE HIV; AIDS; malignancy; epidemiology ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; AIDS-DEFINING CONDITIONS; NON-HODGKINS-LYMPHOMA; KAPOSIS-SARCOMA; VIRUS INFECTION; HOMOSEXUAL MEN; UNITED-STATES; SAN-FRANCISCO; CELL COUNTS; EPIDEMIOLOGY AB We examined incidence trends in seven HIV-associated cancers (Kaposi's sarcoma [KS], invasive cervical cancer, immunoblastic lymphoma, primary brain lymphoma [PBL], Burkitt's lymphoma, other non-Hodgkin's lymphomas, and Hodgkin's lymphoma) and the effects of antiretroviral therapy an these trends. Data were abstracted from medical records in 89 hospitals and clinics in nine U.S. cities from January 1994 through June 1997. The stratified Cochran-Mante-Haenszel statistic was used to test for trend. There were 19,684 HIV-infected persons representing 26,638 years of follow-up. Decreases in incidence per 1000 person-years were observed for KS (January through June 1994, 49.9; January through June 1997, 25.7; p = .001) and PBL (January through June 1994, 8.0; January through June 1997, 2.3; p = .01), especially during time on antiretroviral therapy, but changes in the incidence of other cancers were not significant. During the study, prescription of combination antiretroviral therapy increased from 16% to 57%. The incidences of KS and PBL are decreasing. Although for KS the decline occurred in both treated and untreated groups (difference in rate of decline not significant, p = .08), it was sharper in the treated group; additionally, KS declined faster in the era after highly active antiretroviral agents were introduced. Thus, these decreases may be due in part to the effect of antiretroviral therapy slowing the progression of HIV disease. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div AIDS STD & TB Lab Res, Atlanta, GA 30333 USA. RP Jones, JL (reprint author), Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA 30333 USA. NR 32 TC 97 Z9 99 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD AUG 1 PY 1999 VL 21 SU 1 BP S11 EP S17 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 220KH UT WOS:000081663800003 PM 10430212 ER PT J AU Tondella, MLC Reeves, MW Popovic, T Rosenstein, N Holloway, BP Mayer, LW AF Tondella, MLC Reeves, MW Popovic, T Rosenstein, N Holloway, BP Mayer, LW TI Cleavase fragment length polymorphism analysis of Neisseria meningitidis basic metabolic genes SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID MULTILOCUS ENZYME ELECTROPHORESIS; POPULATION-GENETICS; GROUP-B; EPIDEMIC; DISEASE; COMPLEX; RECOMBINATION; SEROTYPES; CLONES AB Cleavase fragment length polymorphism (CFLP) is a subtyping system based on the property of the enzyme cleavase to recognize junctions between single- and double-stranded regions of DNA formed after denaturation and cooling. To assess the capacity of CFLP for discriminating Neisseria meningitidis serogroup B strains belonging to the electrophoretic type (ET) 5 (ET-5) complex from other serogroup B strains, 30 serogroup B N, N.meningitidis isolates were subtyped by CFLP with internal fragments of five housekeeping genes, adk, aspC, carA, dhp, and glnA, Two genes (glnA and carA) which demonstrated a high degree of diversity for the serogroup B isolates were then used to further evaluate the suitability of CFLP for screening 50 serogroup C N, meningitidis outbreak-associated and sporadic-case isolates with a single metabolic gene. The results were compared to those from multilocus enzyme electrophoresis (MEE), the current standard subtyping method, CFLP was able to distinguish the ET-5 complex isolates from other serogroup B isolates as efficiently as MEE. Furthermore, CFLP analysis of a single gene was sufficient to identify and cluster the serogroup C isolates belonging to the ET-37 complex from other, unrelated serogroup C isolates but was not capable of differentiating between the isolates of the major individual ETs of this complex (ET-17 and ET-24) causing most serogroup C meningococcal disease outbreaks in the United States, CFLP based on a single gene with a high degree of diversity but not under selective pressure can be applied to the rapid screening of a large number of isolates related to the recognized epidemic complex ET-5 or ET-37. Additionally, CFLP can be used as an initial screening tool to survey the amount of diversity in genes that might be used to develop a DNA sequence-based subtyping system. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Meningitidis & Special Pathogens Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Sci Resources Program, Atlanta, GA 30333 USA. RP Tondella, MLC (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Meningitidis & Special Pathogens Branch, MS C-02, Atlanta, GA 30333 USA. EM mlt5@cdc.gov NR 21 TC 3 Z9 5 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2402 EP 2407 PG 6 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600003 PM 10405375 ER PT J AU Weir, S Cuccherini, B Whiney, AM Ray, ML MacGregor, JP Steigerwalt, A Daneshvar, MI Weyant, R Wray, B Steele, J Strober, W Gill, VJ AF Weir, S Cuccherini, B Whiney, AM Ray, ML MacGregor, JP Steigerwalt, A Daneshvar, MI Weyant, R Wray, B Steele, J Strober, W Gill, VJ TI Recurrent bacteremia caused by a "Flexispira"-like organism in a patient with X-linked (Bruton's) agammaglobulinemia SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID RIBOSOMAL-RNA SEQUENCE; SP-NOV; HELICOBACTER; AIDS; GASTROENTERITIS; CULTURES; STRAINS; RAPPINI; HUMANS; BLOOD AB Helicobacter spp., except for Helicobaeter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a Helicobacter-like organism despite multiple courses of antibiotics, His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H-2 for growth. Optimal growth was observed at 35 to 37 degrees C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every it to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to Helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic DNA hybridization studies, however, found 24 to 37% relatedness to "F. rappini'' and even less to other Helicobacter spp. Although the organism phenotypically resembles "Flexispira" and Helicobacter, it is thought to represent a new taxon, The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin. C1 NIH, WG Magnuson Clin Ctr, Dept Clin Pathol, Microbiol Serv, Bethesda, MD 20892 USA. NIAID, NIH, Bethesda, MD 20892 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Meningitis & Special Pathogens Branch, Atlanta, GA USA. Georgia Dept Human Resources, Bacteriol Lab, Atlanta, GA USA. Med Coll Georgia, Dept Pediat, Sect Allergy Immunol, Augusta, GA 30912 USA. Med Coll Georgia, Dept Internal Med, Sect Allergy Immunol, Augusta, GA 30912 USA. Med Coll Georgia, Dept Pathol, Clin Microbiol Lab, Augusta, GA 30912 USA. RP Gill, VJ (reprint author), NIH, WG Magnuson Clin Ctr, Dept Clin Pathol, Microbiol Serv, Bldg 10,Rm 2C-385, Bethesda, MD 20892 USA. NR 29 TC 35 Z9 36 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2439 EP 2445 PG 7 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600009 PM 10405381 ER PT J AU Yang, CF Pieniazek, D Owen, SM Fridlund, C Nkengasong, J Mastro, TD Rayfield, MA Downing, R Biryawaho, B Tanuri, A Zekeng, L Van der Groen, G Gao, F Lal, RB AF Yang, CF Pieniazek, D Owen, SM Fridlund, C Nkengasong, J Mastro, TD Rayfield, MA Downing, R Biryawaho, B Tanuri, A Zekeng, L Van der Groen, G Gao, F Lal, RB TI Detection of phylogenetically diverse human immunodeficiency virus type 1 groups M and O from plasma by using highly sensitive and specific generic primers SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; HIV-1; VARIABILITY; INFECTIONS; SEQUENCE; CAMEROON; DISTINCT; STRAINS AB The high degree of genetic diversity within human immunodeficiency virus type 1 (HIV-1), which includes two major groups, M (major) and O (outlier), and various env subtypes within group M (subtypes A to J), has made designing assays that will detect all known HIV-1 strains difficult. We have developed a generic primer set based on the conserved immunodominant region of transmembrane protein gp41 that can reliably amplify as few as 10 copies/PCR of viral DNA from near-full-length clones representing group M subtypes A to H (subtypes I and J were not available). The assay is highly sensitive in detecting plasma viral RNA from HIV-1 strains of diverse geographic origins representing different subtypes of HIV I group M as well as HIV-1 group O, Of the 253 group M plasma specimens (subtypes A, 68 specimens; B, 71; C, 19; D, 27; E, 23; F, 33; and G, 12), 250 (98.8%) were amplified by using the gp41 M/O primer set. More importantly, all 32 (100%) group O plasma samples were also amplified with these primers. In vitro spiking experiments further revealed that the assay could reliably detect as few as 25 copies/ml of viral RNA and gave positive signals in HIV-1-seropositive specimens with plasma copy numbers below the limits of detection by all commercially available viral load assays. In addition, analysis of five seroconversion panels indicated that the assay is highly sensitive for early detection of plasma viremia during the "window period." Thus, the highly sensitive assay will be useful for early detection of HIV-1 in clinical specimens from all known HIV-1 infections, regardless of their genotypes and geographic origins. C1 Project RETRO CI, Abidjan, Cote Ivoire. HIV AIDS Collaborat, Nonthaburi, Thailand. Ctr Dis Control & Prevent, Int Act Branch, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Uganda Virus Res Inst, Entebbe, Uganda. Dept Genet, Mol Virol Lab, Rio De Janeiro, Brazil. Univ Yaounde, Ctr Hosp, Yaounde, Cameroon. Inst Trop Med, Div Microbiol, B-2000 Antwerp, Belgium. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. RP Lal, RB (reprint author), Ctr Dis Control & Prevent, Hiv & Retrovirol Branch, DASTLR, Natl Ctr Infect Dis, Mail Stop D-12,1600 Clifton Rd, Atlanta, GA 30333 USA. RI Yang, Chunfu/G-6890-2013 NR 27 TC 68 Z9 72 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2581 EP 2586 PG 6 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600033 PM 10405405 ER PT J AU Welch, DF Carroll, KC Hofmeister, EK Persing, DH Robison, DA Steigerwalt, AG Brenner, DJ AF Welch, DF Carroll, KC Hofmeister, EK Persing, DH Robison, DA Steigerwalt, AG Brenner, DJ TI Isolation of a new subspecies, Bartonella vinsonii subsp arupensis, from a cattle rancher: Identity with isolates found in conjunction with Borrelia burgdorferi and Babesia microti among naturally infected mice SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID SP-NOV; ROCHALIMAEA-HENSELAE; COMB-NOV; CLARRIDGEIAE; SEPTICEMIA; BACTEREMIA; PROPOSALS; PATHOGEN; UNIFY; FEVER AB Bacteremia with fever due to a novel subspecies of Bartonella vinsonii was found in a cattle rancher. The subspecies shared major characteristics of the genus Bartonella in terms of most biochemical features and cellular fatty acid profile, but it was distinguishable from other subspecies of B. vinsonii by good growth on heart infusion agar supplemented with X factor and by its pattern of enzymatic hydrolysis of peptide substrates. DNA relatedness studies verified that the isolate belonged to the genus Bartonella and that it was genotypically related to B. vinsonii. The highest level of relatedness was observed with recently characterized strains from naturally infected mice that were coinfected with Borrelia burgdorferi and Babesia microti. We propose the name Bartonella vinsonii subsp. arupensis subsp. nov. as the new subspecies to accommodate these human and murine isolates. C1 Lab Corp Amer, Dallas, TX 75230 USA. Univ Texas, SW Med Ctr, Dept Pathol, Dallas, TX 75235 USA. Associated & Reg Univ Pathologists Inc, Salt Lake City, UT 84108 USA. Univ Utah, Dept Pathol, Med Ctr, Salt Lake City, UT 84108 USA. Mayo Clin & Mayo Fdn, Dept Lab Med & Pathol, Rochester, MN 55905 USA. Univ Hosp Oklahoma, Clin Microbiol Lab, Oklahoma City, OK 73126 USA. Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Welch, DF (reprint author), Lab Corp Amer, 7777 Forest Ln,Suite C-350, Dallas, TX 75230 USA. NR 19 TC 130 Z9 138 U1 0 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2598 EP 2601 PG 4 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600036 PM 10405408 ER PT J AU Kremer, K van Soolingen, D Frothingham, R Haas, WH Hermans, PWM Martin, C Palittapongarnpim, P Plikaytis, BB Riley, LW Yakrus, MA Musser, JM van Embden, JDA AF Kremer, K van Soolingen, D Frothingham, R Haas, WH Hermans, PWM Martin, C Palittapongarnpim, P Plikaytis, BB Riley, LW Yakrus, MA Musser, JM van Embden, JDA TI Comparison of methods based on different molecular epidemiological markers for typing of Mycobacterium tuberculosis complex strains: Interlaboratory study of discriminatory power and reproducibility SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; GENETIC-MARKERS; BOVIS BCG; INSERTION-SEQUENCE; DNA; RESTRICTION; IS6110; POLYMORPHISM; FRAGMENT; ELEMENT AB In this study, the currently known typing methods for Mycobacterium tuberculosis isolates were evaluated with regard to reproducibility, discrimination, and specificity. Therefore, 90 M. tuberculosis complex strains, originating from 38 countries, were tested in five restriction fragment length polymorphism (RFLP) typing methods and in seven PCR-based assays. In all methods, one or more repetitive DNA elements were targeted. The strain typing and the DNA fingerprint analysis were performed in the laboratory most experienced in the respective method. To examine intralaboratory reproducibility, blinded duplicate samples were included. The specificities of the various methods were tested by inclusion of 10 non-M. tuberculosis complex strains. All five RFLP typing methods were highly reproducible. The reliability of the PCR-based methods was highest for the mixed-linker PCR, followed by variable numbers of tandem repeat (VNTR) typing and spoligotyping. Tn contrast, the double repetitive element PCR (DRE-PCR), IS6110 inverse PCR, IS6220 ampliprinting, and arbitrarily primed PCR (APPCR) typing were found to be poorly reproducible, The 90 strains were best discriminated by IS6110 RFLP typing, yielding 84 different banding patterns, followed by mixed-linker PCR (81 patterns), APPCR (71 patterns), RFLP using the polymorphic GC-rich sequence as a probe (70 patterns), DRE-PCR (63 patterns), spoligotgping (61 patterns), and VNTR typing (56 patterns). We conclude that for epidemiological investigations, strain differentiation by IS6110 RFLP or mixed-linker PCR are the methods of choice. A strong association was found between the results of different genetic markers, indicating a clonal population structure of M. tuberculosis strains. Several separate genotype families within the M. tuberculosis complex could be recognized on the basis of the genetic markers used. C1 Natl Inst Publ Hlth & Environm, Diagnost Lab Infect Dis & Perinatal Screening, NL-3720 BA Bilthoven, Netherlands. Natl Inst Publ Hlth & Environm, Res Lab Infect Dis, NL-3720 BA Bilthoven, Netherlands. Erasmus Univ, Pediat Lab, NL-3000 DR Rotterdam, Netherlands. Univ Heidelberg, Mol Mycobacteriol Lab, D-69120 Heidelberg, Germany. Durham VA Med Ctr, Durham, NC 27705 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Diagnost & Mol Epidemiol Sect, Atlanta, GA 30333 USA. Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA. Baylor Coll Med, Inst Study Human Bacterial Pathogenesis, Dept Pathol, Houston, TX 77030 USA. Univ Zaragoza, Dept Microbiol, E-50009 Zaragoza, Spain. Mahidol Univ, Dept Microbiol, Bangkok 10400, Thailand. RP Kremer, K (reprint author), Natl Inst Publ Hlth & Environm, Lab Infect Dis & Perinatal Screening, Mycobacteria Dept PB22, POB 1, NL-3720 BA Bilthoven, Netherlands. RI Hermans, Peter/F-4655-2010; Hermans, Peter/H-8042-2014; Martin, Carlos/A-7283-2008 OI Martin, Carlos/0000-0003-2993-5478 FU NIAID NIH HHS [AI-370040]; NIDA NIH HHS [DA-09238] NR 62 TC 436 Z9 468 U1 1 U2 11 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2607 EP 2618 PG 12 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600038 PM 10405410 ER PT J AU Brenner, DJ O'Hara, CM Grimont, PAD Janda, JM Falsen, E Aldova, E Ageron, E Schindler, J Abbott, SL Steigerwalt, AG AF Brenner, DJ O'Hara, CM Grimont, PAD Janda, JM Falsen, E Aldova, E Ageron, E Schindler, J Abbott, SL Steigerwalt, AG TI Biochemical identification of Citrobacter species defined by DNA hybridization and description of Citrobacter gillenii sp nov (formerly Citrobacter genomospecies 10) and Citrobacter murliniae sp nov (formerly Citrobacter genomospecies 11) SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID FAMILY ENTEROBACTERIACEAE; CLINICAL SPECIMENS; SYSTEMS; GENUS AB Recent work describing six named species and two unnamed genomospecies within Citrobacter has enlarged the genus to II species. DNA relatedness and phenotypic tests were used to determine how well these species can be identified. One hundred thirty-six strains were identified to species level by DNA relatedness and then identified phenotypically in a blinded fashion. By using conventional tests, 119 of the 136 strains (88%) were correctly identified to species level. Three additional strains (2%) were identified as citrobacteria but were not identified to species level, and 14 strains (10%) were misidentified as other Citrobacter species, Carbon source utilization tests were used to identify 86 of the strains. Eighty-four strains (98%) were correctly identified, and two strains (2%) were misidentified as other Citrobacter species, Additional strains of Citrobacter genomospecies 10 and Citrobacter genomospecies 11 were identified, allowing these species to be formally named as Citrobacter gillenii sp, nov. and Citrobacter murliniae sp. nov., respectively. C1 Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Hosp Environm Lab Branch, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Inst Natl Rech Sci, Unite Enterobacteries, U199, Inst Pasteur, F-75724 Paris, France. Calif Dept Hlth Serv, Microbial Dis Lab, Div Communicable Dis Control, Berkeley, CA 94704 USA. Gothenburg Univ, Dept Clin Bacteriol, Culture Collect, S-41346 Gothenburg, Sweden. Natl Publ Hlth Inst, Dept Clin Microbiol, Prague 10042 10, Czech Republic. RP Brenner, DJ (reprint author), Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 15 TC 38 Z9 40 U1 0 U2 4 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2619 EP 2624 PG 6 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600039 PM 10405411 ER PT J AU Singh, PN Ranjana, K Singh, YI Singh, KP Sharma, SS Kulachandra, M Nabakumar, Y Chakrabarti, A Padhye, AA Kaufman, L Ajello, L AF Singh, PN Ranjana, K Singh, YI Singh, KP Sharma, SS Kulachandra, M Nabakumar, Y Chakrabarti, A Padhye, AA Kaufman, L Ajello, L TI Indigenous disseminated Penicillium marneffei infection in the state of Manipur, India: Report of four autochthonous cases SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID SOUTHEAST-ASIA; THAILAND; PATHOGEN AB We describe four cases of disseminated infection caused by endemic Penicillium marneffei in human immunodeficiency virus (HIV)-infected patients from the Manipur state of India. The most common clinical features observed were fever, anorexia, weight loss, hepatosplenomegaly, and, more importantly, skin lesions resembling molluscum contagiosum. The diagnosis in each of the four cases was achieved by direct examination of smears, observance of intracellular yeast-like cells multiplying by fission in biopsied tissue from skin lesions, and isolation of the dimorphic P. marneffei in pure culture in each case. In one case, fluorescent antibody studies allowed specific diagnosis. This report documents a new area in which P. marneffei is endemic, located in eastern India, and describes the first occurrence in India of P. marneffei in HIV-infected patients as well as the extension of the areas of P. marneffei endemicity westward to the northeastern state of Manipur. C1 Ctr Dis Control & Prevent, Mycot Dis Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. JN Med Hosp, Dept Med, Imphal, Manipur, India. JN Med Hosp, Dept Microbiol, Imphal, Manipur, India. JN Med Hosp, Dept Pathol, Imphal, Manipur, India. Postgrad Inst Med Educ & Res, Dept Med Microbiol, Chandigarh 160012, India. Emory Univ, Sch Med, Dept Ophthalmol, Atlanta, GA 30322 USA. RP Padhye, AA (reprint author), Ctr Dis Control & Prevent, Mycot Dis Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Mail Stop G-11, Atlanta, GA 30333 USA. NR 17 TC 30 Z9 36 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD AUG PY 1999 VL 37 IS 8 BP 2699 EP 2702 PG 4 WC Microbiology SC Microbiology GA 216VR UT WOS:000081465600053 PM 10405425 ER PT J AU Bosworth, K Espelage, DL Simon, TR AF Bosworth, K Espelage, DL Simon, TR TI Factors associated with bullying behavior in middle school students SO JOURNAL OF EARLY ADOLESCENCE LA English DT Article ID BULLY/VICTIM PROBLEMS; PEER VICTIMIZATION; VICTIM PROBLEMS; AGGRESSION; CHILDREN; BULLIES; ATTITUDES; BOYS AB In this study, bullying,uas examined as a continuum of mild-to-extreme behaviors, and the potential correlates of bullying others were delineated. To improve identification and targeting of those youth at risk for bullying, demographic, behavioral and psychosocial correlates were tested on a continuous measure of bullying behavior rated according to the number and frequency of behaviors. Among 558 middle school students surveyed in 1995, only 20% reported no bullying behavior. In multiple regression analysis, misconduct anger beliefs supportive of violence, confidence in using nonviolent strategies, and intentions to use nonviolent strategies were associated with levels of bullying behavior. Although boys reported more bullying behavior than did girls, gender was nota significant predictor in the multiple regression analysis. These study results were inconsistent with the perspective that early adolescents were either bullies or nonbullies and indicated the need for a comprehensive approach to preventing bullying behavior. C1 Univ Arizona, Coll Educ, Smith Endowed Chair Substance Abuse Educ, Tucson, AZ 85721 USA. Univ Illinois, Urbana, IL 61801 USA. Ctr Dis Control & Prevent, Natl Ctr Injury Prevent, Atlanta, GA USA. RP Bosworth, K (reprint author), Univ Arizona, Coll Educ, Smith Endowed Chair Substance Abuse Educ, POB 210069, Tucson, AZ 85721 USA. NR 50 TC 163 Z9 166 U1 5 U2 26 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0272-4316 J9 J EARLY ADOLESCENCE JI J. Early Adolesc. PD AUG PY 1999 VL 19 IS 3 BP 341 EP 362 DI 10.1177/0272431699019003003 PG 22 WC Family Studies; Psychology, Developmental SC Family Studies; Psychology GA 223UQ UT WOS:000081860300003 ER PT J AU Nelson, KE Rungruengthanakit, K Margolick, J Suriyanon, V Niyomthai, S de Boer, MA Kawichai, S Robison, V Celentano, DD Nagachinta, T Duerr, A AF Nelson, KE Rungruengthanakit, K Margolick, J Suriyanon, V Niyomthai, S de Boer, MA Kawichai, S Robison, V Celentano, DD Nagachinta, T Duerr, A TI High rates of transmission of subtype E human immunodeficiency virus type 1 among heterosexual couples in northern Thailand: Role of sexually transmitted diseases and immune compromise SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID INJECTING DRUG-USERS; MALE-TO-FEMALE; HIV-INFECTION; HOMOSEXUAL MEN; TRANSFUSION RECIPIENTS; ENZYME-IMMUNOASSAY; BLOOD-DONORS; VIRAL LOAD; PARTNERS; RISK AB The heterosexual transmission of subtype E human immunodeficiency virus type 1 (HIV-1) infection was evaluated in 467 couples in Thailand in whom the man was HIV-1 positive and the woman had no risk factors for HIV other than sex with her infected partner. At baseline, 216 (46.3%) of the 467 women were positive for HIV-1: 52.2% had male partners with CD4(+) lymphocyte counts of <200 cells/mu L, 45.9% had partners with counts of 200-499, and 39.2% had partners with counts of greater than or equal to 500. Women were twice as likely to be HIV positive if their male partners had a history of a sexually transmitted disease (STD); however, their HIV prevalence was 29% among couples who had no STD history. We conclude that female partners of men infected with subtype E HIV-1 are at high risk of infection even when the man's CD4(+) cell count is relatively high. A high rate of STDs may contribute significantly to this risk. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. Chiang Mai Univ, Res Inst Hlth Sci, Chiang Mai 50000, Thailand. Minist Publ Hlth, Lampang Prov Hosp, Lampang, Thailand. Ctr Dis Control & Prevent, Atlanta, GA USA. Contracept Res & Dev Program, Atlanta, GA USA. RP Nelson, KE (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Suite E7132, Baltimore, MD 21205 USA. NR 40 TC 17 Z9 18 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 337 EP 343 DI 10.1086/314882 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000012 PM 10395847 ER PT J AU Trick, WE Kuehnert, MJ Quirk, SB Arduino, MJ Aguero, SM Carson, LA Hill, BC Banerjee, SN Jarvis, WR AF Trick, WE Kuehnert, MJ Quirk, SB Arduino, MJ Aguero, SM Carson, LA Hill, BC Banerjee, SN Jarvis, WR TI Regional dissemination of vancomycin-resistant enterococci resulting from interfacility transfer of colonized patients SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-of-Healthcare-Epidemiology-of-America CY APR, 1998 CL ORLANDO, FLORIDA SP Soc Healthcare Epidemiol Amer ID FAECIUM; EPIDEMIOLOGY; RISK AB During early 1997, the Siouxland District Health Department (SDHD; Sioux City, IA) reported an increased incidence of vancomycin-resistant enterococcal (VRE) isolates at area health care facilities. To determine the prevalence and risk factors for colonization with VRE strains at 32 health care facilities in the SDHD region, a prevalence survey and case-control study were performed. Of 2266 patients and residents, 1934 (85%) participated, and 40 (2.1%) were positive for (gastrointestinal) VRE colonization. The prevalence of VRE isolates was significantly higher in acute care facilities (ACFs) than in long-term care facilities (LTCFs) (10/152 [6.6%] vs, 30/1782 [1.7%]; odds ratio [OR], 4.1; 95% confidence interval [CI], 1.8-9.0). LTCF case patients were significantly more likely than controls to have been inpatients at any ACF (19/30 vs, 12/66; OR, 8.0; 95% CI, 2.7-23.8). Of 40 VRE isolates, 34 (85%) were a related strain. The predominant strain was present in all 12 LTCFs that had at least 1 case patient in each facility. Soon after the introduction of VRE isolates into this region, dissemination to multiple LTCFs resulted from resident transfer from ACFs to LTCFs. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Siouxland Dist Hlth Dept, Sioux City, IA USA. RP Trick, WE (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Mailstop E-69,1600 Clifton Rd NE, Atlanta, GA 30333 USA. RI Arduino, Matthew/C-1461-2012 OI Arduino, Matthew/0000-0001-7072-538X NR 21 TC 46 Z9 46 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 391 EP 396 DI 10.1086/314898 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000019 PM 10395854 ER PT J AU Jones, LP Erdman, DD Anderson, LJ AF Jones, LP Erdman, DD Anderson, LJ TI Prevalence of antibodies to human parvovirus B19 nonstructural protein in persons with various clinical outcomes following B19 infection SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT VIIth International Parvovirus Workshop / 1st Euroconference on Health Benefits and Risks from Parvovirus Infection CY SEP, 1997 CL HEIDELBERG, GERMANY ID PATHOGENESIS; SEQUENCE; DISEASE; CELLS AB Persistent infections with human parvovirus B19 (B19) associated with debilitating chronic disease have been described, although evidence linking B19 to these more unusual clinical outcomes has been inconclusive. Recent reports have suggested that the development of antibodies to the B19 nonstructural protein (NS1) following B19 infection might be linked to development of severe arthropathy and chronic infection. To confirm these findings, the C-terminal region of the NS1 protein was expressed for use in Western blot assays for detection of anti-NS1 IgG antibodies in human serum. Among 91 persons tested, 0 of 20 not previously infected with B19, 9 (36%) of 25 with past B19 infection, and 5 (12.5%) of 40 with recent B19 infection, had detectable anti-NS1 antibodies. Of 6 persons with chronic B19 infection, 2 had detectable antibodies to NS1. The presence of anti-NS1 antibodies did not appear to correlate with unusual clinical outcomes or chronic B19 infection. C1 Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, US PHS, US Dept HHS, Atlanta, GA 30333 USA. RP Erdman, DD (reprint author), Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, US PHS, US Dept HHS, Mailstop G-09,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 15 TC 25 Z9 25 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 500 EP 504 DI 10.1086/314894 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000034 PM 10395869 ER PT J AU Mounts, AW Kwong, H Izurieta, HS Ho, YY Au, TK Lee, M Bridges, CB Williams, SW Mak, KH Katz, JM Thompson, WW Cox, NJ Fukuda, K AF Mounts, AW Kwong, H Izurieta, HS Ho, YY Au, TK Lee, M Bridges, CB Williams, SW Mak, KH Katz, JM Thompson, WW Cox, NJ Fukuda, K TI Case-control study of risk factors for avian influenza A (H5N1) disease, Hong Kong, 1997 SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT International Conference on Emerging Infectious Diseases CY MAR 08-11, 1998 CL ATLANTA, GEORGIA SP Ctr Dis Control & Prevent, Council State & Terr Epidemiologists, Amer Soc Microbiol, Natl Fdn CDC, Alliance Prudent Use Antibiot, Amer Acad Pediat, Amer Assoc Blood Banks, Amer Assoc Hlth Plans, Amer Canc Soc, Amer Coll Prevent Med, Amer Hosp Assoc, Amer Med Assoc, Amer Mosquito Control Assoc, Amer Publ Hlth Assoc, Amer Sexually Transmitted Dis Assoc, Amer Soc Clin Pathologists, Amer Soc Trop Med & Hyg, Amer Vet Med Assoc, Assoc Amer Vet Med Coll, Assoc Sch Publ Hlth, Assoc State & Terr Directors Hlth Promot & Publ Hlth Educ, Assoc State & Terr Hlth Officials, Assoc State & Terr Publ Hlth Lab Directors, Assoc Teachers Prevent Med, Burroughs Wellcome Fund, Emory Univ, Sch Med, Fogarty Int Ctr, US FDA, Indian Hlth Serv, Infect Dis Soc Amer, Int Life Sci Inst, Int Soc Infect Dis, Int Soc Travel Med, Int Union Hlth Promot & Educ, Int Union Microbiol Soc, Minor Hlth Profess Fdn, Morehouse Sch Med, NASA, Natl Assoc City & County Hlth Officials, Natl Assoc State Publ Hlth Vetinarians, Natl Council Int Hlth, Natl Fdn Infect Dis, Natl Hispan Med Assoc, NIAID, Natl Med Assoc, NOAA, Off Sci & Technol Policy, Pan Amer Hlth Org, Emory Univ, Rollins Sch Publ Hlth, Soc Healthcare Epidemiol Amer, Soc Occupat & Environm Hlth, Soc Publ Hlth Educ, Carter Ctr, Henry J Kaiser Family Fdn, HMO Grp, Robert Wood Johnson Fdn, Rockefeller Fdn, World Bank, Us Agcy Int Dev, USDA, US Dept Def, US Dept State, US Dept Justice, US Dept Vet Affairs, US EPA, WHO ID VIRUS; CONJUNCTIVITIS AB In May 1997, a 3-year-old boy in Hong Kong died of a respiratory illness related to influenza A (H5N1) virus infection, the first known human case of disease from this virus. An additional 17 cases followed in November and December. A case-control study of 15 of these patients hospitalized for influenza A (H5N1) disease was conducted using controls matched by age, sex, and neighborhood to determine risk factors for disease. Exposure to live poultry (by visiting either a retail poultry stall or a market selling live poultry) in the week before illness began was significantly associated with H5N1 disease (64% of cases vs. 29% of controls, odds ratio, 4.5, P = .045), By contrast, travel, eating or preparing poultry products, recent exposure to persons with respiratory illness, including persons with known influenza A (H5N1) infection, were not associated with H5N1 disease. C1 Ctr Dis Control & Prevent, Influenza Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Div Appl Publ Hlth Training, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidemiol & Surveillance Div, Natl Immunizat Program, Atlanta, GA 30333 USA. Dept Hlth, Hong Kong, Peoples R China. RP Fukuda, K (reprint author), Ctr Dis Control & Prevent, Influenza Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Mailstop A32, Atlanta, GA 30333 USA. NR 15 TC 184 Z9 196 U1 2 U2 12 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 505 EP 508 DI 10.1086/314903 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000035 PM 10395870 ER PT J AU Mitchell, DK Matson, DO Jiang, X Berke, T Monroe, SS Carter, MJ Willcocks, MM Pickering, LK AF Mitchell, DK Matson, DO Jiang, X Berke, T Monroe, SS Carter, MJ Willcocks, MM Pickering, LK TI Molecular epidemiology of childhood astrovirus infection in child care centers SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 64th Annual Meeting of the Society-for-Pediatric-Research CY MAY 05-11, 1995 CL SAN DIEGO, CALIFORNIA SP Soc Pediat Res ID POLYMERASE CHAIN-REACTION; IMMUNOASSAY; SEROTYPE-1; DIARRHEA; SEQUENCE; REGION AB This study assessed the role of human astrovirus (HAstV) in outbreaks and sporadic cases of diarrhea among children attending child care centers (CCCs) and determined the infecting astrovirus antigenic types by reverse transcriptase-polymerase chain reaction (RT-PCR) and sequence analysis. Eight astrovirus outbreaks occurred in 6 CCCs, Of 179 children with diarrhea, 36 (20%) had astrovirus-associated diarrhea, Diarrhea stools obtained during diarrhea outbreaks were more likely to contain astrovirus (40/476) than were samples not associated with a diarrhea outbreak (14/452) (P < .001). Type-specific RT-PCR and DNA sequencing identified 5 outbreaks associated with HAstV-1 and 3 outbreaks with HAstV-2, Sequential outbreaks in 2 CCCs occurred with a different type in the same year. Phylogenetic analysis identified 6 clades of HAstV-1 and 2 clades of HAstV-2 during this 1-year surveillance. Astrovirus was a significant cause of diarrhea outbreaks, and 2 antigenic types were present in the community during 1 diarrhea season. C1 Childrens Hosp Kings Daughters, Eastern Virginia Med Sch, Ctr Pediat Res, Norfolk, VA 23510 USA. Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Div Viral & Rickettsial Dis, Atlanta, GA USA. Univ Surrey, Sch Biol Sci, Guildford GU2 5XH, Surrey, England. RP Mitchell, DK (reprint author), Childrens Hosp Kings Daughters, Eastern Virginia Med Sch, Ctr Pediat Res, 855 W Brambleton Ave, Norfolk, VA 23510 USA. OI Monroe, Stephan/0000-0002-5424-716X FU NICHD NIH HHS [NICHD-13021] NR 15 TC 37 Z9 39 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 514 EP 517 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000037 PM 10395872 ER PT J AU Xiao, LH Lal, RB Lal, AA AF Xiao, LH Lal, RB Lal, AA TI Effect of immune activation induced by Cryptosporidium parvum whole antigen on in vitro human immunodeficiency virus type 1 infection SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 46th Annual Meeting of the American-Society-of-Tropical-Medicine-and-Hygiene CY DEC 07-11, 1997 CL ORLANDO, FLORIDA SP Amer Soc Trop Med & Hyg ID NECROSIS-FACTOR-ALPHA; IN-VITRO; REPLICATION; GAMMA; CELLS; HIV; PROLIFERATION; INTERFERON; SURVIVAL; AIDS AB Previous epidemiologic investigations have suggested that persons with AIDS who are infected with Cryptosporidium parvum have a shorter survival time than those with other opportunistic infections, In this study, the effect of immune activation by a crude Cryptosporidium whole antigen on human immunodeficiency virus type 1 (HIV-1) infection was evaluated. Peripheral blood mononuclear cells from healthy persons without HIV-1 infection had increased proliferative and cytokine (interleukin-4, interferon-gamma, and tumor necrosis factor [TNF]-alpha) responses to stimulation with the crude Cryptosporidium whole antigen. This stimulation increased HIV-1 p24 antigen production in in vitro infection by >30-fold. A similar increase in p24 production was also seen when stimulation was done after cells were infected with HIV-1, Neutralization of TNF-alpha reduced Cryptosporidium antigen-induced p24 production by >50%. Results of this study suggest that Cryptosporidium-induced immune activation may be a cofactor in regulating HIV-1 production. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Parasit Dis, Immunol Branch, Atlanta, GA USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Retrovirus Dis Branch, Div AIDS Sexually Transmitted Dis, Atlanta, GA USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, TB Lab Res, Atlanta, GA USA. RP Lal, AA (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Immunol Branch, Mail Stop F-12,4770 Buford Highway, Chamblee, GA 30341 USA. RI Xiao, Lihua/B-1704-2013 OI Xiao, Lihua/0000-0001-8532-2727 NR 15 TC 5 Z9 5 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD AUG PY 1999 VL 180 IS 2 BP 559 EP 563 DI 10.1086/314885 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 222CZ UT WOS:000081767000048 PM 10395883 ER PT J AU Schulte, PA Lomax, GP Ward, EM Colligan, MJ AF Schulte, PA Lomax, GP Ward, EM Colligan, MJ TI Ethical issues in the use of genetic markers in occupational epidemiologic research SO JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE LA English DT Article ID INFORMED CONSENT; SUSCEPTIBILITY; RISK; BIOMARKERS; WORKERS AB This review was conducted to characterize the nature of contemporary occupational epidemiologic research involving genetic markers, consider how genetic information is unique with regard to its social applications, and examine some of the ethical dilemmas that may arise over the course of studies. Sire have reviewed the literature and the lessons from our experience in conducting occupational epidemiologic research involving genetic markers, This review describes how, occupational epidemiologic studies differ from other epidemiologic studies on issues of participation, confidentiality, and the history of including genetic markers. Of primary concern in occupational studies are genes that have multiple alleles and are sometimes referred to as "metabolic polymorphisms." They generally do not confer risk on their own but rather only in combination with a specific exposure. There is a need for a clear policy and guidelines for the conduct of occupational epidemiologic studies using genetic material. This policy should address all of the steps in study design, implementation, interpretation, and communication of results. C1 NIOSH, Ctr Dis Control & Prevent, Educ & Informat Div, Robert A Taft Labs, Cincinnati, OH 45226 USA. Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA. RP Schulte, PA (reprint author), NIOSH, Ctr Dis Control & Prevent, Educ & Informat Div, Robert A Taft Labs, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 36 TC 15 Z9 15 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-2752 J9 J OCCUP ENVIRON MED JI J. Occup. Environ. Med. PD AUG PY 1999 VL 41 IS 8 BP 639 EP 646 DI 10.1097/00043764-199908000-00005 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 226LM UT WOS:000082021500005 PM 10457506 ER PT J AU Frazier, LM Berberich, NJ Moser, R Cromer, JW Hitchcock, MA Monteiro, FM Greenberg, GN AF Frazier, LM Berberich, NJ Moser, R Cromer, JW Hitchcock, MA Monteiro, FM Greenberg, GN TI Developing occupational and environmental medicine curricula for primary care residents: Project EPOCN-Envi SO JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE LA English DT Article; Proceedings Paper CT National Meeting of the Society-of-General-Internal-Medicine CY APR 28-30, 1994 CL WASHINGTON, D.C. SP Soc Gen Internal Med ID UNITED-STATES; EDUCATION AB To help primary care residency programs develop or improve residency curricula in occupational and environmental medicine, the National Institute for Occupational Safety and Health launched a train-the-trainer initiative. This project was called EPOCH-Envi (Educating Physicians in OCcupational Health and the Environment). From 1990 to 1996, 46 2-day curriculum development workshops were held. These featured (1) guidelines on how to plan, implement, and evaluate a curriculum (2) continuing education on occupational illnesses and injuries, (3) a worksite or environmental site visit, and (4) information resources. A total of 435 faculty from 305 residency programs participated, representing 42.5% of the family practice residencies and 24.9% of the internal medicine residencies in the United States. A survey conducted among attendees (60.4% response rate) 17 months after their workshop revealed that 65.6% of respondents had added lectures on occupational and environmental topics to the residency curriculum. Other curriculum improvements were also made. Primary care physicians manage most patients with occupational and environmental health problems or concerns. Providing technical assistance specifically designed to support occupational and environmental health education in primary care residencies can have a positive impact on curriculum content. C1 Duke Univ, Med Ctr, Dept Community & Family Med, Div Environm & Occupat Med, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Community & Family Med, Div Educ, Durham, NC 27710 USA. NIOSH, Cincinnati, OH 45226 USA. Univ Utah, Rocky Mt Ctr Occupat Safety & Hlth, Salt Lake City, UT USA. RP Frazier, LM (reprint author), Univ Kansas, Sch Med, Dept Prevent Med, 1010 N Kansas Ave, Wichita, KS 67214 USA. FU PHS HHS [U60/CCU407280] NR 30 TC 8 Z9 8 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1076-2752 J9 J OCCUP ENVIRON MED JI J. Occup. Environ. Med. PD AUG PY 1999 VL 41 IS 8 BP 706 EP 711 DI 10.1097/00043764-199908000-00014 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 226LM UT WOS:000082021500014 PM 10457515 ER PT J AU Sullivan, JS Morris, CL Richardson, BB Galland, GG Jennings, VM Kendall, J Collins, WE AF Sullivan, JS Morris, CL Richardson, BB Galland, GG Jennings, VM Kendall, J Collins, WE TI Adaptation of the AMRU-1 strain of Plasmodium vivax to Aotus and Saimiri monkeys and to four species of anopheline mosquitoes SO JOURNAL OF PARASITOLOGY LA English DT Article ID PAPUA-NEW-GUINEA; CHLOROQUINE-RESISTANT STRAIN; NANCYMAI MONKEYS; IRIAN-JAYA; FALCIPARUM; INDONESIA; INFECTION AB A chloroquine-resistant strain of Plasmodium vivax (AMRU-1) from Papua New Guinea has been adapted to grow in 4 species of Aotus monkeys (Aotus lemurinus griseimembra, Aotus vociferanus, Aotus nancymai, and Aotus azarae boliviensis), hybrid Aotus monkeys, and Saimiri boliviensis monkeys. Whereas it was possible to infect Saimiri monkeys with this parasite by inoculation of parasitized erythrocytes, only 42% of Saimiri monkeys became infected, compared to 92% of Aotus monkeys attempted. Comparative mosquito feedings showed that only A. vociferans, A. l. griseimembra, and Saimiri boliviensis monkeys produced infections in mosquitoes. Oocysts were observed on the guts of the 4 species of mosquitoes used (Anopheles gambiae, Anopheles stephensi, A,Anopheles freeborni, and Anoplteles dirus), but sporozoite transmission was effected only with the intravenous inoculation of sporozoites from An. dirus into an A. l. griseimembra monkey. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Sci Resources Program, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. RP Sullivan, JS (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, 4770 Buford Highway, Atlanta, GA 30341 USA. NR 13 TC 10 Z9 11 U1 0 U2 2 PU AMER SOC PARASITOLOGISTS PI LAWRENCE PA 810 EAST 10TH STREET, LAWRENCE, KS 66044 USA SN 0022-3395 J9 J PARASITOL JI J. Parasitol. PD AUG PY 1999 VL 85 IS 4 BP 672 EP 677 DI 10.2307/3285741 PG 6 WC Parasitology SC Parasitology GA 225XE UT WOS:000081990600012 PM 10461947 ER PT J AU Hoekstra, EJ LeBaron, CW Johnson-Partlow, T AF Hoekstra, EJ LeBaron, CW Johnson-Partlow, T TI Does reminder-recall augment the impact of voucher incentives on immunization rates among inner-city infants enrolled in WIC? SO JOURNAL OF PEDIATRICS LA English DT Article ID CHILDREN; PROGRAM; WOMEN AB Inner-city infants (n = 565) enrolled in the WIC program were randomly assigned at 6 months of age to either of 2 groups: (1) voucher incentive (frequency of issuance of food vouchers based on immunization status) plus reminder-recall (calls and/or letters to families of under-vaccinated children) or (2) voucher incentive alone. At 12 months, both groups' immunization levels were high and not significantly different: 80% +/- 4% versus 79% +/- 5% (P = .749). C1 Ctr Dis Control & Prevent, NIP, Publ Hlth Serv, US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. Chicago Dept Publ Hlth, Chicago, IL USA. RP LeBaron, CW (reprint author), Ctr Dis Control & Prevent, NIP, Publ Hlth Serv, US Dept Hlth & Human Serv, MS E-61, Atlanta, GA 30333 USA. NR 12 TC 8 Z9 8 U1 1 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-3476 EI 1097-6833 J9 J PEDIATR-US JI J. Pediatr. PD AUG PY 1999 VL 135 IS 2 BP 261 EP 263 DI 10.1016/S0022-3476(99)70033-8 PN 1 PG 3 WC Pediatrics SC Pediatrics GA 224FC UT WOS:000081885900024 PM 10431125 ER PT J AU Smith, TL Jarvis, WR AF Smith, TL Jarvis, WR TI Antimicrobial resistance in Staphylococcus aureus SO MICROBES AND INFECTION LA English DT Review DE Staphylococcus aureus; antimicrobials; resistance ID COAGULASE-NEGATIVE STAPHYLOCOCCI; PENICILLIN-BINDING PROTEINS; LEVEL MUPIROCIN RESISTANCE; BETA-LACTAM ANTIBIOTICS; UNITED-STATES HOSPITALS; GRAM-POSITIVE COCCI; IN-VITRO ACTIVITIES; VANCOMYCIN-RESISTANT; GLYCOPEPTIDE ANTIBIOTICS; CIPROFLOXACIN RESISTANCE AB Recognized since 1883 as a common cause of infection, Staphylococcus aureus' preantimicrobial-era bacteremia mortality rate was 82%. The mortality of that era threatens to return as evidence of growing vancomycin resistance undermines the utility of vancomycin therapy. Successful treatment of S. aureus infections requires knowledge of its antimicrobial resistance capacity. (C) Elsevier, Paris. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Smith, TL (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 101 TC 29 Z9 30 U1 8 U2 12 PU EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER PI PARIS CEDEX 15 PA 23 RUE LINOIS, 75724 PARIS CEDEX 15, FRANCE SN 1286-4579 J9 MICROBES INFECT JI Microbes Infect. PD AUG PY 1999 VL 1 IS 10 BP 795 EP 805 DI 10.1016/S1286-4579(99)80082-3 PG 11 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 235AE UT WOS:000082515900007 PM 10816085 ER PT J AU Reid, TM Schafer, MP AF Reid, TM Schafer, MP TI Direct detection of Histoplasma capsulatum in soil suspensions by two-stage PCR SO MOLECULAR AND CELLULAR PROBES LA English DT Article DE Histoplasma capsulatum; PCR; soil ID POLYMERASE CHAIN-REACTION; AMPLIFICATION; OUTBREAK; PRIMERS; FUNGI; GENE; DNA AB Histoplasmosis is the most common pulmonary mycosis in the United States. The responsible fungal pathogen, Histoplasma capsulatum, grows in soils contaminated with bird or bat droppings. Inhalation of dust from contaminated areas containing H. capsulatum spores is a primary route of infection. The ability to detect H. capsulatum in soil samples has been limited by the lack of fast, reliable and inexpensive methods. A polymerase chain reaction (PCR) method was developed that allows the direct detection of H. capsulatum in soil. A two-stage PCR protocol was followed employing both fungal-specific primers and nested primers specific for the internal transcribed spacer (ITS) region of the 5.8S rRNA gene of H. capsulatum. The estimated limit of detection of this method is 10 spores. In contrast to the more expensive and indirect mouse inoculum assay, wh ich requires 6-8 weeks for sample analysis, PCR analysis of soil contaminated with H, capsulatum can be completed in less than 2 days. C1 NIOSH, Div Biomed & Behav Sci, Cincinnati, OH 45226 USA. NIOSH, Div Phys Sci & Engn, Cincinnati, OH 45226 USA. RP Reid, TM (reprint author), NIOSH, Div Biomed & Behav Sci, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 31 TC 17 Z9 20 U1 0 U2 2 PU ACADEMIC PRESS LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0890-8508 J9 MOL CELL PROBE JI Mol. Cell. Probes PD AUG PY 1999 VL 13 IS 4 BP 269 EP 273 DI 10.1006/mcpr.1999.0247 PG 5 WC Biochemical Research Methods; Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Cell Biology SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Cell Biology GA 226BD UT WOS:000081999700004 PM 10441199 ER PT J AU Hoe, NP Nakashima, K Lukomski, S Grigsby, D Liu, MY Kordari, P Dou, SJ Pan, X Vuopio-Varkila, J Salmelinna, S McGeer, A Low, DE Schwartz, B Schuchat, A Naidich, S De Lorenzo, D Fu, YX Musser, JM AF Hoe, NP Nakashima, K Lukomski, S Grigsby, D Liu, MY Kordari, P Dou, SJ Pan, X Vuopio-Varkila, J Salmelinna, S McGeer, A Low, DE Schwartz, B Schuchat, A Naidich, S De Lorenzo, D Fu, YX Musser, JM TI Rapid selection of complement-inhibiting protein variants in group A Streptococcus epidemic waves SO NATURE MEDICINE LA English DT Article ID GROUP-A STREPTOCOCCUS; MOLECULAR EPIDEMIOLOGY; SIZE MUTANTS; INFECTIONS; SEROTYPE; DISEASE; GLYCOPROTEIN; ATLANTA; STRAINS; SPREAD AB Serotype M1 group A Streptococcus strains cause epidemic waves of human infections long thought to be mono- or pauciclonal. The gene encoding an extracellular group A Streptococcus protein (streptococcal inhibitor of complement) that inhibits human complement was sequenced in 1,132 M1 strains recovered from population-based surveillance of infections in Canada, Finland and the United States. Epidemic waves are composed of strains expressing a remarkably heterogeneous array of variants of streptococcal inhibitor of complement that arise very rapidly by natural selection on mucosal surfaces. Thus, our results enhance the understanding of pathogen population dynamics in epidemic waves and infectious disease reemergence. C1 Natl Publ Hlth Inst, Dept Bacteriol, FIN-00300 Helsinki, Finland. Mt Sinai Hosp, Dept Microbiol, Toronto, ON M5G 1X5, Canada. Univ Toronto, Toronto, ON M5G 1X5, Canada. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Genomics, New York, NY 10013 USA. Univ Texas, Hlth Sci Ctr, Ctr Human Genet, Houston, TX 77030 USA. RP Musser, JM (reprint author), NIAID, Rocky Mt Lab, NIH, 903 S 4th St, Hamilton, MT 59840 USA. RI Low, Donald/B-1726-2012; mcgeer, allison /H-7747-2014 OI mcgeer, allison /0000-0001-5647-6137 FU NIAID NIH HHS [AI-33119]; NIGMS NIH HHS [GM-50428] NR 34 TC 62 Z9 62 U1 0 U2 4 PU NATURE AMERICA INC PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 1078-8956 J9 NAT MED JI Nat. Med. PD AUG PY 1999 VL 5 IS 8 BP 924 EP 929 PG 6 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 220TR UT WOS:000081684000037 PM 10426317 ER PT J AU Dick, RB Pinkerton, LE Krieg, EF Biagini, RE Deddens, JA Brightwell, WS Grubb, PL Taylor, BT Russo, JM AF Dick, RB Pinkerton, LE Krieg, EF Biagini, RE Deddens, JA Brightwell, WS Grubb, PL Taylor, BT Russo, JM TI Evaluation of postural stability in workers exposed to lead at a secondary lead smelter SO NEUROTOXICOLOGY LA English DT Article DE neurotoxicity; postural sway; lead exposure; blood lead; zinc protoporphyrin AB Postural sway testing was carried out on a group of 145 workers exposed to lead in a secondary lead smelter and 84 workers not exposed to lead in a hinge manufacturing plant. All workers were measured for blood lead levels (BLL) and erythrocyte zinc protoporphyrin (ZPP) concentrations at the time of testing and both a total cumulative and a time-weighted average BLL value was constructed for the lead exposed workers. The lead exposed workers mean BLL at the time of testing was 38.9 mu g/dl and the non-exposed workers mean was 2.3 mu g/dl. ZPP levels averaged 55.2 mu g/dl for exposed workers and 18.9 mu g/dl for non-exposed workers. Total cumulative BLL averaged 83476 mu g/dl days for the exposed workers, with a mean time-weighted average BLL of 35. 1 mu g/dl. Six tests of postural stability, four two leg conditions and two single leg conditions were administered to all subjects using a force platform to produce measurements of sway for comparison purposes. The two leg conditions also manipulated the visual and proprioceptive systems. A statistically significant association was observed for sway measurements and the current BLL for all workers, but not with the current BLL of only the lead exposed workers. No statistically significant associations were present with the cumulative measures of long-term exposure. Of the six tests of sway, only the single leg conditions showed significant exposure effects. The results suggest effects of lead exposure among those with average BLL near 40.0 mu g/dl, but only in the most challenging one leg conditions. (C)1999 Inter Press, Inc. C1 NIOSH, Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept HHS, Cincinnati, OH 45226 USA. Univ Cincinnati, Div Biomed & Behav Sci, Cincinnati, OH 45221 USA. Univ Cincinnati, Div Surveillance Hazard Evaluat & Field Studi, Cincinnati, OH 45221 USA. Univ Cincinnati, Dept Math Sci, Coll Arts & Sci, Cincinnati, OH 45221 USA. RP Dick, RB (reprint author), NIOSH, Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept HHS, 4676 Columbia Pkwy,MS C-24, Cincinnati, OH 45226 USA. NR 18 TC 11 Z9 11 U1 0 U2 0 PU INTOX PRESS INC PI LITTLE ROCK PA PO BOX 24865, LITTLE ROCK, AR 72221 USA SN 0161-813X J9 NEUROTOXICOLOGY JI Neurotoxicology PD AUG PY 1999 VL 20 IS 4 BP 595 EP 607 PG 13 WC Neurosciences; Pharmacology & Pharmacy; Toxicology SC Neurosciences & Neurology; Pharmacology & Pharmacy; Toxicology GA 233PT UT WOS:000082435800006 PM 10499358 ER PT J AU Peterson, HB Xia, ZS Wilcox, LS Tylor, LR Trussell, J AF Peterson, HB Xia, ZS Wilcox, LS Tylor, LR Trussell, J CA US Collaborative Review Sterilization Working G TI Pregnancy after tubal sterilization with bipolar electrocoagulation SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID RISK; FAILURES; HYSTERECTOMY AB Objective: To determine risk factors for pregnancy after tubal sterilization with bipolar electrocoagulation. Methods: A total of 2267 women who had bipolar electrocoagulation were followed for up to 8 to 14 years as part of a multicenter, prospective, cohort study conducted in medical centers in nine United States cities. We used proportional hazards analysis and cumulative life-table probabilities to assess pregnancy risk in these women. Results: The 5-year cumulative probability of pregnancy for women sterilized in 1978-1982 was 19.5 per 1000 procedures (95% confidence interval [CII, 12.2, 26.9); the comparable probability for women sterilized in 1985-1987 was significantly lower, 6.3 per 1000 procedures (95% Cl, 0.0, 13.5) tone-tailed P =.01). Women enrolled in 1985-1987 who had fewer than three sites of coagulation had a probability of failure of 12.9 per 1000 procedures (95% CI, 0.0, 38.0); by contrast, women who had three or more sites coagulated had a probability of failure of 3.2 per 1000 procedures (95% CI, 0.0, 9.6) tone-tailed P =.01). Conclusion: The long-term probability of pregnancy after tubal sterilization with bipolar coagulation was very low when three or more sites of the fallopian tube were coagulated. Bipolar coagulating systems can be highly effective for sterilization when the fallopian tube is coagulated adequately. (C) 1999 by The American College of Obstetricians and Gynecologists. C1 Ctr Dis Control & Prevent, Div Reprod Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. Princeton Univ, Off Populat Res, Princeton, NJ 08544 USA. RP Peterson, HB (reprint author), CDC Mailstop K-34,4770 Buford Highway NE, Atlanta, GA 30341 USA. FU NICHD NIH HHS [3-Y02-HD4-1075-10] NR 16 TC 31 Z9 31 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD AUG PY 1999 VL 94 IS 2 BP 163 EP 167 DI 10.1016/S0029-7844(99)00316-6 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 219UW UT WOS:000081626400001 PM 10432120 ER PT J AU Saraiya, M Green, CA Berg, CJ Hopkins, FW Koonin, LM Atrash, HK AF Saraiya, M Green, CA Berg, CJ Hopkins, FW Koonin, LM Atrash, HK TI Spontaneous abortion-related deaths among women in the United States - 1981-1991 SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID INTRAUTERINE-DEVICE; MORTALITY AB Objective: To examine trends in spontaneous abortion-related mortality and risk factors for these deaths from 1981 through 1991. Methods: We used national data from the Centers for Disease Control and Prevention's Pregnancy Mortality Surveillance System to identify deaths due to spontaneous abortion (less than 20 weeks' gestation). Case-fatality rates were defined as the number of spontaneous abortion-related deaths per 100,000 spontaneous abortions. We calculated annual case-fatality rates as well as risk ratios by maternal age, race, and gestational age. Results: During 1981-1991, a total of 62 spontaneous abortion-related deaths were reported to the Pregnancy Mortality Surveillance System. The overall case fatality rate was 0.7 per 100,000 spontaneous abortions. Maternal age 35 years and older (risk ratio [RR] 1.7, 95% confidence interval [CI] 0.9-3.0), maternal race other than white (RR 3.8, 95% CI 2.2-5.9), and gestational age over 12 weeks (RR 8.0, 95% CI 4.2-11.9) were risk factors for death due to spontaneous abortion. Of the 62 deaths, 59% were caused by infection, 18% by hemorrhage, 13% by embolism, 5% from complications of anesthesia, and 5% by other causes. Disseminated intravascular coagulation (DIC) was an associated condition among half of those deaths for which it was not the primary cause of death. Conclusion: Women 35 years of age and older, of races other than white, and in the second trimester of pregnancy age are at increased risk of death from spontaneous abortion. In addition, DIC complicates many spontaneous abortion cases that end in death. Because spontaneous abortion is a common outcome of pregnancy, continued monitoring of spontaneous abortion-related deaths is recommended. C1 Ctr Dis Control & Prevent, Epidemiol Program Off, Epidem Intelligence Serv, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA 30341 USA. RP Saraiya, M (reprint author), Ctr Dis Control & Prevent, Div Canc Prevent & Control, Mailstop K-55, Atlanta, GA 30341 USA. NR 18 TC 21 Z9 23 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD AUG PY 1999 VL 94 IS 2 BP 172 EP 176 DI 10.1016/S0029-7844(99)00280-X PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 219UW UT WOS:000081626400003 PM 10432122 ER PT J AU Jakeman, GN Saul, A Hogarth, WL Collins, WE AF Jakeman, GN Saul, A Hogarth, WL Collins, WE TI Anaemia of acute malaria infections in non-immune patients primarily results from destruction of uninfected erythrocytes SO PARASITOLOGY LA English DT Article DE anaemia; malaria; merozoite; modelling; Plasmodium falciparum ID BASIC MODELS LEAD; IN-HOST DYNAMICS; FALCIPARUM-MALARIA; GROWTH-RATES; ANEMIA; SEQUESTRATION; CELLS; ERRORS AB While anaemia has long been recognized as a consequence of acute infections with malaria, the relative contributions of direct erythrocyte destruction by parasites, destruction of uninfected erythrocytes and changes in erythropoiesis have been unclear. Fitting of parasitaemia and anaemia data from neurosyphilis patients undergoing malaria therapy to a mathematical model shows that in these patients, an average of 8.5 erythrocytes were destroyed in addition to each erythrocyte observed to become parasitized. The model also showed that dyserythropoiesis plays an insignificant role in the resulting anaemia. The anaemia occurs before a substantial antibody response to parasites or erythrocytes could be generated. We postulate that uninfected erythrocyte destruction occurs through phagocytosis of erythrocytes bound to merozoites killed as a result of the accompanying malaria paroxysms. C1 Univ Queensland, Royal Brisbane Hosp, Queensland Inst Med Res, Herston, Qld 4029, Australia. Griffith Univ, Sch Appl Math & Stat, Nathan, Qld 4111, Australia. Queensland Inst Med Res, Herston, Qld 4029, Australia. Griffith Univ, Australian Sch Environm Studies, Nathan, Qld 4111, Australia. Ctr Dis Control & Prevent, Div Parasit Dis, Chamblee, GA 30341 USA. RP Saul, A (reprint author), Univ Queensland, Royal Brisbane Hosp, Queensland Inst Med Res, Herston, Qld 4029, Australia. RI Saul, Allan/I-6968-2013 OI Saul, Allan/0000-0003-0665-4091 NR 21 TC 108 Z9 109 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0031-1820 J9 PARASITOLOGY JI Parasitology PD AUG PY 1999 VL 119 BP 127 EP 133 DI 10.1017/S0031182099004564 PN 2 PG 7 WC Parasitology SC Parasitology GA 228KV UT WOS:000082136400002 PM 10466119 ER PT J AU Wilfert, CM Aronson, JE Beck, DT Fleischman, AR Kline, MW Mofenson, LM Scott, GB Wara, DW Whitley-Williams, PN Lindegren, ML Halsey, NA Abramson, JS Chesney, PJ Fisher, MC Gerber, MA Marcy, SM Murray, DL Overturf, GD Prober, CG Saari, TN Weiner, LB Whitley, RJ Baker, CJ Peter, G Pickering, LK Hirsch, A Jacobs, RF MacDonald, NE Myers, MG Orenstein, WA Patriarca, PA Rabinovich, NR Schwartz, B AF Wilfert, CM Aronson, JE Beck, DT Fleischman, AR Kline, MW Mofenson, LM Scott, GB Wara, DW Whitley-Williams, PN Lindegren, ML Halsey, NA Abramson, JS Chesney, PJ Fisher, MC Gerber, MA Marcy, SM Murray, DL Overturf, GD Prober, CG Saari, TN Weiner, LB Whitley, RJ Baker, CJ Peter, G Pickering, LK Hirsch, A Jacobs, RF MacDonald, NE Myers, MG Orenstein, WA Patriarca, PA Rabinovich, NR Schwartz, B CA Comm Pediat AIDS Comm Infect Dis TI Issues related to human immunodeficiency virus transmission in schools, child care, medical settings, the home, and community SO PEDIATRICS LA English DT Article ID HEPATITIS-B VIRUS; INFECTED CHILDREN; HIV-INFECTION; TYPE-1 HIV-1; WORKERS; BLOOD; RISK; SURVEILLANCE; PERSONNEL; EXPOSURE AB Current recommendations of the American Academy of Pediatrics (AAP) for infection control practices to prevent transmission of blood-borne pathogens, including human immunodeficiency virus (HIV) in hospitals, other medical settings, schools, and child care facilities, are reviewed and explained. Hand-washing is essential, whether or not gloves are used, and gloves should be used when contact with blood or blood-containing body fluids may occur. In hospitalized children, the 1996 recommendations of the Centers for Disease Control and Prevention (CDC) should be implemented as modified in the 1997 Red Book. The generic principles of Standard Precautions in the CDC guidelines generally are applicable to children in all health care settings, schools, child care facilities, and the home. However, gloves are not required for routine changing of diapers or for wiping nasal secretions of children in most circumstances. This AAP recommendation differs from that in the CDC guidelines. Current US Public Health Service guidelines for the management of potential occupational exposures of health care workers to HIV are summarized. As previously recommended by the AAP, HIV-infected children should be admitted without restriction to child care centers and schools and allowed to participate in all activities to the extent that their health and other recommendations for management of contagious diseases permit. Because it is not required that the school be notified of HIV infection, it may be helpful if the pediatrician notify the school that he or she is operating under a policy of nondisclosure of infection with blood-borne pathogens. Thus, it is possible that the pediatrician will not report the presence of such infections on the form. Because HIV infection occurs in persons throughout the United States, these recommendations for prevention of HIV transmission should be applied universally. C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Amer Thorac Soc, New York, NY USA. Canadian Paediat Soc, Ottawa, ON, Canada. Natl Vaccine Program Off, Atlanta, GA USA. US FDA, Rockville, MD 20857 USA. NIH, Bethesda, MD 20892 USA. RP Wilfert, CM (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. OI Mofenson, Lynne/0000-0002-2818-9808 NR 55 TC 4 Z9 4 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 1999 VL 104 IS 2 BP 318 EP 324 PG 7 WC Pediatrics SC Pediatrics GA 222EP UT WOS:000081770700039 ER PT J AU Desposito, F Desposito, F Cunniff, C Frias, JL Panny, SR Trotter, TL Wappner, RS Hanson, JW Elias, S Moore, CA Lloyd-Puryear, M de la Cruz, F Pletcher, BA Cho, SC AF Desposito, F Desposito, F Cunniff, C Frias, JL Panny, SR Trotter, TL Wappner, RS Hanson, JW Elias, S Moore, CA Lloyd-Puryear, M de la Cruz, F Pletcher, BA Cho, SC CA Comm Genetics TI Folic acid for the prevention of neural tube defects SO PEDIATRICS LA English DT Article ID VITAMIN SUPPLEMENTATION AB The American Academy of Pediatrics endorses the US Public Health Service (USPHS) recommendation that all women capable of becoming pregnant consume 400 mu g of folic acid daily to prevent neural tube defects (NTDs). Studies have demonstrated that periconceptional folic acid supplementation can prevent 50% or more of NTDs such as spina bifida and anencephaly. For women who have previously had an NTD-affected pregnancy, the Centers for Disease Control and Prevention (CDC) recommends increasing the intake of folic acid to 4000 mu g per day beginning at least 1 month before conception and continuing through the first trimester. Implementation of these recommendations is essential for the primary prevention of these serious and disabling birth defects. Because fewer than 1 in 3 women consume the amount of folic acid recommended by the USPHS, the Academy notes that the prevention of NTDs depends on an urgent and effective campaign to close this prevention gap. C1 Amer Coll Med Genet, Bethesda, MD USA. Amer Coll Obstetricians & Gynecologists, Washington, DC 20024 USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. US Hlth Resources & Serv Adm, Rockville, MD 20857 USA. NIH, Bethesda, MD 20892 USA. RP Desposito, F (reprint author), Amer Coll Med Genet, Bethesda, MD USA. NR 18 TC 50 Z9 55 U1 0 U2 2 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 1999 VL 104 IS 2 BP 325 EP 327 PG 3 WC Pediatrics SC Pediatrics GA 222EP UT WOS:000081770700040 ER PT J AU Etzel, RA Balk, SJ Bearer, CF Miller, MD Shannon, MW Shea, KM Falk, H Goldman, LR Miller, RW Rogan, W Coven, B AF Etzel, RA Balk, SJ Bearer, CF Miller, MD Shannon, MW Shea, KM Falk, H Goldman, LR Miller, RW Rogan, W Coven, B CA Comm Environm Hlth TI Ultraviolet light: A hazard to children SO PEDIATRICS LA English DT Article ID CUTANEOUS MALIGNANT-MELANOMA; SUN EXPOSURE; SKIN-CANCER; FASHION MAGAZINES; SUNSCREEN USE; PROTECTION; TRENDS; NEVI; PHOTOPROTECTION; MORTALITY C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. US EPA, Washington, DC 20460 USA. NCI, Bethesda, MD 20892 USA. NIEHS, Bethesda, MD 20892 USA. RP Etzel, RA (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RI Goldman, Lynn/D-5372-2012; OI Miller, Mark/0000-0002-9301-0093 NR 45 TC 56 Z9 60 U1 0 U2 4 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 1999 VL 104 IS 2 BP 328 EP 333 PG 6 WC Pediatrics SC Pediatrics GA 222EP UT WOS:000081770700041 ER PT J AU Kairys, SW Alexander, RC Block, RW Everett, VD Hymel, KP Johnson, CF Goldman, LS Shelley, GA Wagner, KD Jenny, C Kirschner, RA Blain, SM Kittle, PE Kenney, JP Musselman, RJ Needleman, HL Mouden, LD AF Kairys, SW Alexander, RC Block, RW Everett, VD Hymel, KP Johnson, CF Goldman, LS Shelley, GA Wagner, KD Jenny, C Kirschner, RA Blain, SM Kittle, PE Kenney, JP Musselman, RJ Needleman, HL Mouden, LD CA Amer Acad Pediat Amer Acad Pediat Dent TI Oral and dental aspects of child abuse and neglect SO PEDIATRICS LA English DT Article AB In all states, physicians and dentists recognize their responsibility to report suspected cases of abuse and neglect. The purpose of this statement is to review the oral and dental aspects of physical and sexual abuse and dental neglect and the role of physicians and dentists in evaluating such conditions. This statement also addresses the oral manifestations of sexually transmitted diseases and bite marks, including the collection of evidence and laboratory documentation of these injuries. C1 Amer Med Assoc, Chicago, IL 60610 USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Amer Acad Child & Adolescent Psychiat, Washington, DC USA. RP Kairys, SW (reprint author), Amer Med Assoc, Chicago, IL 60610 USA. NR 35 TC 12 Z9 15 U1 2 U2 6 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 1999 VL 104 IS 2 BP 348 EP 350 PG 3 WC Pediatrics SC Pediatrics GA 222EP UT WOS:000081770700046 ER PT J AU Santoli, JM Rodewald, LE Maes, EF Battaglia, MP Coronado, VG AF Santoli, JM Rodewald, LE Maes, EF Battaglia, MP Coronado, VG TI Vaccines for Children program, United States, 1997 SO PEDIATRICS LA English DT Article; Proceedings Paper CT Annual Meeting of the Ambulatory-Pediatrics-Association CY MAY 01-08, 1998 CL NEW ORLEANS, LOUISIANA SP Ambulatory Pediat Assoc DE childhood; vaccination; immunization; medical home; Vaccines for Children Program ID DELAYED IMMUNIZATION; RISK-FACTORS; INTERVENTIONS; WASHINGTON; INSURANCE; DELIVERY; CLINICS; IMPACT; CARE AB Objectives. 1) To determine the proportion of preschool children receiving immunizations from providers enrolled in the Vaccines for Children (VFC) program; 2) to assess whether their immunization providers serve as their medical home for primary care; and 3) to examine the relationship between various provider characteristics and immunization status. Design. Two-phase national survey consisting of parent interviews verified by provider record check. Setting. A total of 78 survey areas (50 states, the District of Columbia, and 27 urban areas). Patients or Other Participants. Noninstitutionalized children from 19 to 35 months of age in 1997. Interventions. None. Outcome Measures. VFC penetration rate (the percentage of children who received all or some vaccines from a VFC-enrolled provider); the frequency with which children received all or some vaccines within a medical home; the number of parent-reported immunization providers; and 4:3:1:3 up-to-date status at 19 to 35 months of age. Results. Of 28 298 children interviewed for whom consent to contact providers was obtained, complete provider data were available for 21 522 (76%). Of these children, 75% received all or some immunizations from a VFC-enrolled provider, 73% received all or some immunizations within a medical home, and 75% had one immunization provider. Children received all or some immunizations from a VFC-enrolled provider more frequently when vaccinated by pediatricians versus family physicians or in public facilities versus private practice. After controlling for poverty, immunization coverage varied only slightly with receipt of vaccines from a VFC-enrolled provider, receipt of vaccines within a medical home, and the number of parent-reported providers. Among children vaccinated within a medical home, those vaccinated solely by pediatricians were 1.63 times as likely to be 4:3:1:3 up-to-date than were those vaccinated solely by family physicians after removing the effects of poverty. Recommendations. Greater numbers of children are likely to benefit from an even higher participation rate among immunization providers in the VFC program, particularly among family physicians and private physicians. The public-private collaboration developed by the VFC program should be capitalized on so that public sector resources can help pediatricians and family physicians practice according to the Standams for Pediatric Immunization Practices. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Immunizat Serv Div, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Immunizat Program, Data Management Div, Atlanta, GA 30333 USA. Abt Associates Inc, Cambridge, MA USA. RP Santoli, JM (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Immunizat Serv Div, Atlanta, GA 30333 USA. NR 41 TC 53 Z9 55 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD AUG PY 1999 VL 104 IS 2 AR e15 DI 10.1542/peds.104.2.e15 PG 7 WC Pediatrics SC Pediatrics GA 222EP UT WOS:000081770700019 PM 10429133 ER PT J AU Rogan, WJ Ragan, NB Damokosh, AI Davoli, C Shaffer, TR Jones, RL Wilkens, S Heenehan, MC Ware, JH Henretig, F AF Rogan, WJ Ragan, NB Damokosh, AI Davoli, C Shaffer, TR Jones, RL Wilkens, S Heenehan, MC Ware, JH Henretig, F TI Recall of a lead-contaminated vitamin and mineral supplement in a clinical trial SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Article DE succimer; lead poisoning; mineral supplements; children; clinical trials AB Purpose - The Treatment of Lead-exposed Children (TLC) trial tested whether developmental outcome differed between children treated for lead poisoning with succimer or placebo. On 7 July 1997, TLC was informed that the vitamin and mineral supplements it gave to ail children were contaminated with about 35 mu g of lead per tablet. Methods - TLC recalled the contaminated supplements and measured the children's exposure. Results - The families of 96% of the children were contacted with 30 days. Among the 571 children to whom the contaminated supplements were dispensed, the mean increase in blood lead was 0.06 +/- 0.01 mu mol/L (1.2 +/- 0.2 mu g/dL); among 78 children to whom they were not, it was 0.09 +/- 0.03 mu mol/L (1.8 +/- 0.7 mu g/dL). There was no evidence of a dose-response relation between estimated supplement consumption and increase in blood lead concentration. Conclusions-The children's blood lead concentrations were not detectably affected by the contamination. Since the association of cognitive delay with lead exposure is best described for blood lead, we believe that the trial's inference about the effect of drug therapy on lead induced cognitive delay should be unaffected. Copyright (C) 1999 John Wiley & Sons, Ltd. C1 NIEHS, Res Triangle Pk, NC 27709 USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Kennedy Krieger Inst, Baltimore, MD USA. US Dept HHS, Program Support Ctr, Perry Point, MD USA. Ctr Dis Control & Prevent, Nutr Biochem Branch, Atlanta, GA USA. Univ Cincinnati, Cincinnati, OH USA. Univ Med & Dent New Jersey, Newark, NJ 07103 USA. Childrens Hosp, Philadelphia, PA 19104 USA. RP Rogan, WJ (reprint author), NIEHS, POB 12233, Res Triangle Pk, NC 27709 USA. RI Jones, Robert/E-1170-2011; Rogan, Walter/I-6034-2012 OI Rogan, Walter/0000-0002-9302-0160 NR 2 TC 9 Z9 9 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD AUG-SEP PY 1999 VL 8 IS 5 BP 343 EP 350 PG 8 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 239XC UT WOS:000082794500005 PM 15073911 ER PT J AU Crosby, RA Yarber, WL Meyerson, B AF Crosby, RA Yarber, WL Meyerson, B TI Perceived monogamy and type of clinic as barriers to seeking care for suspected STD or HIV infection: Results from a brief survey of low-income women attending women, infants, and children (WIC) clinics in Missouri SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID SERVICES; CHOICE AB Background and Objectivess: Barriers to seeking rare for sexually transmitted diseases (STDs) have not been assessed for low-income women. We sought to determine barriers to seeking care for STDs among women receiving Women, Infants, and Children (WIC) benefits in 21 Missouri counties. Goal of This Study: Provide information for promoting care-seeking behavior among low-income women suspecting STD infection. Study Design: A survey of 2,256 women was conducted; 491 reported a history of at least one STD. These women indicated possible barriers to seeing a doctor about a suspected STD and preference for type of clinic providing STD services. Results: More than one fifth (21.3%) of those reporting an STD also reported at least one barrier to seeing a doctor about suspected STD or human immunodeficiency virus infection. Among those reporting barriers, the most common barrier was "I only have sex with my steady" (36.2%) followed by being asymptomatic (33.3%), embarrassment (22.8%), and cost (25.7%). Most (63.8%) preferred seeing their own doctor, with others reporting preference for community health centers (14.8%), family planning clinics (16.8%), and STD clinics (4.6%). Conclusions: Low-income women experience multiple barriers to seeking care including perceptions about a protective value of monogamy. Also, STD services in locations providing other health services for women were preferred. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div STD Prevent, Behav Intervent & Res Branch, Atlanta, GA 30333 USA. Indiana Univ, Rural Ctr AIDS STD Prevent, Bloomington, IN USA. Purdue Univ, Bloomington, IN USA. RP Crosby, RA (reprint author), Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div STD Prevent, Behav Intervent & Res Branch, 1600 Clifton Rd NE,MS-E44, Atlanta, GA 30333 USA. NR 9 TC 1 Z9 1 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD AUG PY 1999 VL 26 IS 7 BP 399 EP 403 DI 10.1097/00007435-199908000-00007 PG 5 WC Infectious Diseases SC Infectious Diseases GA 224JK UT WOS:000081894100007 PM 10458634 ER PT J AU Piper, MA Severin, ST Wiktor, SZ Unger, ER Ghys, PD Miller, DL Horowitz, IR Greenberg, AE Reeves, WC Vernon, SD AF Piper, MA Severin, ST Wiktor, SZ Unger, ER Ghys, PD Miller, DL Horowitz, IR Greenberg, AE Reeves, WC Vernon, SD TI Association of human papillomavirus with HIV and CD4 cell count in women with high or low numbers of sex partners SO SEXUALLY TRANSMITTED INFECTIONS LA English DT Article; Proceedings Paper CT 9th International AIDS Conference on AIDS and STD in Africa CY DEC 10-14, 1995 CL KAMPALA, UGANDA DE human papillomavirus; HIV; CD4 count ID HUMAN-IMMUNODEFICIENCY-VIRUS; CERVICAL INTRAEPITHELIAL NEOPLASIA; HPV INFECTION; RISK; IMMUNOSUPPRESSION; PROSTITUTES; CANCER AB Objective: To explore whether HIV serostatus (HIV-1, HIV-2, and dual (HIV-D) reactivity) and CD4 cell count affect human papillomavirus (HPV) in two groups of women from Cote d'Ivoire. Methods: We conducted a cross sectional study of two groups of women. One group had low numbers of lifetime sex partners (maternal women, n=258) and were enrolled based on HIV serostatus. The other group had high numbers of sex partners (female sex workers, n=278) and all consenting self identified sex workers were admitted to this study. We collected epidemiological and clinical data, and cervicovaginal lavage for HPV testing. Results: The groups had different distributions of HIV seroreactivity, but the rates of HPV DNA detection were similar. Most of the HPV DNAs detected in both groups were high risk types. A strong association of high risk HPV DNA and HIV-1 seropositivity was found in both maternal women (adjusted odds ratio (OR) 7.5 (95% CI 3.2-17.4)) and in sex workers (OR 5.0 (2.1-12.0)). The maternal group also showed an association of high risk HPV DNA detection with HIV-2 (OR 3.7 (1.6-8.5)) and HIV-D (OR 12.7 (4.3-37.5)) that was not observed in the sex workers. In addition, the association of high risk HPV DNA with HIV-1 in the maternal group was independent of low CD4 cell count, while in the sex workers the association depended on CD4: cell counts less than or equal to 500 x 10(6)/l. Conclusions: We found that an association between HPV and HIV varied depending on the sexual behaviour and CD4 cell count of the population examined. C1 Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. NCI, Rockville, MD USA. CHU Treichville, Projet RETROCI, Abidjan, Cote Ivoire. Inst Trop Med, B-2000 Antwerp, Belgium. Emory Univ, Emory Sch Med, Atlanta, GA USA. RP Vernon, SD (reprint author), Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept Hlth & Human Serv, 1600 Clifton Rd NE,MS G18, Atlanta, GA 30333 USA. OI Unger, Elizabeth/0000-0002-2925-5635 NR 27 TC 11 Z9 12 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1368-4973 J9 SEX TRANSM INFECT JI Sex. Transm. Infect. PD AUG PY 1999 VL 75 IS 4 BP 253 EP 257 PG 5 WC Infectious Diseases SC Infectious Diseases GA 232YE UT WOS:000082396900011 PM 10615312 ER PT J AU Vernon, SD Unger, ER Piper, MA Severin, ST Wiktor, SZ Ghys, PD Miller, DL Horowitz, IR Greenberg, AE Reeves, WC AF Vernon, SD Unger, ER Piper, MA Severin, ST Wiktor, SZ Ghys, PD Miller, DL Horowitz, IR Greenberg, AE Reeves, WC TI HIV and human papillomavirus as independent risk factors for cervical neoplasia in women with high or low numbers of sex partners SO SEXUALLY TRANSMITTED INFECTIONS LA English DT Article DE HIV; human papillomavirus; cervical neoplasia ID INTRAEPITHELIAL NEOPLASIA; INFECTION; PREVALENCE; CANCER; VIRUS AB Objective: To explore whether HIV types 1 and 2 and CD4 cell count affect cervical neoplasia independent of human papillomavirus (HPV) in women with high or low numbers of sexual partners residing in Abidjan, Cote d'Ivoire. Methods: The study population and methods are described in the companion paper. Additional methods include a Papanicolaou smear for cytological diagnosis and statistical analysis. Results: In maternal women, both HIV-1 and high risk HPV were significant independent risk factors for squamous intraepithelial lesions (SIL) (adjusted odds ratio (OR) 11.0 (95% CI 1.1-112) and 5.4 (1.5-18.8), respectively). Only high levels of HPV DNA in the lavage were associated with SIL (OR 13.2 (3.6-47.8)) in the maternal group. In female sex workers, high risk HPV was significantly associated with SIL (OR 23.7 (4.4-126)); HN seropositivity was not. Any positive level (high or low amounts) of HPV DNA was significantly associated with SIL in sex workers (ORs 15.9 (3.3-76) and 12.7 (3.6-44), respectively). There was no association of SIL with CD4 cell counts less than or equal to 500 x 10(6)/l in HN seropositive women from either group. Conclusion: HPV or HIV-1 infection independently affect cervical neoplasia in women with low numbers of sex partners. C1 Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. NCI, Canc Prevent Fellowship Off, Rockville, MD USA. CHU Treichville, Projet RETROCI, Abidjan, Cote Ivoire. Inst Trop Med, B-2000 Antwerp, Belgium. Emory Univ, Emory Sch Med, Atlanta, GA 30322 USA. RP Vernon, SD (reprint author), Ctr Dis Control & Prevent, Publ Hlth Serv, US Dept Hlth & Human Serv, 1600 Clifton Rd,MSG18, Atlanta, GA 30333 USA. OI Unger, Elizabeth/0000-0002-2925-5635 NR 12 TC 12 Z9 12 U1 0 U2 0 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1368-4973 J9 SEX TRANSM INFECT JI Sex. Transm. Infect. PD AUG PY 1999 VL 75 IS 4 BP 258 EP 260 PG 3 WC Infectious Diseases SC Infectious Diseases GA 232YE UT WOS:000082396900012 PM 10615313 ER PT J AU Kittner, SJ Giles, WH Macko, RF Hebel, JR Wozniak, MA Wityk, RJ Stolley, PD Stern, BJ Sloan, MA Sherwin, R Price, TR McCarter, RJ Johnson, CJ Earley, CJ Buchholz, DW Malinow, MR AF Kittner, SJ Giles, WH Macko, RF Hebel, JR Wozniak, MA Wityk, RJ Stolley, PD Stern, BJ Sloan, MA Sherwin, R Price, TR McCarter, RJ Johnson, CJ Earley, CJ Buchholz, DW Malinow, MR TI Homocyst(e)ine and risk of cerebral infarction in a biracial population - The stroke prevention in young women study SO STROKE LA English DT Article DE case-control studies; cerebrovascular disorders; homocysteine; risk factors; vitamins ID PLASMA HOMOCYSTEINE CONCENTRATIONS; ARTERIAL OCCLUSIVE DISEASE; VASCULAR-DISEASE; METHYLENETETRAHYDROFOLATE REDUCTASE; ISCHEMIC STROKE; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; ATHEROSCLEROSIS RISK; COMMON MUTATION; FOLATE AB Background and Purpose-Genetic enzyme variation and vitamin intake are important determinants of blood homocyst(e)ine levels. The prevalence of common genetic polymorphisms influencing homocyst(e)ine levels varies by race, and vitamin intake Varies by socioeconomic status. Therefore, we examined the effect of vitamin intake,race,and socioeconomic status on the association of homocyst(e)ine with stroke risk. Methods-All 59 hospitals in the greater Baltimore-Washington area participated in a population-based case-control study of stroke in young women. One hundred sixty-seven cases of first ischemic stroke among women aged 15 to 44 years were compared with 328 controls identified by random-digit dialing from the same region. Risk actor data were collected by standardized interview and nonfasting phlebotomy. Plasma homocyst(e)ine was measured by high-performance liquid chromatography and electrochemical detection. Results-Blacks and whites did not differ in median homocyst(e)ine levels, nor did race modify the association between homocyst(e)ine and stroke. After adjustment for cigarettes per day, poverty status, and regular vitamin use, a plasma homocyst(e)ine level of greater than or equal to 7.3 mu mol/L was associated with an odds ratio or stroke of 1.6 (95% CI, 1.1 to 2.5). Conclusions The association between elevated homocyst(e)ine and stroke was independent not only of traditional vascular risk factors but also of vitamin use and poverty status. The degree of homocyst(e)ine elevation associated with an increased stroke risk in young women is lower than that previously reported for middle-aged men and be elderly and was highly prevalent, being present in one third of the control group. C1 Univ Maryland, Dept Neurol, Baltimore, MD 21201 USA. Univ Maryland, Dept Epidemiol & Prevent Med, Baltimore, MD 21201 USA. Baltimore Dept Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Baltimore, MD USA. Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA. Ctr Dis Control & Prevent, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. Emory Univ, Dept Neurol, Atlanta, GA 30322 USA. Harbin Clin, Dept Neurosci, Rome, GA USA. Tulane Sch Publ Hlth & Trop Med, New Orleans, LA USA. Oregon Reg Primate Res Ctr, Lab Cardiovasc Dis, Beaverton, OR 97006 USA. RP Kittner, SJ (reprint author), Univ Maryland, Dept Neurol, Bressler Bldg,Room 12-006,655 W Baltimore St, Baltimore, MD 21201 USA. FU NINDS NIH HHS [NS16332-11] NR 49 TC 46 Z9 51 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD AUG PY 1999 VL 30 IS 8 BP 1554 EP 1560 PG 7 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 224JM UT WOS:000081894300011 PM 10436100 ER PT J AU Gillum, RF AF Gillum, RF TI Stroke mortality in blacks - Disturbing trends SO STROKE LA English DT Article DE blacks; cerebrovascular disorders; mortality ID UNITED-STATES; AFRICAN-AMERICANS; ETHNIC-DIFFERENCES; WHITE DIFFERENCES; DECLINE; EPIDEMIOLOGY; HYPERTENSION; EXPERIENCE; DISEASE; WOMEN AB Background-Despite long-term declines in US stroke mortality rates, declines have slowed in the past decade and targets for blacks for the years 2000 and 2010 seem attainable only by extraordinary measures, if at all. This review focuses attention on key aspects of this problem. Data from the US National Center for Health Statistics and reports of population-based studies of stroke mortality published since 1987 retrieved by computerized literature searches were reviewed. Summary of Review-The third leading cause of death in black women and the sixth in black men in the United States in 1996, stroke accounted for 10 509 deaths in women and 7972 in men among blacks: 7.92% and 5.33%, respectively, of the total deaths. Age-adjusted death rates per 100 000 were black women, 39.2; white women, 22.9; black men, 50.9; and white men, 26.3. Available data indicate that compared with US whites, US blacks have greater mortality rates for every stroke subtype, with the likely exception of cerebral infarction due to extracranial carotid artery occlusion. These differences will persist into the 21st century. The number of stroke deaths in blacks increased by >8% between 1992 and 1996. Conclusions-Increased research on stroke in blacks is needed to develop more effective strategies for primary and secondary prevention of stroke to reduce the high burden of premature mortality and morbidity. Renewed efforts to prevent and control stroke risk factors tin particular elevated blood pressure, diabetes, and smoking) are needed among US blacks. C1 Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Gillum, RF (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Room 730,6525 Belcrest Rd, Hyattsville, MD 20782 USA. NR 45 TC 63 Z9 64 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD AUG PY 1999 VL 30 IS 8 BP 1711 EP 1715 PG 5 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 224JM UT WOS:000081894300043 PM 10436126 ER PT J AU Chamberland, ME AF Chamberland, ME TI Surveillance for bloodborne infections SO THROMBOSIS AND HAEMOSTASIS LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; TRANSFUSION-TRANSMITTED BABESIOSIS; CREUTZFELDT-JAKOB-DISEASE; UNITED-STATES; HEPATITIS-A; TRANSMISSION; HEMOPHILIA; RISK; EPIDEMIOLOGY; CONCENTRATE C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Chamberland, ME (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd,MS A30, Atlanta, GA 30333 USA. NR 34 TC 8 Z9 9 U1 1 U2 1 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 VL 82 IS 2 BP 494 EP 499 PG 6 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 246QN UT WOS:000083176200042 PM 10605741 ER PT J AU Briones, MA Hooper, WC Evatt, B AF Briones, MA Hooper, WC Evatt, B TI Cytokine-regulated expression of intracellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and E-selectin in human coronary artery endothelial cells (HCAEC) SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Hematol Dis Branch, Div AIDS STD TB Res Lab, NCID, Atlanta, GA USA. Emory Univ, Sch Med, Div Pediat Hematol Oncol BMT, Atlanta, GA 30322 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 230 BP 76 EP 76 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900231 ER PT J AU Briones, MA Phillips, D Hooper, WC AF Briones, MA Phillips, D Hooper, WC TI Differential chemokine expression between human coronary artery endothelial cells compared to human umbilical vein endothelial cells SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Sch Med, Dept Pediat, Div Pediat Hematol Oncol, Atlanta, GA USA. Ctr Dis Control & Prevent, Hematol Dis Branch, Div AIDS STD & TB Lab Res, Natl Ctr Infect Dis, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 462 BP 148 EP 148 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900462 ER PT J AU Hooper, WC Benson, J El-Jamil, M Dilley, A Wenger, NK Evatt, BL AF Hooper, WC Benson, J El-Jamil, M Dilley, A Wenger, NK Evatt, BL TI The association of a C -> T mutation in the promoter region of the endothelial cell nitric oxide synthase gene with myocardial infarction in African-Americans SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Rollins Sch Publ Hlth, Ctr Dis Control & Prevent, Hematol Dis Branch, Atlanta, GA 30322 USA. Emory Sch Med, Dept Med, Atlanta, GA USA. Grady Mem Hosp, Atlanta, GA 30335 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 594 BP 189 EP 190 PG 2 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900593 ER PT J AU Hooper, WC Benson, J El-Jamil, M Dilley, A Wenger, NK Evatt, BL AF Hooper, WC Benson, J El-Jamil, M Dilley, A Wenger, NK Evatt, BL TI The lack of an association of the HPA-2b polymorphism of the glycoprotein 1b-alpha gene and the Glu298Asp variant of the endothelial cell nitric oxide synthase gene with myocardial infarction in African-Americans SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Rollins Sch Publ Hlth, Ctr Dis Control & Prevent, Haemtol Dis Branch, Atlanta, GA 30322 USA. Emory Sch Med, Dept Med, Atlanta, GA USA. Grady Mem Hosp, Atlanta, GA 30335 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 592 BP 189 EP 189 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900591 ER PT J AU Hooper, WC Ellingsen, D El-Jamil, EM Dilley, A Wenger, NK Evatt, BL AF Hooper, WC Ellingsen, D El-Jamil, EM Dilley, A Wenger, NK Evatt, BL TI The association of the M29 ICAM-1 polymorphism with myocardial infarction in African-Americans SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Rollins Sch Publ Hlth, Ctr Dis Control & Prevent, Hematol Dis Branch, Atlanta, GA 30322 USA. Emory Sch Med, Dept Med, Atlanta, GA USA. Grady Mem Hosp, Atlanta, GA 30335 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 593 BP 189 EP 189 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900592 ER PT J AU Dilley, A Hooper, WC El-Jamil, M Austin, H Evatt, B Philipp, CS AF Dilley, A Hooper, WC El-Jamil, M Austin, H Evatt, B Philipp, CS TI The role of four coagulation genes in thrombosis during pregnancy: Factor V Leiden, prothrombin 20210, MTHFR, ACE SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 NCID, Ctr Dis Control & Prevent, Hematol Dis Branch, Atlanta, GA USA. Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Hematol, New Brunswick, NJ USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 714 BP 227 EP 227 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900713 ER PT J AU Benson, JM Ellingsen, D Renshaw, MA Resler, AG Evatt, BL Hooper, WC AF Benson, JM Ellingsen, D Renshaw, MA Resler, AG Evatt, BL Hooper, WC TI Multiplex analysis of mutations in four genes using fluorescence scanning technology SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div AIDS STD & TB Lab Res, Hematol Dis Branch, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 915 BP 291 EP 292 PG 2 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900914 ER PT J AU Miller, CH Dilley, A Hooper, WC Evatt, B AF Miller, CH Dilley, A Hooper, WC Evatt, B TI Disproportionately high factor VIII levels using the 3rd international plasma standard under clinical conditions SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 NCID, Hematol Dis Branch, Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 931 BP 297 EP 297 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665900930 ER PT J AU Nuss, R Soucie, JM Evatt, B AF Nuss, R Soucie, JM Evatt, B CA Hemophilia Surveillance System Pro TI Intracranial hemorrhage (ICH) in persons with hemophilia (PWH) SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Univ Colorado, Ctr Hlth Sci, Denver, CO 80202 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 1040 BP 329 EP 329 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665901041 ER PT J AU Soucie, JM Symons, J Evatt, B AF Soucie, JM Symons, J Evatt, B CA Hemophilia Surveillance System Pro TI Factors associated with hospitalization for a bleeding complication in a large cohort of hemophilic males SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 1039 BP 329 EP 329 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665901040 ER PT J AU Briones, MA Hooper, WC Benson, J Elsas, L Evatt, B AF Briones, MA Hooper, WC Benson, J Elsas, L Evatt, B TI The relationship between polymorphisms in the endothelial cell nitric oxide synthase gene and the ICAM-1 gene polymorphism with cerebrovascular accidents in HbSS patients SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Sch Med, Div Pediat Hematol Oncol, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Hematol Dis Branch, Div AIDS STD & TB Lab Res, NCID, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 1210 BP 381 EP 381 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665901211 ER PT J AU Hooper, WC El-Jamil, M Dilley, A Ellingsen, D Philipp, C Austin, H Evatt, BL AF Hooper, WC El-Jamil, M Dilley, A Ellingsen, D Philipp, C Austin, H Evatt, BL TI The relationship between the tissue plasminogen activator ALU I/D polymorphism and venous thromboembolism during pregnancy SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Emory Univ, Rollins Sch Publ Hlth, Ctr Dis Control & Prevent, Hematol Dis Branch, Atlanta, GA 30322 USA. Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, Div Hematol, New Brunswick, NJ USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 1678 BP 533 EP 533 PG 1 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665901680 ER PT J AU Dilley, A Miller, C Drews-Botsch, C Lally, C AF Dilley, A Miller, C Drews-Botsch, C Lally, C TI Inherited bleeding disorders in women with menorrhagia SO THROMBOSIS AND HAEMOSTASIS LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, NCID, Hematol Dis Branch, Atlanta, GA USA. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 43, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD AUG PY 1999 SU S MA 1760 BP 559 EP 560 PG 2 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 290FP UT WOS:000085665901761 ER PT J AU Pohl, HR Roney, N Fay, M Chou, CHSJ Wilbur, S Holler, J AF Pohl, HR Roney, N Fay, M Chou, CHSJ Wilbur, S Holler, J TI Site-specific consultation for a chemical mixture SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Article ID OCCUPATIONAL EXPOSURE; EPICHLOROHYDRIN; RATS; 1,4-DIOXANE; TOXICITY AB The Agency for Toxic Substances and Disease Registry (ATSDR) uses the weight of evidence methodology to evaluate interactions of chemical mixtures. In the process, toxicity, toxicokinetics, and toxicodynamics of chemical components of the mixture are carefully examined. Based on the evaluation, predictions are made that can be used in real-life situations at hazardous waste sites. In this paper, health outcomes were evaluated for a mixture of eight compounds that were found at a specific site. These eight chemicals were identified and possibly associated with human exposure. The health assessors could consider similar thought processes when evaluating chemical mixtures at hazardous waste sites. C1 CDC, ATSDR, US Dept HHS, Agcy Tox Subst & Dis Registry, Atlanta, GA 30333 USA. RP Pohl, HR (reprint author), CDC, ATSDR, US Dept HHS, Agcy Tox Subst & Dis Registry, 4 Execut Pk E-29, Atlanta, GA 30333 USA. NR 59 TC 5 Z9 5 U1 0 U2 2 PU STOCKTON PRESS PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD AUG PY 1999 VL 15 IS 5 BP 470 EP 479 DI 10.1177/074823379901500502 PG 10 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA 295BL UT WOS:000085946000004 PM 10487358 ER PT J AU Risher, JF De Rosa, CT Jones, DE Murray, HE AF Risher, JF De Rosa, CT Jones, DE Murray, HE TI Letter to the editor: updated toxicological profile for mercury SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Letter ID SEYCHELLES CHILD-DEVELOPMENT; METHYLMERCURY EXPOSURE; OUTCOMES; HAIR C1 Agcy Tox Subst & Dis Registry, Div Toxicol E29, Atlanta, GA 30333 USA. RP Risher, JF (reprint author), Agcy Tox Subst & Dis Registry, Div Toxicol E29, 1600 Clifton Rd, Atlanta, GA 30333 USA. NR 10 TC 3 Z9 3 U1 0 U2 3 PU STOCKTON PRESS PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD AUG PY 1999 VL 15 IS 5 BP 480 EP 482 DI 10.1191/074823399680451731 PG 3 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA 295BL UT WOS:000085946000005 PM 10487359 ER PT J AU Risher, JF De Rosa, CT Jones, DE Murray, HE AF Risher, JF De Rosa, CT Jones, DE Murray, HE TI Summary report for the expert panel review of the toxicological profile for mercury SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Article ID METHYLMERCURY; EXPOSURE; CHILDREN; FISH; INGESTION; TREMOR; BLOOD AB In fulfillment of its legislative mandate to update existing toxicological profiles, the Agency for Toxic Subtances and Disease Registry (ATSDR) released an updated version of the Toxicological Profile for Mercury in April of this year (1999). As part of an extensive peer review process to ensure the scientific merit and credibility of this profile, ATSDR assembled a panel of experts in environmental health, mercury, and health risk assessment in Atlanta, Georgia on July 20 and 21, 1998 to review the draft version of the Mercury Profile developed following the Public Comment Period which lasted from October 17, 1997 to February 17, 1998. During the two-day meeting, this panel, which included key investigators from the Iraqi, Seychelles, and Faroes Islands studies, as well as representatives from other federal partner agencies and the academic and private sectors, conducted open, free-ranging discussion concerning the various aspects of mercury toxicity and the interpretation of the large data base available for mercury and its compounds. ATSDR's proposed responses to public comments was also a significant focus of discussion. The following is a summary report of the proceedings of that meeting. The contributions of the expert panel were instrumental in ensuring the quality of the final profile, and are gratefully acknowledged. C1 Agcy Tox Subst & Dis Registry, Div Toxicol E29, Atlanta, GA 30333 USA. RP Risher, JF (reprint author), Agcy Tox Subst & Dis Registry, Div Toxicol E29, 1600 Clifton Rd, Atlanta, GA 30333 USA. NR 25 TC 7 Z9 7 U1 0 U2 1 PU STOCKTON PRESS PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD AUG PY 1999 VL 15 IS 5 BP 483 EP + DI 10.1177/074823379901500504 PG 31 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA 295BL UT WOS:000085946000006 PM 10487360 ER PT J AU Arguin, PM Singleton, J Rotz, LD Marston, E Treadwell, TA Slater, K Chamberland, M Schwartz, A Tengelsen, L Olson, JG Childs, JE AF Arguin, PM Singleton, J Rotz, LD Marston, E Treadwell, TA Slater, K Chamberland, M Schwartz, A Tengelsen, L Olson, JG Childs, JE CA Transfusion Associated Tick Borne Illness Task TI An investigation into the possibility of transmission of tick-borne pathogens via blood transfusion SO TRANSFUSION LA English DT Article ID BORRELIA-BURGDORFERI; TRANSMITTED BABESIOSIS; HUMAN EHRLICHIOSIS; SPOTTED-FEVER; SURVIVAL; RICKETTSIAE; INFECTIONS; AGENT; RISK AB BACKGROUND: Tick-borne illnesses were diagnosed in a group of National Guard members, including some who had donated blood a few days before the onset of symptoms. A voluntary recall of those blood components was issued and a multistate investigation was conducted to determine if transfusion-transmitted illness had occurred. STUDY DESIGN AND METHODS: Donors and recipients were asked to complete questionnaires regarding symptoms and risk factors for infection and to provide blood samples for laboratory analysis. RESULTS: Among National Guard personnel who donated blood, 12 individuals were found to have a confirmed or probable case of Rocky Mountain spotted fever or ehrlichiosis. A total of 320 units (platelets or packed red cells) from 377 donors were transfused into 129 recipients. Although 10 recipients received units from National Guard personnel with confirmed or probable infection, none became ill. CONCLUSION: Transfusion-transmitted illness did not occur. Despite the awareness of the risk for tick-borne diseases and the use of tick-preventive measures, many National Guard personnel reported exposure to ticks. In addition to augmenting current tick-preventive measures, scheduling blood drives before rather than after field exercises could further reduce the potential for transmission of tick-borne pathogens. C1 Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Off Director, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Biometr Act, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Arkansas Dept Hlth, Little Rock, AR 72205 USA. Mississippi State Dept Hlth, Jackson, MS USA. Oklahoma State Dept Hlth, Oklahoma City, OK USA. Nebraska Hlth & Human Serv Syst, Lincoln, NE USA. Iowa Dept Publ Hlth, Des Moines, IA 50319 USA. Iowa Natl Guard, Des Moines, IA USA. RP Arguin, PM (reprint author), Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Natl Ctr Infect Dis, 1600 Clifton Rd,MS G-13, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 24 TC 16 Z9 17 U1 0 U2 0 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 USA SN 0041-1132 J9 TRANSFUSION JI Transfusion PD AUG PY 1999 VL 39 IS 8 BP 828 EP 833 DI 10.1046/j.1537-2995.1999.39080828.x PG 6 WC Hematology SC Hematology GA 226ZH UT WOS:000082052700006 PM 10504117 ER PT J AU Cowan, EP Nemo, GJ Williams, AE Alexander, RK Vallejo, A Hewlett, IK Lal, RB Dezzutti, CS Gallahan, D George, K Pancake, BA Zucker-Franklin, D McCurdy, PR Tabor, E AF Cowan, EP Nemo, GJ Williams, AE Alexander, RK Vallejo, A Hewlett, IK Lal, RB Dezzutti, CS Gallahan, D George, K Pancake, BA Zucker-Franklin, D McCurdy, PR Tabor, E TI Absence of human T-lymphotropic virus type I tax sequences in a population of normal blood donors in the Baltimore, MD/Washington, DC, area: results from a multicenter study SO TRANSFUSION LA English DT Article ID MYCOSIS-FUNGOIDES; MYELOPATHY; PROVIRUS AB BACKGROUND: It was reported recently that sequences corresponding to the human T-lymphotropic virus type I (HTLV-I) tax gene were detected in peripheral blood mononuclear cells from 8 to 11 percent of healthy blood donors without detectable antibodies to HTLV-I. A multicenter blind study was conducted to determine if these results could be independently confirmed. STUDY DESIGN AND METHODS: Specimens were collected from 100 anti-HTLV-I-negative healthy blood donors and from 11 anti-HTLV-I- or anti-HTLV-II-positive individuals. All samples were coded and distributed to each of four independent testing laboratories for polymerase chain reaction analysis to detect sequences of the HTLV-I or HTLV-II fax gene, using detailed procedures specified by the laboratory reporting the original observation. Each laboratory also tested a dilution panel of a plasmid containing HTLV-I tax to determine the analytical sensitivity of the procedure. RESULTS: The analytical sensitivity of the screening methods permitted detection of as few as 1 to 10 copies of the fax gene. However, HTLV-I tax sequences could not be detected in any of the anti-HTLV-I-negative blood donors at more than one test site. CONCLUSION: HTLV-I tax sequences appear not to be present in this population of 100 blood donors negative for anti-HTLV-I. C1 NHLBI, Transfus Med Sci Res Grp, Bethesda, MD 20892 USA. US FDA, Div Transfus Transmitted Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, HIV & Retrovirus Dis Branch, Atlanta, GA 30333 USA. Amer Red Cross, Jerome H Holland Lab, Transmissible Dis Dept, Rockville, MD USA. Retrovirus Epidemiol Donor Study, Rockville, MD USA. NYU Med Ctr, Dept Med, New York, NY 10016 USA. RP Cowan, EP (reprint author), 1401 Rockville Pike,HFM-320, Rockville, MD 20852 USA. RI Vallejo, Alejandro/I-5881-2015 OI Vallejo, Alejandro/0000-0001-5360-878X NR 15 TC 12 Z9 12 U1 0 U2 0 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 USA SN 0041-1132 J9 TRANSFUSION JI Transfusion PD AUG PY 1999 VL 39 IS 8 BP 904 EP 909 DI 10.1046/j.1537-2995.1999.39080904.x PG 6 WC Hematology SC Hematology GA 226ZH UT WOS:000082052700018 PM 10504129 ER PT J AU Dreyer, G Santos, A Noroes, J Addiss, D AF Dreyer, G Santos, A Noroes, J Addiss, D TI Proposed panel of diagnostic criteria, including the use of ultrasound, to refine the concept of 'endemic normals' in lymphatic filariasis SO TROPICAL MEDICINE & INTERNATIONAL HEALTH LA English DT Article DE diethylcarbamazine; adult worm; filariasis; Wuchereria bancrofti; ultrasound ID ADULT WUCHERERIA-BANCROFTI; ULTRASONOGRAPHIC EVIDENCE; SCROTAL AREA; DIETHYLCARBAMAZINE; INFECTION; MICROFILAREMIA; INDIVIDUALS; ANTIGENEMIA; EFFICACY; RECIFE AB Although living adult Wuchereria bancrofti worms can be detected by ultrasound examination of the scrotal area in approximately 80% of men infected with this filarial parasite, the location of the adult worms in the remaining 20% remains unclear. To determine this, 32 individuals who had W. bancrofti microfilaraemia but no adult worms detectable on ultrasound were treated with diethylcarbarmazine (DEC), either with a single 6 mg/kg dose (n = 13) or with a 12-day course of 6 mg/kg per day (n = 19). They were then monitored with serial physical and ultrasound examinations. Thirteen (41%) subjects developed small, single scrotal nodules 12 h to 7 days after treatment; this rate was unaffected by the dose of DEC. No nodules were detected outside the scrotal area. All 5 men with lymphangiectasia suspected on ultrasound before treatment developed scrotal nodules, compared to 8 (29.6%) of 27 men without ultrasonographic evidence (P = 0.006). Thus, using both ultrasound and 'provocative' treatment with DEC, adult W. bancrofti can be detected in the scrotal area of an estimated 88% of infected men. Because no single diagnostic test for W. bancrofti infection is completely sensitive, a panel of tests, including ultrasound, is proposed to identify with greater accuracy 'endemic normals' for immunological and epidemiological studies. C1 Univ Fed Pernambuco, Dept Cirugia, Hosp Clin, BR-50670901 Recife, PE, Brazil. FIOCRUZ, Ctr Pesquisas Aggeu Magalhaes, Dept Parasitol, Recife, PE, Brazil. Univ Fed Pernambuco, Hosp Clin, Serv Urol, BR-50670901 Recife, PE, Brazil. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA USA. RP Dreyer, G (reprint author), Univ Fed Pernambuco, Dept Cirugia, Hosp Clin, Av Moraes Rego S-N,Cidade Univ, BR-50670901 Recife, PE, Brazil. NR 32 TC 16 Z9 18 U1 0 U2 0 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 1360-2276 J9 TROP MED INT HEALTH JI Trop. Med. Int. Health PD AUG PY 1999 VL 4 IS 8 BP 575 EP 579 DI 10.1046/j.1365-3156.1999.00440.x PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 258RC UT WOS:000083851500007 PM 10499081 ER PT J AU Khudyakov, YE Lopareva, EN Jue, DL Fang, S Spelbring, J Krawczynski, K Margolis, HS Fields, HA AF Khudyakov, YE Lopareva, EN Jue, DL Fang, S Spelbring, J Krawczynski, K Margolis, HS Fields, HA TI Antigenic epitopes of the hepatitis A virus polyprotein SO VIROLOGY LA English DT Article ID A VIRUS; SYNTHETIC PEPTIDE; NONSTRUCTURAL PROTEINS; MONOCLONAL-ANTIBODIES; IDENTIFICATION; SITE; PICORNAVIRUSES; LOCALIZATION; DETERMINANTS; INDUCTION AB Forty-two antigenic domains were identified across the hepatitis A virus (HAV) polyprotein by using a set of 237 overlapping 20-mer synthetic peptides spanning the entire HAV polyprotein and a panel of serum samples from acutely HAV-infected patients. The term "antigenic domain" is used in this study to define a protein region spanned with consecutive overlapping immunoreactive peptides, Nineteen antigenic domains were found within the structural proteins, and 22 were found within the nonstructural proteins, with 1 domain spanning the junction of VP1 and P2A proteins. Five of these domains were considered immunodominant, as judged by both the breadth and the strength of their immunoreactivity. One domain is located within the VP2 protein at position 57-90 aa. A second domain, located at position 767-842 aa, contains the C-terminal part of the VP1 protein and the entire P2A protein. A third domain, located at position 1403-1456 aa, comprises the C-terminal part of the P2C protein and the N-terminal half of the P3A protein. The fourth domain, located at position 1500-1519 aa, includes almost the entire P3B, and the last domain, located at position 1719-1764 aa, contains the C-terminal region of the P3C protein and the N-terminal region of the P3D protein. It is interesting to note that four of the five most immunoreactive domains are derived from small HAV proteins and/or encompass protein cleavage sites separating different HAV proteins. The HAV-specific immunoreactivity of each antigenically reactive peptide was confirmed by using seven HAV seroconversion panels. Collectively, these data demonstrate that HAV structural and nonstructural proteins contain antigenic epitopes that can be efficiently modeled with short synthetic peptides. C1 Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis,Publ Hlth Serv,US Dept HHS, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Biotechnol Core Facil Branch, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept HHS, Atlanta, GA 30333 USA. RP Khudyakov, YE (reprint author), Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis,Publ Hlth Serv,US Dept HHS, MS A-33,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 35 TC 15 Z9 20 U1 0 U2 2 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0042-6822 J9 VIROLOGY JI Virology PD AUG 1 PY 1999 VL 260 IS 2 BP 260 EP 272 DI 10.1006/viro.1999.9813 PG 13 WC Virology SC Virology GA 226NY UT WOS:000082027100006 PM 10417261 ER PT J AU Chesson, HW Pinkerton, SD Irwin, KL Rein, D Kassler, WJ AF Chesson, HW Pinkerton, SD Irwin, KL Rein, D Kassler, WJ TI New HIV cases attributable to syphilis in the USA: estimates from a simplified transmission model SO AIDS LA English DT Article DE syphilis; costs; modelling; HIV prevention ID HUMAN-IMMUNODEFICIENCY-VIRUS; SEXUALLY-TRANSMITTED DISEASES; NEW-YORK-CITY; UNITED-STATES; HETEROSEXUAL PARTNERS; RISK FACTOR; HIV-1-INFECTED MEN; POSITIVE PATIENTS; ECONOMIC-IMPACT; GENITAL ULCERS AB Objective: Because syphilis can raise the likelihood of HIV transmission and acquisition, syphilis prevention in the USA has the potential benefit of reducing the number of new cases of HIV. We developed a simplified transmission model to estimate the annual number and cost of new, heterosexually-acquired HIV cases in the USA attributable to syphilis. Design: We estimated the number of heterosexual, HIV serodiscordant partnerships in which syphilis was present in 1996. The model included the probability of transmission of HIV (with and without the presence of syphilis) and other parameters based on data from recent literature. Published direct costs (HIV treatment costs including antiretroviral therapy) and indirect costs (e.g., lost productivity) per case of HIV were used to estimate the annual cost of HIV cases attributable to syphilis. The potential savings in averted HIV costs related to syphilis were used to estimate the potential benefits of a syphilis elimination program. Results: In 1996, an estimated 1082 new heterosexual cases of HIV in the USA could be attributed to syphilis. These cases represented direct costs of US$ 211 million and indirect costs of US$ 541 million; yielding US$ 752 million in total costs. Over 15 years, a syphilis elimination program could save over US$ 833 million (discounted at 3% annually) in averted direct medical costs of syphilis-related HIV infections. Conclusions: If the only benefit of syphilis elimination were to prevent new HIV cases attributable to syphilis, a national syphilis elimination program costing less than US$ 833 million would probably pay for itself. (C) 1999 Lippincott Williams & Wilkins. C1 Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA 30333 USA. Med Coll Wisconsin, Dept Psychiat & Behav Med, Ctr AIDS Intervent Res, Milwaukee, WI 53226 USA. New Hampshire Dept Hlth & Human Serv, Concord, NH 03301 USA. RP Chesson, HW (reprint author), Ctr Dis Control & Prevent, Div STD Prevent, Mail Stop E-44,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 79 TC 24 Z9 25 U1 0 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 EI 1473-5571 J9 AIDS JI Aids PD JUL 30 PY 1999 VL 13 IS 11 BP 1387 EP 1396 DI 10.1097/00002030-199907300-00017 PG 10 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 221JD UT WOS:000081723200017 PM 10449293 ER PT J AU Potischman, N Swanson, CA Coates, RJ Gammon, MD Brogan, DR Curtin, J Brinton, LA AF Potischman, N Swanson, CA Coates, RJ Gammon, MD Brogan, DR Curtin, J Brinton, LA TI Intake of food groups and associated micronutrients in relation to risk of early-stage breast cancer SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article ID VITAMIN-A; DIETARY FIBER; NUTRITION; QUESTIONNAIRE; CONSUMPTION; GREECE; WOMEN; FAT AB Epidemiologic studies have evaluated the risk of breast cancer related to dietary fat intake, but only recently have other dietary factors received attention. Frequent intakes of fruit, vegetables and fiber have been associated with low risk of the disease in some studies but results are inconsistent. In a large case-control study of early-onset breast cancer, we evaluated risk related to a variety of food groups, associated micronutrients and non-nutritive constituents. Cases treated with chemotherapy appeared to have altered reporting of food intake and were excluded. Analyses were restricted to 568 cases with in situ and localized disease and 1,451 population-based controls. Reduced risks were observed for high intake of cereals and grains [odds ratio (OR) = 0.84, 95% confidence interval (CI) = 0.6-1.1 for highest compared with lowest quartile], vegetables (OR = 0.86, 95% CI = 0.6-1.1), beans (OR = 0.87, 95% CI = 0.7-1.2) and fiber from beans (OR = 0.88, 95% CI = 0.7-1.2). However, no trends of decreasing risk across quartiles of increasing intake were observed. Risk was not associated with dietary constituents related to these food groups including dietary fiber, carotenoids, vitamins A, C and E and folate. Incorporation of information from vitamin supplements did not alter the results for micronutrients. Our data suggest that intakes of cereals and grains, vegetables and beans are associated with minimal, if any, reduction in risk of early-stage breast cancer among young women. Int. J. Cancer 82:315-321, 1999. Published 1999 Wiley-Liss, Inc.dagger C1 NCI, Div Canc Epidemiol & Genet, NIH, Bethesda, MD 20892 USA. Ctr Dis Control & Prevent, Div Canc Prevent & Control, Atlanta, GA USA. Columbia Univ, Sch Publ Hlth, Div Epidemiol, New York, NY USA. Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA. Informat Management Syst, Silver Spring, MD USA. RP Brinton, LA (reprint author), NCI, Div Canc Epidemiol & Genet, NIH, Room 7068, Bethesda, MD 20892 USA. RI Brinton, Louise/G-7486-2015 OI Brinton, Louise/0000-0003-3853-8562 NR 32 TC 100 Z9 101 U1 2 U2 12 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD JUL 30 PY 1999 VL 82 IS 3 BP 315 EP 321 DI 10.1002/(SICI)1097-0215(19990730)82:3<315::AID-IJC1>3.0.CO;2-N PG 7 WC Oncology SC Oncology GA 211YJ UT WOS:000081189200001 PM 10399945 ER PT J AU Fedson, DS Anthony, J Scott, G AF Fedson, DS Anthony, J Scott, G TI The burden of pneumococcal disease among adults in developed and developing countries: what is and is not known SO VACCINE LA English DT Article; Proceedings Paper CT 1st International Symposium on Adult Immunization in Asia - Prevention of Influenza and Pneumococcal Infections CY APR 20-22, 1998 CL HANOI, VIETNAM SP Marcel Merieux Fdn, WHO DE mortality; morbidity; adults; pneumococcal vaccination; Streptococcus pneumoniae ID STREPTOCOCCUS-PNEUMONIAE; BACTEREMIA; EPIDEMIOLOGY; VACCINE; POPULATION; SURVEILLANCE; PREVENTION; ADMISSIONS; MORTALITY; EFFICACY AB The burden of pneumococcal disease among adults in developed countries is neither widely known nor appreciated. The incidence of pneumococcal pneumonia is uncertain because a precise diagnosis cannot be obtained for most patients. Population-based data on invasive pneumococcal disease (e.g., bacteraemia and meningitis) suggest an annual incidence in all developed countries of greater than or equal to 15-20 cases per 100,000 persons of all ages and greater than or equal to 50 cases per 100,000 elderly adults (greater than or equal to 65 years). In developing countries there are no population-based data on the burden of pneumococcal disease among adults. Studies of high risk groups, hospital-based studies, vaccine efficacy trials, extrapolations from surveillance of "native populations" in developed countries, and demographic studies in developing regions all suggest a high burden of disease. The broad variation in these estimates, however, indicates that better studies are needed. Increased use of pneumococcal vaccines among adults in all countries will depend on better scientific and public understanding of the burden of pneumococcal disease. In developing countries, intensive community-based studies of the impact of pneumococcal disease, or, alternatively, a "vaccine probe" approach, in which a population is vaccinated and the reduction in pneumonia is compared with that in a control population, could give more accurate estimates of the burden of disease and of the potential effectiveness of pneumococcal vaccination among adults. (C) 1999 Elsevier Science Ltd. All rights reserved. C1 Pasteur Merieux MSD, F-69367 Lyon 07, France. Ctr Dis Control & Prevent, Resp Dis Branch, Atlanta, GA USA. Univ Oxford, John Radcliffe Hosp, Nuffield Dept Clin Med, Oxford OX3 9DU, England. RP Fedson, DS (reprint author), Pasteur Merieux MSD, 8 Rue Jonas Salk, F-69367 Lyon 07, France. FU Wellcome Trust NR 44 TC 94 Z9 97 U1 0 U2 4 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD JUL 30 PY 1999 VL 17 SU 1 BP S11 EP S18 DI 10.1016/S0264-410X(99)00122-X PG 8 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 225BM UT WOS:000081936200003 PM 10471174 ER PT J AU Klimov, A Simonsen, L Fukuda, K Cox, N AF Klimov, A Simonsen, L Fukuda, K Cox, N TI Surveillance and impact of influenza in the United States SO VACCINE LA English DT Article; Proceedings Paper CT 1st International Symposium on Adult Immunization in Asia - Prevention of Influenza and Pneumococcal Infections CY APR 20-22, 1998 CL HANOI, VIETNAM SP Marcel Merieux Fdn, WHO ID MORTALITY; DISEASE C1 Ctr Dis Control & Prevent, Influenza Branch, Atlanta, GA 30333 USA. RP Klimov, A (reprint author), Ctr Dis Control & Prevent, Influenza Branch, G-16,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 12 TC 36 Z9 37 U1 0 U2 0 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD JUL 30 PY 1999 VL 17 SU 1 BP S42 EP S46 DI 10.1016/S0264-410X(99)00104-8 PG 5 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 225BM UT WOS:000081936200008 PM 10471179 ER PT J AU Reeves, WC Fukuda, K Nisenbaum, R Thompson, WW AF Reeves, WC Fukuda, K Nisenbaum, R Thompson, WW TI Chronic multisystem illness among Gulf War veterans - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Reeves, WC (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 4 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 28 PY 1999 VL 282 IS 4 BP 328 EP 329 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 219FG UT WOS:000081596800026 ER PT J CA Natl Vaccine Advisory Comm TI Strategies to sustain success in childhood immunizations SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID GENERATED TELEPHONE MESSAGES; MISSED OPPORTUNITIES; RISK-FACTORS; DELAYED IMMUNIZATION; UNITED-STATES; VACCINATION COVERAGE; PREVENTIVE CARE; CHILDREN; VISITS; IMPACT AB Objective Following an outbreak of measles in 1989-1991,a blueprint for change was developed to improve immunization coverage by addressing deficiencies in the immunization delivery system. A review was undertaken by the National Vaccine Advisory Committee (NVAC) to assess progress in improving immunization coverage, decreasing disease incidence, and developing an immunization delivery system to serve children in the United States. Based on this review, strategies were recommended to sustain success in immunization coverage. Participants A Subcommittee on Immunization Coverage was appointed by the chairman of the NVAC in 1995 and included representatives from federal agencies, professional organizations, vaccine manufacturers, state and regional health departments, and academic centers. Evidence Presentations on immunization programs, strategies, and financing were made to the subcommittee by representatives from federal, state, and local agencies; professional organizations; insurers; businesses; and public and private health care providers. Evidence from the published literature also was reviewed. Consensus Process After review and discussion of evidence presented, conclusions and recommendations were crafted and endorsed by members of the subcommittee. The subcommittee's report was submitted to the NVAC for review, comment, and approval. Conclusions Although incidence rates of traditional vaccine-preventable diseases are at all-time low levels and corresponding vaccination coverage rates are at all-time high levels, a system to ensure timely vaccination of the 11 000 US infants born each day that also incorporates newly recommended vaccines is incomplete. Key barriers include lack of financing of vaccination in many insurance programs and the lack of implementation of evidence-based interventions to raise coverage levels. The NVAC makes 15 recommendations to achieve a sustainable childhood immunization delivery system organized around (1) vaccination financing to ensure full insurance coverage of recommended vaccines and to support the Vaccines for Children program; (2) provider practices to ensure the implementation of recall/reminder systems and office-based assessment of coverage levels; (3) information systems for monitoring disease, vaccination coverage, and performance on immunization delivery; and (4) support for communities and families to ensure that the public is aware of the importance of vaccination, that resources are focused to help underserved children, that immunization linkages with WIC (the Special Supplemental Nutrition Program for Women, Infants, and Children) are enhanced, and that citizen coalitions can advocate improvements in the immunization delivery system. C1 Rhode Isl Hosp, Providence, RI USA. Childrens Hosp & Reg Med Ctr, Seattle, WA 98105 USA. Ctr Dis Control & Prevent, Natl Vaccine Program Off, Atlanta, GA USA. Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA. City Houston Dept Hlth & Human Serv, Houston, TX USA. Merck & Co Inc, Whitehouse Stn, NJ USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Amer Assoc Hlth Plans, Columbus, OH USA. Boston Univ, Sch Med, Boston, MA 02118 USA. Univ Rochester, Genessee Hosp, Rochester, NY 14607 USA. Univ Maryland, Sch Med, Baltimore, MD 21201 USA. Stanford Univ, Med Ctr, Sch Med, Stanford, CA 94305 USA. OraVax Inc, Cambridge, MA USA. Josiah Macy Jr Fdn, New York, NY USA. Amer Home Prod, Wyeth Lederle Vaccines & Pediat, W Henrietta, NY USA. Pasteur Merieux Connaught, Doylestown, PA USA. Mayo Clin & Mayo Fdn, Rochester, MN 55905 USA. Iowa Dept Publ Hlth, Des Moines, IA 50319 USA. Amer Acad Pediat, DePere, WI USA. Texas Tech Univ, Hlth Sci Ctr, Lubbock, TX 79430 USA. Any Baby Can Inc, San Antonio, TX USA. SmithKline Beecham Pharmaceut, Philadelphia, PA USA. Univ Med & Dent New Jersey, Robert Wood Johnson Med Sch, New Brunswick, NJ USA. Alabama Dept Publ Hlth, Montgomery, AL 36102 USA. RP Childrens Hosp & Reg Med Ctr, POB 5371-CH03, Seattle, WA 98105 USA. NR 64 TC 0 Z9 0 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 28 PY 1999 VL 282 IS 4 BP 363 EP 370 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 219FG UT WOS:000081596800032 ER PT J AU Switzer, WM Shanmugam, V Heneine, W AF Switzer, WM Shanmugam, V Heneine, W TI Polymerase chain reaction assays for the diagnosis of infection with the porcine endogenous retrovirus and the detection of pig cells in human and nonhuman recipients of pig xenografts SO TRANSPLANTATION LA English DT Article ID IMMUNODEFICIENCY-VIRUS TYPE-1; REVERSE-TRANSCRIPTASE; TRANSPLANTATION; XENOTRANSPLANTATION; PLASMA; DNA AB Background. Pigs offer an unlimited source of xenografts for humans. However, recipients of pig xenografts are inevitably exposed to the porcine endogenous retrovirus (PERV), which is carried in the pig germline, The ability of PERV to infect human cells in vitro has heightened safety concerns regarding the transmission of PERV to pig xenograft recipients. Methods. In response to the need to establish laboratory tests for the surveillance of PERV infection, we have developed polymerase chain reaction (PCR) assays to detect PERV pol and gag sequences by using conserved primers and probes. In addition, we have developed a PCR assay to detect pig-specific mitochondrial DNA (mtDNA) sequences as a marker of pig cells. Results. Analysis of assay sensitivities using cloned target copies in a background of human DNA demonstrated a detection threshold of 1, 5, and 1 copy for the PERV gag, pol, and pig mtDNA PCR assays, respectively, All three PCR assays gave negative results on peripheral blood lymphocyte samples from 69 humans, as well as 6 baboons and 6 macaques, demonstrating 100% specificity. The PERV and pig mtDNA assays were integrated into a simple testing algorithm that allows the differentiation between pig cell microchimerism and true xenogeneic infection, To allow for monitoring of PERV expression, a reverse transcriptase-PCR assay was also developed to detect cell-free PERV RNA. Conclusion. The use of the diagnostic tests described here will help define the risks of PERV transmission associated with the use of pig xenografts in humans and nonhuman primates. C1 Ctr Dis Control & Prevent, US Dept Hlth & Human Serv, Publ Hlth Serv,HIV & Retrovirol Branch, Div AIDS Sexually Transmitted Dis & TB Lab Res, Atlanta, GA 30333 USA. RP Switzer, WM (reprint author), Ctr Dis Control & Prevent, US Dept Hlth & Human Serv, Publ Hlth Serv,HIV & Retrovirol Branch, Div AIDS Sexually Transmitted Dis & TB Lab Res, 1600 Clifton Rd,MS-G19, Atlanta, GA 30333 USA. NR 24 TC 56 Z9 64 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD JUL 27 PY 1999 VL 68 IS 2 BP 183 EP 188 DI 10.1097/00007890-199907270-00003 PG 6 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 224RB UT WOS:000081911100003 PM 10440384 ER PT J AU Palmer, CJ Validum, L Vorndam, VA Clark, GG Validum, C Cummings, R Lindo, JF Ager, AL Cuadrado, RR AF Palmer, CJ Validum, L Vorndam, VA Clark, GG Validum, C Cummings, R Lindo, JF Ager, AL Cuadrado, RR TI Dengue in Guyana SO LANCET LA English DT Article ID HEMORRHAGIC-FEVER AB There have been dramatic increases in dengue fever (DF) and dengue haemorrhagic fever in South America. Guyana has reported less than five cases per year for most of the past decade. We evaluated patients in a clinic in Georgetown, Guyana, over 2 days and found evidence of 50 cases of dengue infection. C1 Nova SE Univ, Coll Allied Hlth, Ft Lauderdale, FL 33328 USA. Woodlands Hosp, Georgetown, Guyana. Ctr Dis Control & Prevent, San Juan, PR USA. Minist Hlth, Georgetown, Guyana. Univ W Indies, Dept Microbiol, Kingston 7, Jamaica. Univ Miami, Dept Microbiol & Immunol, Miami, FL USA. RP Palmer, CJ (reprint author), Nova SE Univ, Coll Allied Hlth, Ft Lauderdale, FL 33328 USA. NR 5 TC 2 Z9 2 U1 0 U2 0 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUL 24 PY 1999 VL 354 IS 9175 BP 304 EP 304 DI 10.1016/S0140-6736(99)03078-0 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 220CB UT WOS:000081646000019 PM 10440312 ER PT J AU Bell, BP Margolis, HS AF Bell, BP Margolis, HS TI Hepatitis A vaccine for secondary hepatitis A infection SO LANCET LA English DT Letter C1 Ctr Dis Control & Prevent, Hepatitis Branch, Dept Hlth & Human Serv, Atlanta, GA 30333 USA. RP Bell, BP (reprint author), Ctr Dis Control & Prevent, Hepatitis Branch, Dept Hlth & Human Serv, Atlanta, GA 30333 USA. NR 4 TC 3 Z9 4 U1 0 U2 0 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUL 24 PY 1999 VL 354 IS 9175 BP 341 EP 341 DI 10.1016/S0140-6736(05)75251-X PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 220CB UT WOS:000081646000067 PM 10440343 ER PT J AU Rackers, DC Donnell, H AF Rackers, DC Donnell, H TI Heat-related illnesses and deaths - Missouri, 1998, and United States, 1979-1996 (Reprinted from MMWR, vol 48, pg 469-473, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Missouri Dept Hlth, Off Epidemiol, Columbia, MO USA. CDC, Atlanta, GA 30333 USA. Natl Ctr Environm Hlth, Hlth Studies Br, Div Environm Hazards & Hlth Effects, Atlanta, GA USA. RP Rackers, DC (reprint author), Missouri Dept Hlth, Off Epidemiol, Columbia, MO USA. NR 8 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 21 PY 1999 VL 282 IS 3 BP 227 EP 228 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 217MW UT WOS:000081504400011 ER PT J AU Abe, K Shoji, M Chen, J Bierhaus, A Danave, I Micko, C Casper, K Dillehay, DL Nawroth, PP Rickles, FR AF Abe, K Shoji, M Chen, J Bierhaus, A Danave, I Micko, C Casper, K Dillehay, DL Nawroth, PP Rickles, FR TI Regulation of vascular endothelial growth factor production and angiogenesis by the cytoplasmic tail of tissue factor SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID PROTEIN-KINASE-C; CANINE KIDNEY-CELLS; FACTOR VIIA; PROCOAGULANT ACTIVITY; FACTOR EXPRESSION; FACTOR GENE; FACTOR-X; IN-SITU; COAGULATION; BINDING AB Tissue factor (TF), a transmembrane receptor for coagulation factor VII/VIIa, is aberrantly expressed in human cancers. We demonstrated a significant correlation between TF and vascular endothelial growth factor (VEGF) production in 13 human malignant melanoma cell lines (r(2) = 0.869, P < 0.0001). Two of these cell lines, RPMI-7951, a high TF and VEGF producer, and WM-115, a low TF and VEGF producer, were grown s.c. in severe combined immunodeficient mice. The high-producer cell line generated solid tumors characterized by intense vascularity, whereas the low producer generated relatively avascular tumors, as determined by immunohistologic staining of tumor vascular endothelial cells with anti-von Willebrand factor antibody. To investigate the structure-function relationship of TF and VEGF, a low-producer melanoma cell line (HT144) was transfected with a TF cDNA containing the full-length sequence, a cytoplasmic deletion mutant lacking the coding sequence for the distal three serine residues (potential substrates for protein kinase C), or an extracellular domain mutant, which has markedly diminished function for activation of factor X, Cells transfected with the full-length sequence produced increased levels of both TF and VEGF, Transfectants with the full length sequence and the extracellular domain mutant produced approximately equal levels of VEGF mRNA, However, cells transfected with the cytoplasmic deletion mutant construct produced increased levels of TF, but little or no VEGF, Thus, the cytoplasmic tail of TF plays a role in the regulation of VEGF expression in some tumor cells. C1 Emory Univ, Div Hematol Oncol, Dept Med, Sch Med, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Univ Tubingen, Dept Internal Med 4, Sect Vasc Med, D-72076 Tubingen, Germany. Hokkaido Univ, Sch Med, Dept Internal Med 3, Sapporo, Hokkaido 0600815, Japan. RP Shoji, M (reprint author), Emory Univ, Div Hematol Oncol, Dept Med, Sch Med, 1003 Woodruff Mem Bldg,1639 Pierce Dr, Atlanta, GA 30322 USA. FU NCI NIH HHS [CA22202] NR 26 TC 257 Z9 269 U1 0 U2 8 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 USA SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD JUL 20 PY 1999 VL 96 IS 15 BP 8663 EP 8668 DI 10.1073/pnas.96.15.8663 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 219CB UT WOS:000081589400069 PM 10411932 ER PT J AU Linthicum, KJ Anyamba, A Tucker, CJ Kelley, PW Myers, MF Peters, CJ AF Linthicum, KJ Anyamba, A Tucker, CJ Kelley, PW Myers, MF Peters, CJ TI Climate and satellite indicators to forecast Rift Valley fever epidemics in Kenya SO SCIENCE LA English DT Article ID DIFFERENCE VEGETATION INDEX; SEA-SURFACE TEMPERATURE; NEAR-INFRARED CHANNELS; DOMESTIC-ANIMALS; EL-NINO; RAINFALL; AVHRR; CALIBRATION; AFRICA; VIRUS AB All known Rift Valley fever virus outbreaks in East Africa from 1950 to May 1998, and probably earlier, followed periods of abnormally high rainfall. Analysis of this record and Pacific and Indian Ocean sea surface temperature anomalies, coupled with satellite normalized difference vegetation index data, shows that prediction of Rift Valley fever outbreaks may be made up to 5 months in advance of outbreaks in East Africa. Concurrent near-real-time monitoring with satellite normalized difference vegetation data may identify actual affected areas. C1 Walter Reed Army Med Ctr, Walter Reed Army Inst Res, Dept Def, Washington, DC 20307 USA. NASA, Goddard Space Flight Ctr, Earth Sci Directorate, Greenbelt, MD 20771 USA. Ctr Dis Control & Prevent, Special Pathogens Branch, Atlanta, GA 30333 USA. RP Anyamba, A (reprint author), Walter Reed Army Med Ctr, Walter Reed Army Inst Res, Dept Def, Washington, DC 20307 USA. NR 30 TC 302 Z9 315 U1 5 U2 34 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 0036-8075 J9 SCIENCE JI Science PD JUL 16 PY 1999 VL 285 IS 5426 BP 397 EP 400 DI 10.1126/science.285.5426.397 PG 4 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 216VV UT WOS:000081465900051 PM 10411500 ER PT J AU Singleton, JA Lloyd, JC Mootrey, GT Salive, ME Chen, RT AF Singleton, JA Lloyd, JC Mootrey, GT Salive, ME Chen, RT CA VAERS Working Grp TI An overview of the vaccine adverse event reporting system (VAERS) as a surveillance system SO VACCINE LA English DT Article DE vaccines; postmarketing surveillance; adverse effects ID SAFETY; IMMUNIZATION; PERTUSSIS AB We evaluated the Vaccine Adverse Event Reporting System (VAERS), the spontaneous reporting system for vaccine-associated adverse events in the United Slates, as a public health surveillance system, using evaluation guidelines from the Centers for Disease Control and Prevention. We found that VAERS is simple for reporters to use, flexible by design and its data are available in a timely fashion. The predictive value positive for one severe event is known to be high, but for most events is unknown. The acceptability, sensitivity and representativeness of VAERS are unknown, The study of vaccine safety is complicated by underreporting, erroneous reporting, frequent multiple exposures and multiple outcomes. (C) 1999 Elsevier Science Ltd. All rights reserved. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Vaccine Safety & Dev Author, Atlanta, GA 30333 USA. US FDA, Div Biostat & Epidemiol, Rockville, MD 20857 USA. RP Singleton, JA (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Adult Vaccine Prevent Dis Branch, 1600 Clifton Rd NE,Mail Stop E-61, Atlanta, GA 30333 USA. NR 43 TC 108 Z9 112 U1 1 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD JUL 16 PY 1999 VL 17 IS 22 BP 2908 EP 2917 DI 10.1016/S0264-410X(99)00132-2 PG 10 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 214FJ UT WOS:000081317700020 PM 10438063 ER PT J AU Moll, DM Summers, RS Fonseca, AC Matheis, W AF Moll, DM Summers, RS Fonseca, AC Matheis, W TI Impact of temperature on drinking water biofilter performance and microbial community structure SO ENVIRONMENTAL SCIENCE & TECHNOLOGY LA English DT Article ID BIOFILTRATION PERFORMANCE; BIOLOGICAL TREATMENT; ORGANIC-CARBON; BACTERIA; BIOMASS; REMOVAL; FILTERS; SEDIMENTS; STREAM; OZONE AB Seasonal changes in removal of natural organic matter (NOM) by drinking water biofilters are often attributed to temperature differences. Bench-scale sand biofilters treating NOM isolated from a surface water source were operated in parallel at 5, 20, and 35 degrees C to isolate the effect of temperature from other water quality and operational parameters, which also vary seasonally. The biofilter operated at 5 degrees C achieved significantly lower removal of NOM and the NOM fraction that reacts with disinfectants (disinfection byproduct precursors) compared to the filters operated at 20 and 35 degrees C, which had similar performance levels. Viable biomass, measured as lipid phosphate, was significantly higher at the top and bottom of the! filter operated at 20 degrees C. Phospholipid fatty acid (PLFA) profiles indicated an increasing gradient in markers for Gram-negative bacteria and microeukaryotes as biofilter operation temperature decreased, replacing general fatty acids and markers for Gram-positive bacteria and sulfate-reducing bacteria, which were observed in greatest abundance in the filter operated at 35 degrees C. Principal components analysis differentiated the microbial PLFA profiles based an biofilter operation temperature and filter depth. These results were corroborated by identifications of the dominant microbial colonies isolated on R2A agar. C1 Univ Cincinnati, Dept Civil & Environm Engn, Cincinnati, OH 45221 USA. RP Moll, DM (reprint author), Ctr Dis Control & Prevent, Hlth Studies Branch, 4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 48 TC 36 Z9 40 U1 3 U2 34 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0013-936X J9 ENVIRON SCI TECHNOL JI Environ. Sci. Technol. PD JUL 15 PY 1999 VL 33 IS 14 BP 2377 EP 2382 DI 10.1021/es9900757 PG 6 WC Engineering, Environmental; Environmental Sciences SC Engineering; Environmental Sciences & Ecology GA 217CA UT WOS:000081480900010 ER PT J AU Montesano, MA Colley, DG Freeman, GL Secor, WE AF Montesano, MA Colley, DG Freeman, GL Secor, WE TI Neonatal exposure to idiotype induces Schistosoma mansoni egg antigen-specific cellular and humoral immune responses SO JOURNAL OF IMMUNOLOGY LA English DT Article ID DIFFERENT CLINICAL FORMS; IN-UTERO EXPOSURE; GRANULOMA-FORMATION; JAPONICUM INFECTION; IMMUNOGLOBULIN IDIOTYPE; PATHOLOGICAL SYNDROMES; CYTOKINE RESPONSES; CHILDREN BORN; CBA/J MICE; T-CELLS AB Exposure of neonatal mice to appropriate, cross-reactive Id (CRI) preparations alters immune responsiveness, ameliorates pathology, and prolongs survival of animals upon subsequent Schistosoma mansoni infection. However, because schistosome infections profoundly affect host immunobiology, which responses are effected by neonatal Id exposure alone and which responses are influenced by infection is unclear, To directly examine the schistosome soluble egg Ag (SEA)-specific immune responses altered by CRI exposure, neonatal mice were injected with CRT-expressing (CRI+) SEA-specific Ab preparations, SEA-specific Abs that did not express CRI (CRI-), or normal mouse Ig, At 9 wk of age, only mice that were neonatally exposed to CRI+ anti-SEA Abs displayed significant SEA-specific IgG serum levels and spleen cell proliferative responses. SEA-stimulated spleen cells from these CRI+-exposed mice also produced IFN-gamma although not at significantly higher levels than mice receiving CRI- Id or normal mouse Ig, If CRI+-exposed mice were also injected with SEA at 8 wk of age, the 9-wk IFN-gamma responses were significantly higher than those of the other neonatal injection groups. The presence of both CRT and anti-CRI in the sera of animals neonatally injected with CRI, but receiving no exposure to S. mansoni Ags or infection, suggested a functional idiotypic network led to these responses. These data demonstrate that appropriate idiotypic exposure induces B and T cell responsiveness to the Ag recognized by the Id and support the hypothesis that neonatal idiotypic exposure can be an important immunoregulatory factor in schistosomiasis. C1 Ctr Dis Control & Prevent, Immunol Branch, Div Parasit Dis,US Dept Hlth & Human Serv, Natl Ctr Infect Dis,Publ Hlth Serv, Atlanta, GA 30341 USA. Univ Fed Juiz Fora, Dept Microbiol Immunol & Parasitol, Juiz De Fora, MG, Brazil. RP Secor, WE (reprint author), Ctr Dis Control & Prevent, Immunol Branch, Div Parasit Dis,US Dept Hlth & Human Serv, Natl Ctr Infect Dis,Publ Hlth Serv, 4770 Buford Highway NE,MS-F13, Atlanta, GA 30341 USA. NR 58 TC 17 Z9 18 U1 0 U2 0 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD JUL 15 PY 1999 VL 163 IS 2 BP 898 EP 905 PG 8 WC Immunology SC Immunology GA 215AY UT WOS:000081360800047 PM 10395685 ER PT J AU Buller, RS Arens, M Hmiel, SP Paddock, CD Sumner, JW Rikihisa, Y Unver, A Gaudreault-Keener, R Manian, FA Liddell, AM Schmulewitz, N Storch, GA AF Buller, RS Arens, M Hmiel, SP Paddock, CD Sumner, JW Rikihisa, Y Unver, A Gaudreault-Keener, R Manian, FA Liddell, AM Schmulewitz, N Storch, GA TI Ehrlichia ewingii, A newly recognized agent of human ehrlichiosis SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID HUMAN GRANULOCYTIC EHRLICHIOSIS; POLYMERASE CHAIN-REACTION; ETIOLOGIC AGENT; AMBLYOMMA-AMERICANUM; POTENTIAL VECTOR; CANIS; DOGS; CHAFFEENSIS; IDENTIFICATION; DIAGNOSIS AB Background Human ehrlichiosis is a recently recognized tick-borne infection. Four species infect humans: Ehrlichia chaffeensis, E. sennetsu, E. canis, and the agent of human granulocytic ehrlichiosis. Methods We tested peripheral-blood leukocytes from 413 patients with possible ehrlichiosis by broad-range and species-specific polymerase-chain-reaction (PCR) assays for ehrlichia. The species present were identified by species-specific PCR assays and nucleotide sequencing of the gene encoding ehrlichia 16S ribosomal RNA. Western blot analysis was used to study serologic responses. Results In four patients, ehrlichia DNA was detected in leukocytes by a broad-range PCR assay, but not by assays specific for E. chaffeensis or the agent of human granulocytic ehrlichiosis. The nucleotide sequences of these PCR products matched that of E. ewingii, an agent previously reported as a cause of granulocytic ehrlichiosis in dogs. These four patients, all from Missouri, presented between May and August 1996, 1997, or 1998 with fever, headache, and thrombocytopenia, with or without leukopenia. All had been exposed to ticks, and three were receiving immunosuppressive therapy. Serum samples obtained from three of these patients during convalescence contained antibodies that reacted with E, chaffeensis and E. canis antigens in a pattern different from that of humans with E. chaffeensis infection but similar to that of a dog experimentally infected with E. ewingii. Morulae were identified in neutrophils from two patients. All four patients were successfully treated with doxycycline. Conclusions These findings provide evidence of E. ewingii infection in humans. The associated disease may be clinically indistinguishable from infection caused by E. chaffeensis or the agent of human granulocytic ehrlichiosis. (N Engl J Med 1999;341: 148-55.) (C) 1999, Massachusetts Medical Society. C1 St Louis Childrens Hosp, Dept Pediat, Div Infect Dis, St Louis, MO 63110 USA. Washington Univ, Sch Med, Edward Mallinckrodt Dept Pediat, St Louis, MO 63110 USA. Washington Univ, Sch Med, Dept Med, St Louis, MO 63110 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Ohio State Univ, Coll Vet Med, Dept Vet Biosci, Columbus, OH 43210 USA. St Johns Mercy Med Ctr, St Louis, MO 63141 USA. RP Storch, GA (reprint author), St Louis Childrens Hosp, Dept Pediat, Div Infect Dis, 1 Childrens Pl, St Louis, MO 63110 USA. FU NIAID NIH HHS [R01 AI409343] NR 31 TC 238 Z9 258 U1 2 U2 12 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 15 PY 1999 VL 341 IS 3 BP 148 EP 155 DI 10.1056/NEJM199907153410303 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 215YV UT WOS:000081413800003 PM 10403852 ER PT J AU Smith, TL Pearson, ML Jarvis, WR AF Smith, TL Pearson, ML Jarvis, WR TI Vancomycin resistance in Staphylococcus aureus - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter ID SUSCEPTIBILITY C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Smith, TL (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 15 PY 1999 VL 341 IS 3 BP 207 EP 208 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 215YV UT WOS:000081413800018 ER PT J AU Conlisk, E Herrick, H Passaro, K AF Conlisk, E Herrick, H Passaro, K TI Patients' reports of counseling on mammography screening by health-care providers - North Carolina, 1997 (Reprinted from MMWR, vol 48, pg 359, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 N Carolina Dept Hlth & Human Svcs, Raleigh, NC USA. CDC, Div Canc Prevent & Control, Atlanta, GA 30333 USA. CDC, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. RP Conlisk, E (reprint author), N Carolina Dept Hlth & Human Svcs, Raleigh, NC USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 14 PY 1999 VL 282 IS 2 BP 124 EP 125 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 215HT UT WOS:000081376800011 ER PT J AU Mehler, L Shannon, J Baum, L AF Mehler, L Shannon, J Baum, L TI Illnesses associated with occupational use of flea-control products - California, Texas, and Washington, 1989-1997 (Reprinted from MMWR, vol 48, pg 443, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Calif Environm Protect Agcy, Dept Pesticide Regulat, Sacramento, CA 95814 USA. Texas Dept Hlth, Environm & Occupat Epidemiol Program, Austin, TX 78756 USA. Washington Dept Hlth, Off Tox Subst, Olympia, WA USA. NIOSH, Div Surveillance Hazard Evaluat & Field Studies, CDC, Cincinnati, OH USA. US EPA, Off Pesticide Programs, Washington, DC USA. RP Mehler, L (reprint author), Calif Environm Protect Agcy, Dept Pesticide Regulat, Sacramento, CA 95814 USA. NR 1 TC 1 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 14 PY 1999 VL 282 IS 2 BP 125 EP 126 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 215HT UT WOS:000081376800012 ER PT J AU Roush, S Birkhead, G Koo, D Cobb, A Fleming, D AF Roush, S Birkhead, G Koo, D Cobb, A Fleming, D TI Mandatory reporting of diseases and conditions by health care professionals and laboratories SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID SURVEILLANCE AB Context Surveillance is a key component of the core public health function of health assessment. Systematic reporting by health care professionals and laboratories, which may vary by state law, statute, or regulation, continues to provide essential data for assessing public health. Objective To describe the state and territorial reporting requirements for diseases and conditions recommended for national public health surveillance. Design, Setting, and Participants Between May and August 1997, the state and territorial epidemiologists from all 50 states, in addition to New York City, Puerto Rico, and Guam, completed questionnaires indicating which diseases and conditions were reportable by health care professionals and laboratories in their jurisdictions, The surveys were subsequently updated to reflect reporting requirements current as of January 1, 1999. The overall response rate for the survey was 100% for US states and 90% overall, including the territories. Main Outcome Measure State and territorial reporting requirements for diseases and conditions of public health concern. Results Of the 58 diseases and conditions recommended for national reporting, 35 (60%) were reportable in greater than 90% of the states and territories, 15 (26%) were reportable in 75% to 90%, and 8 (14%)were reportable in less than 75%. Nineteen of the infectious diseases were reportable in all of the states and territories that responded. Conclusions Required reporting varies substantially by state or territory. Health care professionals are integral to public health efforts at the local, state, and national levels. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Child Vaccine Preventable Dis Branch, Council State & Terr Epidemiologists, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Atlanta, GA USA. Oregon State Dept Hlth, Portland, OR USA. RP Roush, S (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Child Vaccine Preventable Dis Branch, Council State & Terr Epidemiologists, MS E-61,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 26 TC 81 Z9 88 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 14 PY 1999 VL 282 IS 2 BP 164 EP 170 DI 10.1001/jama.282.2.164 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 215HT UT WOS:000081376800034 PM 10411198 ER PT J AU Ostrowsky, BE Venkataraman, L D'Agata, EMC Gold, HS DeGirolami, PC Samore, MH AF Ostrowsky, BE Venkataraman, L D'Agata, EMC Gold, HS DeGirolami, PC Samore, MH TI Vancomycin-resistant enterococci in intensive care units - High frequency of stool carriage during a non-outbreak period SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID BLOOD-STREAM INFECTIONS; NOSOCOMIAL OUTBREAK; FAECIUM; RISK; BACTEREMIA; EMERGENCE; EPIDEMIOLOGY; MORTALITY AB Background: We aimed to define the epidemiological associations of vancomycin-resistant enterococci (VRE) in intensive care units (ICUs) during a non-outbreak period by examining prevalence, risk factors for colonization, frequency of acquisition, and molecular strain types. Design: A prospective cohort design was followed. Consecutive patient admissions to 2 surgical ICUs at a tertiary care hospital were enrolled. The main outcome measures were results of serial surveillance cultures screened for VRE. Results: Of 290 patients enrolled, 35 (12%) had colonization with VRE on admission. The VRE colonization or infection had been previously detected by clinical cultures in only 4 of these patients. Using logistic regression, VRE colonization at the time of ICU admission was associated with second- and third-generation cephalosporins (odds ratio [OR] = 6.0, P<.0001), length of stay prior to surgical ICU admission (OR = 1.06, P=.01) greater than 1 prior ICU stay (OR = 9.6, P = .002), and a history of solid-organ transplantation (OR = 3.8, P = .021). Eleven (12.8%) of 78 patients with follow-up cultures acquired VRE. By pulsed-field gel electrophoresis, 2 strains predominated, one of which was associated with an overt outbreak on a non-ICU ward near the end of the study period. Conclusions: Colonization was common and usually not recognized by clinical culture. Most patients who had colonization with VRE and were on the surgical ICU acquired VRE prior to surgical ICU entry. Exposure to second- and third-generation cephalosporins, but not vancomycin, was an independent risk factor for colonization. Prospective surveillance of hospitalized patients may yield useful insights about the dissemination of nosocomial VRE beyond what is appreciated by clinical cultures alone. C1 Beth Israel Deaconess Med Ctr, Dept Med, Div Infect Dis, Boston, MA USA. Beth Israel Deaconess Med Ctr, Dept Pathol, Microbiol Lab, Boston, MA USA. Harvard Univ, Sch Med, Boston, MA USA. Vanderbilt Univ, Div Infect Dis, Nashville, TN USA. RP Ostrowsky, BE (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Hosp Infect Program, MS-A07, Atlanta, GA 30333 USA. FU PHS HHS [440] NR 29 TC 103 Z9 111 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUL 12 PY 1999 VL 159 IS 13 BP 1467 EP 1472 DI 10.1001/archinte.159.13.1467 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 212PA UT WOS:000081224400009 PM 10399898 ER PT J AU Shaffer, N Siriwasin, W Bhadrakom, C Chotplayasunondh, T Chearskul, S AF Shaffer, N Siriwasin, W Bhadrakom, C Chotplayasunondh, T Chearskul, S TI Effect of zidovudine on perinatal HIV-1 transmission and maternal viral load - Reply SO LANCET LA English DT Letter C1 HIV AIDS Collaborat, Nonthaburi, Thailand. Rajavithi Hosp, Minist Publ Hlth, Dept Med Serv, Bangkok, Thailand. Mahidol Univ, Siriraj Hosp, Fac Med, Bangkok, Thailand. Minist Publ Hlth, Dept Med Serv, Queen Sirikit Natl Inst Child Hlth, Bangkok, Thailand. CDC, Int Act Branch, Atlanta, GA 30333 USA. RP Shaffer, N (reprint author), HIV AIDS Collaborat, Nonthaburi, Thailand. NR 3 TC 0 Z9 0 U1 0 U2 0 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUL 10 PY 1999 VL 354 IS 9173 BP 157 EP 158 DI 10.1016/S0140-6736(05)75284-3 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 215HW UT WOS:000081377100049 ER PT J AU Coles, FB Birkhead, GS Johnson, P Smith, PF Berke, R Allenson, P Clark, M AF Coles, FB Birkhead, GS Johnson, P Smith, PF Berke, R Allenson, P Clark, M TI Cluster of HIV-positive young women - New York, 1997-1998 (Reprinted from MMWR, vol 48, pg 413-416, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 New York State Dept Hlth, Albany, NY 12237 USA. Chautauqua Cty Dept Hlth, Mayville, NY USA. CDC, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. CDC, Intervent Res Svcs, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. CDC, Div AIDS STD & TB Lab Res, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Coles, FB (reprint author), New York State Dept Hlth, Albany, NY 12237 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 7 PY 1999 VL 282 IS 1 BP 20 EP 21 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 212BE UT WOS:000081195800008 ER PT J AU Lenaway, DD Bailey, AM Smith, H DeGroote, MA Gershman, K Hoffman, RE AF Lenaway, DD Bailey, AM Smith, H DeGroote, MA Gershman, K Hoffman, RE TI Blastomycosis acquired occupationally during prairie dog relocation - Colorado, 1998 (Reprinted from MMWR, vol 48, pg 98, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Boulder Cty Hlth Dept, Boulder, CO 80306 USA. Boulder Community Hosp, Boulder, CO USA. Colorado Dept Publ Hlth & Environm, Div Epidemiol, Denver, CO 80222 USA. NIOSH, Cincinnati, OH 45226 USA. CDC, Mycot Dis Br, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. CDC, Div Appl Publ Hlth Training, Epidemiol Program Off, Atlanta, GA 30333 USA. RP Lenaway, DD (reprint author), Boulder Cty Hlth Dept, Boulder, CO 80306 USA. NR 1 TC 3 Z9 3 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 7 PY 1999 VL 282 IS 1 BP 21 EP 22 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 212BE UT WOS:000081195800009 ER PT J AU Salmon, DA Haber, M Gangarosa, EJ Phillips, L Smith, NJ Chen, RT AF Salmon, DA Haber, M Gangarosa, EJ Phillips, L Smith, NJ Chen, RT TI Health consequences of religious and philosophical exemptions from immunization laws - Individual and societal risk of measles SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID VACCINATION; OUTBREAK AB Context All US states require proof of immunization for school entry. Exemptions are generally offered for medical, religious, or philosophical reasons, but the health consequences of claiming such exemptions are poorly documented. Objectives To quantify the risk of contracting measles among individuals claiming religious and/or philosophical exemptions from immunization (exemptors) compared with vaccinated persons, and to examine the risk that exemptors pose to the nonexempt population. Design, Setting, and Participants Population-based, retrospective cohort study of data from 1985 through 1992, collected by the Measles Surveillance System of the Centers for Disease Control and Prevention, as well as from annual state immunization program reports on prevalence of exemptors and vaccination coverage. The study group was restricted to individuals aged 5 to 19 years. To empirically determine and quantify community risk, a mathematical model was developed that examines the spread of measles through communities with varying proportions of exemptors and vaccinated children. Main Outcome Measures Relative risk of contracting measles for exemptors vs vaccinated individuals based on cohort study data. Community risk of contracting measles derived from a mathematical model. Results On average, exemptors were 35 times more likely to contract measles than were vaccinated persons (95% confidence interval, 34-37), Relative risk varied by age and year. Comparing the incidence among exemptors with that among vaccinated children and adolescents during the years 1985-1992 indicated that the 1989-1991 measles resurgence may have occurred 1 year earlier among exemptors. Mapping of exemptors by county in California indicated that exempt populations tended to be clustered in certain geographic regions. Depending on assumptions of the model about the degree of mixing between exemptors and nonexemptors, an increase or decrease in the number of exemptors would affect the incidence of measles in nonexempt populations. If the number of exemptors doubled, the incidence of measles infection in nonexempt individuals would increase by 5.5%, 18.6%, and 30.8%, respectively, for intergroup mixing ratios of 20%, 40%, and 60%. Conclusions These data suggest the need for systematic review of vaccine-preventable incidents to examine the effect of exemptors, increased surveillance of the number of exemptors and cases among them, and research to determine the reasons why individuals claim exemptions. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA USA. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. Calif Dept Human Serv, Immunizat Branch, Berkeley, CA USA. RP Salmon, DA (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Room 580,624 N Broadway, Baltimore, MD 21205 USA. FU NIAID NIH HHS [R01-AI32042] NR 24 TC 155 Z9 157 U1 1 U2 20 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUL 7 PY 1999 VL 282 IS 1 BP 47 EP 53 DI 10.1001/jama.282.1.47 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 212BE UT WOS:000081195800028 PM 10404911 ER PT J AU Hall, HI Coates, RJ Uhler, RJ Brinton, LA Gammon, MD Brogan, D Potishcman, N Malone, KE Swanson, CA AF Hall, HI Coates, RJ Uhler, RJ Brinton, LA Gammon, MD Brogan, D Potishcman, N Malone, KE Swanson, CA TI Stage of breast cancer in relation to body mass index and bra cup size SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article ID WEIGHT; WOMEN; RISK; SURVIVAL; OBESITY; DISEASE; DIAGNOSIS; HEALTH; HEIGHT AB Most studies on women with breast cancer indicate that obesity is positively associated with late-stage disease. Some results have shown a similar relationship between breast size and stage. A recent study found that the association between body mass index (BMI) and stage was limited to cancers that were self-detected, suggesting that the BMI-stage relation may be due to delayed symptom recognition. We examined the relationships between stage and both BMI and breast (bra cup) size, stratified by method of detection, using data from a population-based case-control study of 1,361 women (ages 20-44 years) diagnosed with breast cancer during 1990-1992, Height and weight measurements and information on bra cup size, method of cancer detection and other factors predictive of stage at diagnosis were collected during in-person interviews. A case-case comparison was conducted using logistic regression to estimate odds of regional or distant stage rather than local stage in relation to BMI and bra size, Odds of late-stage disease were increased with higher BMI [adjusted odds ratio (OR) for highest to lowest tertile = 1.46, 95% confidence interval (CI) 1.10-1.93] and larger bra cup size (OR for cup D vs, cup A = 1.61, 95% CI 1.04-2.48), These relationships were not modified by the method of detection. Differences in etiologic effects, rather than differences in detection methods, may explain the relations observed between stage and both BMI and breast size. (C) 1999 Wiley-Liss, Inc. C1 CDC, NCCDPHP, DCPC, Atlanta, GA 30341 USA. NCI, Bethesda, MD 20892 USA. Columbia Univ, Sch Publ Hlth, New York, NY USA. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. RP Hall, HI (reprint author), CDC, NCCDPHP, DCPC, Mailstop K-53,4770 Buford Highway NE, Atlanta, GA 30341 USA. RI Brinton, Louise/G-7486-2015 OI Brinton, Louise/0000-0003-3853-8562 NR 21 TC 51 Z9 51 U1 2 U2 5 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD JUL 2 PY 1999 VL 82 IS 1 BP 23 EP 27 DI 10.1002/(SICI)1097-0215(19990702)82:1<23::AID-IJC5>3.0.CO;2-E PG 5 WC Oncology SC Oncology GA 201DF UT WOS:000080579100005 PM 10360815 ER PT J AU Maitra, A Singh, B Banu, S Deshpande, A Robbins, K Kalish, ML Broor, S Seth, P AF Maitra, A Singh, B Banu, S Deshpande, A Robbins, K Kalish, ML Broor, S Seth, P TI Subtypes of HIV type 1 circulating in India: Partial envelope sequences SO AIDS RESEARCH AND HUMAN RETROVIRUSES LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; POLYMERASE CHAIN-REACTION; SPECIMENS C1 All India Inst Med Sci, Dept Microbiol, New Delhi 110029, India. Reg Inst Med Sci, Dept Microbiol, Manipal 795004, India. Madras Med Coll, Dept Microbiol, Chennai 600003, India. Grant Med Coll, Dept Med, Mumbai 400008, India. Ctr Dis Control & Prevent, HIV & Retrovirol Branch, Atlanta, GA 30333 USA. RP Seth, P (reprint author), All India Inst Med Sci, Dept Microbiol, New Delhi 110024, India. NR 12 TC 25 Z9 26 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 0889-2229 J9 AIDS RES HUM RETROV JI Aids Res. Hum. Retrovir. PD JUL 1 PY 1999 VL 15 IS 10 BP 941 EP 944 DI 10.1089/088922299310656 PG 4 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 212GC UT WOS:000081208100010 PM 10408731 ER PT J AU Myers, WR Zhuang, ZQ AF Myers, WR Zhuang, ZQ TI Issues for variability - Reply SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Letter C1 W Virginia Univ, Morgantown, WV 26506 USA. NIOSH, Hlth Effects Lab Div, Cincinnati, OH 45226 USA. NIOSH, Div Resp Dis Studies, Cincinnati, OH 45226 USA. RP Myers, WR (reprint author), W Virginia Univ, Morgantown, WV 26506 USA. RI Zhuang, Ziqing/K-5462-2012 NR 4 TC 1 Z9 1 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 429 EP 431 PG 3 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200002 ER PT J AU Pendergrass, SM AF Pendergrass, SM TI Determination of glycols in air: Development of sampling and analytical methodology and application to theatrical smokes SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE gas chromatography; glycols; theatrical fogging agents ID DIETHYLENE GLYCOL; PROPYLENE-GLYCOL; ETHYLENE-GLYCOL; URINE; CHROMATOGRAPHY; SERUM AB Glycol-based fluids are used in the production of theatrical smokes in theaters, concerts, and other stage productions. The fluids are heated and dispersed in aerosol form to create the effect of a smoke, mist, or fog. There have been reports of adverse health effects such as respiratory irritation, chest tightness, shortness of breath, asthma, and skin rashes. Previous attempts to collect and quantify the aerosolized glycols used in fogging agents have been plagued by inconsistent results, both in the efficiency of collection and in the chromatographic analysis of the glycol components. The development of improved sampling and analytical methodology for aerosolized glycols was required to assess workplace exposures more effectively. An Occupational Safety and Health Administration versatile sampler tube was selected for the collection of ethylene glycol, propylene glycol, 1,3-butylene glycol, diethylene glycol, triethylene glycol, and tetraethylene glycol aerosols, Analytical methodology for the separation, identification, and quantitation of the six glycols using gas chromatography/flame ionization detection is described. Limits of detection of the glycol analytes ranged from 7 to 16 mu g/sample. Desorption efficiencies for all glycol compounds were determined over the range of study and averaged greater than 90%. Storage stability results were acceptable after 28 days for all analytes except ethylene glycol, which was stable at ambient temperature for 14 days. Based on the results of this study, the new glycol method was published in the NIOSH Manual of Analytical Methods. C1 NIOSH, US Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevet,Div Phys Sci & Engn, Cincinnati, OH 45226 USA. RP Pendergrass, SM (reprint author), NIOSH, US Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevet,Div Phys Sci & Engn, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 21 TC 6 Z9 6 U1 1 U2 6 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 452 EP 457 DI 10.1080/00028899908984464 PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200006 PM 10462779 ER PT J AU Lonon, MK Abanto, M Findlay, RH AF Lonon, MK Abanto, M Findlay, RH TI A pilot study for monitoring changes in the microbiological component of metalworking fluids as a function of time and use in the system SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE fatty acid; metalworking fluid; phospholipid ID MICROBIAL BIOMASS AB This article describes the results of a pilot study to examine changes in the biological component of metalworking fluids (MWF) as a function of use. Fluid samples were taken from two newly charged systems, designated BT-7415 and BT-7707, at 1-week intervals for 8 weeks and characterized with respect to the kinds and numbers of bacteria present and presence of soluble protein in cell-free supernatants. In addition, lipid extracts of pelleted cells from fluids in BT-7415 were examined by gas chromatography/mass spectroscopy for the kinds and relative amounts of phospholipid fatty acids (PLFA) present. A total of 19 different bacterial species was cultured and identified, more than half (12/19) of which were gram-negative. Total colony-forming units (CFU) reached levels of 2.2 x 10(3)/mL in BT-7415 and 2.4 x 10(5)/mL in BT-7707. The most common genus isolated was Pseudomonas. Estimations of cell numbers based on total biomass from PLFA in samples from BT-7415 indicated 1.1 x 10(7)/mL after 8 weeks of use. Both the numbers of PLFA identified and the amounts of each detected in BT-7415 increased as the fluids were used. The chromatograms were dominated by two fatty acids, the amounts of which increased with time. These fatty acids, 18:2 omega 6 and 18:1 omega 9c, are not commonly associated with pseudomonads. This suggests that there is an important component of the biological consortium in MWF that is not being detected by currently used culture techniques. There was no soluble protein detected in any of the samples from either system. C1 NIOSH, Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent,Div Phys Sci & Engn, Cincinnati, OH 45226 USA. Miami Univ, Dept Microbiol, Oxford, OH 45056 USA. Cincinnati Milacron, Consumable Prod Div, Cincinnati, OH USA. RP Lonon, MK (reprint author), Univ Arkansas, 521 S Razorback Rd, Fayetteville, AR 72701 USA. RI Findlay, Robert/G-4223-2011 NR 13 TC 19 Z9 19 U1 1 U2 5 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 480 EP 485 DI 10.1080/00028899908984468 PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200010 PM 10462781 ER PT J AU Bloom, TF Egeland, GM AF Bloom, TF Egeland, GM TI Evaluation of exposures to fluorocarbon 113 in a horizontal and a vertical laminar airflow clean room SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE 113; clean room; fluorocarbon 113; Freon (R); 1,1,2-trichloro-1,2,2-trifluoroethane AB Exposures to 1,1,2-trichloro-1,2,2-trifluoroethane or fluorocarbon (FC) 113 were evaluated in a horizontal laminar airflow (HLAF) clean room and a vertical laminar airflow (VLAF) clean room. A full period consecutive samples measurement strategy was employed. Data were used to calculate 8-hour time-weighted averages (8-TWA) for major work groups and to characterize exposures associated with specific cleaning tasks. The MIRAN(R) 1B infrared analyzer was used to estimate peak concentrations. In the HLAF clean room, 8-TWAs ranged from 193 to 439 ppm; in the VLAF clean room, 8-TWAs ranged from 110 to 935 ppm. These levels were below the current Occupational Safety and Health Administration permissible exposure limit and the National Institute for Occupational Safety and Health (NIOSH) recommended exposure limit for FC 113 of 1000 ppm. Short-term sample concentrations ranged from 104 ppm (inspection) to 1080 ppm (assembly) in the HLAF clean room and 51 ppm (packaging)-3380 ppm (Rushing) in the VLAF clean room. In the VLAF clean room, several short-term concentrations measured during the flushing task-1421 ppm and 2522 ppm-were above the NIOSH short-term exposure limit (STEL) of 1250 ppm. These data suggest the possibility that the STEL may be exceeded for tasks involving direct work with liquid FC 113. Peak exposure levels may be reduced by modification of worker position in the HLAF clean room and by use of open wire tables in the VLAF clean room. C1 NIOSH, Cincinnati, OH 45226 USA. RP Bloom, TF (reprint author), NIOSH, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 14 TC 0 Z9 0 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 486 EP 494 PG 9 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200011 PM 10462782 ER PT J AU Eller, PM Feng, HA Song, RGS Key-Schwartz, RJ Esche, CA Groff, JH AF Eller, PM Feng, HA Song, RGS Key-Schwartz, RJ Esche, CA Groff, JH TI Proficiency Analytical Testing (PAT) silica variability, 1990-1998 SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE colorimetric; infrared; PAT program; quartz; silica; X-ray diffraction AB Industrial hygiene laboratories use one of three analytical techniques (X-ray diffraction spectrometry, infrared absorption spectrometry, and colorimetric spectrophotometry) for the quantitative determination of crystalline silica. Interlaboratory variability historically has been high for these analyses (similar to 25-35% relative standard deviation). Agreement between laboratories, as measured by the American Industrial Hygiene Association Proficiency Analytical Testing program over the period April 1990 through April 1998, was studied. Analysis of over 11,000 data points (laboratory/sample/round combinations) showed some significant differences between analytical methods in their relative recovery and precision, although overall mean recoveries were similar for the three techniques. Relative recovery of colorimetric results (but not those of the X-ray or infrared results) was significantly affected by sample loading in the range 40-170 mu g silica per sample. Differences on the order of 5-10% were produced in some intermatrix comparisons for infrared and colorimetric recoveries, but not for those of X-ray, X-ray and infrared techniques were both more precise than colorimetric, Small differences, on the order of 2-5%, were observed in the interlaboratory and intralaboratory relative standard deviations between different matrices for X-ray and infrared analyses, but not for the more variable colorimetric results. C1 NIOSH, Div Phys Sci & Engn, Cincinnati, OH 45226 USA. RP Eller, PM (reprint author), NIOSH, Div Phys Sci & Engn, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 10 TC 11 Z9 13 U1 0 U2 3 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 533 EP 539 DI 10.1080/00028899908984475 PG 7 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200017 ER PT J AU Feng, HA Schlecht, P AF Feng, HA Schlecht, P TI Proficiency Analytical Testing (PAT) Program (March 1999) SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article C1 NIOSH, Dept Hlth & Human Serv,Robert A Taft Labs, US Publ Hlth Serv,Analyt Res & Dev Branch, Ctr Dis Control & Prevent,Div Phys Sci & Engn, Cincinnati, OH 45226 USA. RP Feng, HA (reprint author), NIOSH, Dept Hlth & Human Serv,Robert A Taft Labs, US Publ Hlth Serv,Analyt Res & Dev Branch, Ctr Dis Control & Prevent,Div Phys Sci & Engn, 4676 Columbia Pkwy MS-R8, Cincinnati, OH 45226 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JUL-AUG PY 1999 VL 60 IS 4 BP 548 EP 550 PG 3 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 227XL UT WOS:000082105200020 ER PT J AU Will, JC Ford, ES Bowman, BA AF Will, JC Ford, ES Bowman, BA TI Serum vitamin C concentrations and diabetes: findings from the third National Health and Nutrition Examination Survey, 1988-1994 SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article DE ascorbic acid; blood chemical analysis; diabetes mellitus; diet surveys; epidemiology; population; NHANES III; vitamin C; oral-glucose-tolerance test; third National Health and Nutrition Examination Survey ID ASCORBIC-ACID; MELLITUS; PLASMA AB Background: Previous studies suggested that diabetes mellitus may lower serum vitamin C concentrations, but most of these studies used clinic-based populations with established diabetes of varying duration and did not adjust for important covariates. Objective: Using a population-based sample and adjusting for important covariates, we asked whether serum vitamin C concentrations in persons with newly diagnosed diabetes differed from those in persons without diabetes. Design: Data were obtained from the third National Health and Nutrition Examination Survey (1988-1994). Serum vitamin C was assayed by using reversed-phase HPLC with multiwavelength detection. Diabetes status (n = 237 persons with diabetes; n = 1803 persons without diabetes) was determined by oral-glucose-tolerance testing of the sample aged 40-74 y. Results: After adjustment for age and sex, mean serum vitamin C concentrations were significantly lower in persons with newly diagnosed diabetes than in those without diabetes. After adjustment for dietary intake of Vitamin C and other important covariates, however, mean concentrations did not differ according to diabetes status. Conclusion: When assessing serum vitamin C concentrations by diabetes status in the future, researchers should measure and account for all factors that influence serum vitamin C concentrations. C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Will, JC (reprint author), Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway,MS K-26, Atlanta, GA 30341 USA. NR 19 TC 76 Z9 77 U1 0 U2 4 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUL PY 1999 VL 70 IS 1 BP 49 EP 52 PG 4 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 212PF UT WOS:000081224900009 PM 10393138 ER PT J AU Dietz, WH Bellizzi, MC AF Dietz, WH Bellizzi, MC TI Introduction: The use of body mass index to assess obesity in children SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Editorial Material DE BMI; body mass index; obesity; children; adolescents; underwater weighing; DXA; dual-energy X-ray absorptiometry; undernutrition; International Obesity Task Force ID X-RAY ABSORPTIOMETRY; SKINFOLD-THICKNESS; FATNESS; OVERWEIGHT AB The International Obesity Task Force (IOTF) was established in 1994 to address the increase in the worldwide prevalence of obesity. The goals of the IOTF are to I) raise awareness in the population and among governments that obesity is a serious medical condition, 2) develop policy recommendations for a coherent and effective global approach to the management and prevention of obesity, and 3) implement appropriate strategies to manage and prevent obesity on a population basis worldwide. To assess the global prevalence of obesity in children and adolescents, the IOTF convened a workshop on childhood obesity to determine the most appropriate measurement to assess obesity in populations of children and adolescents around the world. At the workshop, a variety of issues related to this problem were considered-including the best measure of fatness, the effect of application of a variety of existing standards on the prevalence of obesity in the same population, and the role of factors such as visceral adiposity and natural history in the definition of obesity. This article and those that follow represent the information presented at the workshop. The workshop concluded that the body mass index (BMI; in kg/m(2)) offered a reasonable measure with which to assess fatness in children and adolescents and that the standards used to identify overweight and obesity in children and adolescents should agree with the standards used to identify grade 1 and grade 2 overweight (BMI of 25 and 30, respectively) in adults. C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Rowett Res Inst, Aberdeen, Scotland. RP Dietz, WH (reprint author), Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway NE,Mailstop K-24, Atlanta, GA 30341 USA. NR 14 TC 151 Z9 162 U1 2 U2 16 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUL PY 1999 VL 70 IS 1 BP 123S EP 125S PG 3 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 212PF UT WOS:000081224900029 PM 10419414 ER PT J AU Flegal, KM AF Flegal, KM TI Curve smoothing and transformations in the development of growth curves SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT International Obesity Task Force Workshop on Childhood Obesity (IOTF) CY JUN 16, 1997 CL DUBLIN, IRELAND DE anthropometry; body weight; body height; body mass index; growth; growth charts; growth curves; growth percentiles; health surveys; curve smoothing; children; adolescents; ponderal index ID STANDARDS; OBESITY AB Growth charts such as those published by the National Center for Health Statistics (NCHS) consist of a set of smoothed percentile curves showing the distribution of different aspects of body size for infants, children, and adolescents. The original NCHS growth charts are currently being revised to incorporate additional national data, to include growth curves for body mass index (BMI, in kg/m(2)), to reduce or eliminate discontinuities, and to use new and improved methods of smoothing. Methods of curve smoothing in the development of growth curves are briefly discussed in the context of this revision by using examples based on the provisional data set for revision of the growth curves. Among the factors that may affect the construction of the revised growth curves are sample sizes, sampling weights, and secular trends. The use of BMI or other weight-height indexes in growth curves presents some new issues because these transformations of weight and height data do not increase monotonically with age. Some of the advantages and disadvantages of several different approaches to creating smoothed percentiles and standardized scores are discussed briefly. These effects need to be considered in the broader context of constructing growth curves. No single method of developing smoothed curves is clearly the best for all purposes, and estimates of overweight and underweight may be sensitive to the method chosen. Alternative approaches to constructing smoothed curves by using weight-height functions other than BMI might warrant further exploration. C1 Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Flegal, KM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, 6525 Belcrest Rd,Room 900, Hyattsville, MD 20782 USA. RI Flegal, Katherine/A-4608-2013 NR 9 TC 22 Z9 24 U1 0 U2 1 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUL PY 1999 VL 70 IS 1 BP 163S EP 165S PG 3 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 212PF UT WOS:000081224900036 PM 10419421 ER PT J AU Bellizzi, MC Dietz, WH AF Bellizzi, MC Dietz, WH TI Workshop on childhood obesity: Summary of the discussion SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT International Obesity Task Force Workshop on Childhood Obesity (IOTF) CY JUN 16, 1997 CL DUBLIN, IRELAND DE children; adolescents; obesity; international; standards; BMI; body mass index; skinfold thickness ID EXPERT COMMITTEE; RECOMMENDATIONS AB Childhood obesity is rapidly emerging as a global epidemic that will have profound public health consequences as overweight children become overweight adults. To address this problem, action is needed at national and international levels. However, well-documented evidence of the trends in and global prevalence of obesity in children and adolescents is required to develop sound public health policies. There is no internationally acceptable index to assess childhood obesity nor is there an established cutoff point to define overweight in children. The purpose of the workshop was to establish a reasonable index with which to assess adiposity (overweight) in children and adolescents worldwide. We present here a summary of the discussion on the establishment of an index. The participants concluded that although body mass index (BMI; in kg/m(2)) is not a perfect measure in children because it covaries with height, it has been validated against measurements of body density. Because a consistent and pragmatic definition for overweight in children and adolescents is required, BMI may therefore be appropriate. However, other alternatives may be considered in the future. The group suggested a scheme for cutoff points for children and adolescents based on internationally accepted BMI cutoff points for adult morbidity of 25 and 30 to identify grade 1 and grade 2 overweight, respectively. Use of these cutoff points would provide a new approach to identifying childhood obesity and make the definition for children and adolescents consistent with that for adults. C1 Rowett Res Inst, Int Obes Task Force, Aberdeen AB21 9SB, Scotland. Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Bellizzi, MC (reprint author), Rowett Res Inst, Int Obes Task Force, Aberdeen AB21 9SB, Scotland. NR 8 TC 77 Z9 91 U1 0 U2 5 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUL PY 1999 VL 70 IS 1 BP 173S EP 175 PG 3 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 212PF UT WOS:000081224900039 PM 10419424 ER PT J AU Stankovic, AK Astles, JR Schalla, W Ridderhof, J Hearn, T Waites, K AF Stankovic, AK Astles, JR Schalla, W Ridderhof, J Hearn, T Waites, K TI Model performance evaluation program (MPEP). SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Div Lab Syst, Publ Hlth Practice Program Off, Atlanta, GA 30341 USA. Univ Alabama, Dept Pathol, Birmingham, AL 35233 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CLIN PATHOLOGISTS PI CHICAGO PA 2100 W HARRISON ST, CHICAGO, IL 60612 USA SN 0002-9173 J9 AM J CLIN PATHOL JI Am. J. Clin. Pathol. PD JUL PY 1999 VL 112 IS 1 MA 10 BP 133 EP 133 PG 1 WC Pathology SC Pathology GA 210CR UT WOS:000081088000030 ER PT J AU Sun, FZ Flanders, WD Yang, QH Khoury, MJ AF Sun, FZ Flanders, WD Yang, QH Khoury, MJ TI Transmission disequilibrium test (TDT) when only one parent is available: The 1-TDT SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE case-parental design; population stratification; TDT ID HAPLOTYPE-RELATIVE-RISK; TRANSMISSION/DISEQUILIBRIUM TEST; LINKAGE DISEQUILIBRIUM; ASSOCIATION; IDDM; DESIGN; GAW9 AB The transmission disequilibrium test (TDT) is a useful method to locate mutations linked to disease genes associated with complex diseases. TDT requires genotypes of affected individuals and their parents, Recently, Ewens and Spielman (Am J Hum Genet 1998;62:450-8) extended the TDT for use in sibships with at least one affected and one unaffected individual and devised a new test called the sib transmission/disequilibrium test (S-TDT). The S-TDT can be applied to diseases with late age at onset such as non-insulin-dependent diabetes mellitus, psychiatric disorders, and diseases related to aging. For some disorders, it might be relatively easy to obtain the genotype of one parent either because the other parent is not available for study or he/she is not cooperative. Curtis and Sham (Ann Hum Genet 1995;59:323-36) showed that bias in transmitting certain alleles is introduced if only heterozygous parents and homozygous offspring are used in the TDT. In this paper, the authors propose a new test, the 1-TDT, to detect linkage between a candidate locus and a disease locus using genotypes of affected individuals and only one available parent for each affected individual. The test is not biased under the null hypothesis of no linkage or association. The authors validate their test using both simulated and real data sets. Finally, they show how to combine data from different types of families. C1 Emory Univ, Sch Med, Dept Genet, Atlanta, GA 30322 USA. Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Birth Defects & Genet Dis Branch, Atlanta, GA USA. Ctr Dis Control & Prevent, Off Genet & Dis Prevent, Atlanta, GA USA. RP Sun, FZ (reprint author), Emory Univ, Sch Med, Dept Genet, 1462 Clifton Rd,4th Floor, Atlanta, GA 30322 USA. RI Sun, Fengzhu /G-4373-2010 FU NIDDK NIH HHS [R29DK53392]; NIGMS NIH HHS [GM31575] NR 16 TC 82 Z9 87 U1 0 U2 4 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUL 1 PY 1999 VL 150 IS 1 BP 97 EP 104 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 209PX UT WOS:000081057900014 PM 10400559 ER PT J AU Wilson, MG DeJoy, DM Jorgensen, CM Crump, CJ AF Wilson, MG DeJoy, DM Jorgensen, CM Crump, CJ TI Health promotion programs in small worksites: Results of a national survey SO AMERICAN JOURNAL OF HEALTH PROMOTION LA English DT Article DE occupational safety and health; small business; worksite health promotion ID IMPACT AB Purpose. This study documents the prevalence of workplace health promotion activities at small worksites with 15 to 99 employees. Design. A random sample of U.S. worksites stratified by size and industry (n = 3628) was drawn using American Business Lists. Measures. Each worksite was surveyed using a computer-assisted telephone interview system to document activities related to health promotion and related programs, worksite policies regarding health and safety health insurance, and philanthropic activities. Subjects. Participation varied by industry and size, with an overall response rate for eligible worksites of 78 % for a total sample of 2680 worksites. Data analysis. Data were analyzed using SUDAAN statistical software. Results. Approximately 25 % of worksites with 15 to 99 employees offered health promotion programs to their employees, compared with 44% of worksites with 100+ employees. As with the larger worksites, the most common programs for worksites with 15 to 99 employees were those related to occupational safety and health, back injury prevention, and CPR. The majority of worksites in both size categories had alcohol, illegal drug, smoking, and occupant protection policies. The majority of both small and large worksites also offered group health insurance to their employees (92% and 98%, respectively), with many of the worksites also extending benefits to family members and dependents (approximately 80% for both business sizes). Conclusions. The results indicated that small worksites are providing programs to their employees, with a primary focus on job-related hazards. Small worksites also have formal policies regarding alcohol, drug use, smoking, and seatbelt use and offer health insurance to their employees at a rate only slightly lower than that of large worksites. C1 Univ Georgia, Dept Hlth Promot & Behav, Athens, GA 30602 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Res Triangle Inst, Durham, NC USA. RP Wilson, MG (reprint author), Univ Georgia, Dept Hlth Promot & Behav, Athens, GA 30602 USA. NR 13 TC 22 Z9 22 U1 0 U2 3 PU AMER J HEALTH PROMOTION INC PI KEEGO HARBOR PA 1660 CASS LAKE RD, STE 104, KEEGO HARBOR, MI 48320 USA SN 0890-1171 J9 AM J HEALTH PROMOT JI Am. J. Health Promot. PD JUL-AUG PY 1999 VL 13 IS 6 BP 358 EP 365 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 228GH UT WOS:000082128400007 PM 10557508 ER PT J AU Burnett, C Robinson, C Walker, J AF Burnett, C Robinson, C Walker, J TI Cancer mortality in health and science technicians SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article; Proceedings Paper CT International Conference on Womens Health - Occupation, Cancer, and Reproduction CY MAY 14-15, 1998 CL REYKJAVIK, ICELAND DE female occupations; mortality; proportionate cancer mortality; leukemia; health technicians; science technicians ID LABORATORY WORKERS; RADIOLOGIC TECHNOLOGISTS; BREAST-CANCER; COHORT; RISK AB Background Nearly one million U.S. women are employed as health or science technicians with various chemical and biological exposures, but few studies have looked at their health outcomes. Methods Using 1984-1995 mortality data with coded occupation information, we calculated race- and age-adjusted proportionate cancer mortality ratios (PCMRs) and 95% confidence intervals for two age groups SOP black and white women with occupations of clinical laboratory (CLT), radiologic, and science technician. Results For CLTs, the PCMRs for breast cancer were borderline significantly elevated The PCMRs for leukemia were significantly elevated particularly for myeloid leukemia. Radiologic technicians had no significantly elevated PCMRs. Science technicians had significantly elevated PCMRs for non-Hodgkin's lymphoma and multiple myeloma in the younger age group. Discussion The elevated risks for lymphatic and hematopoietic neoplasms in CLTs and science technicians may be associated with occupational exposures. Am. J. Ind. Med. 36:155-158, 1999. Published 1999 Wiley-Liss, Inc.dagger C1 NIOSH, Div Surveillance Hazard Evaluat & Field Studies, Cincinnati, OH 45226 USA. RP Burnett, C (reprint author), NIOSH, Div Surveillance Hazard Evaluat & Field Studies, 4676 Columbia Pkwy,MS R-18, Cincinnati, OH 45226 USA. NR 23 TC 13 Z9 15 U1 0 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD JUL PY 1999 VL 36 IS 1 BP 155 EP 158 DI 10.1002/(SICI)1097-0274(199907)36:1<155::AID-AJIM22>3.0.CO;2-Z PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 201YM UT WOS:000080624900022 PM 10361601 ER PT J AU Robinson, CF Walker, JT AF Robinson, CF Walker, JT TI Cancer mortality among women employed in fast-growing US occupations SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article; Proceedings Paper CT International Conference on Womens Health - Occupation, Cancer, and Reproduction CY MAY 14-15, 1998 CL REYKJAVIK, ICELAND ID BREAST-CANCER; OVARIAN-CANCER; HODGKINS-DISEASE; RISK-FACTORS; EXPOSURE; BRAIN; RADIATION; WORKERS; TUMORS; COHORT AB Our study examined cancer mortality before the age of 65 for women employed in the fastest growing and/or traditionally female occupations. Analysis of mortality data from 28 U.S. states for 1984-1995 revealed elevated proportionate cancer mortality ratios (PCMRs). The highest PCMRs observed were thyroid cancer among health aides, lymphatic and multiple myeloma among computerprogrammers, and brain cancer among actresses and directresses. Some of the excess mortality occurred for occupations that have been previously cited. These included-elevated breast and ovarian cancer among teachers, Hodgkin's disease among hairdressers and cosmetologists, and thyroid cancer among health aides and: therapists. A few of the associations were new, i.e., had not been previously observed. These included cancer of the connective tissue and lymphatic system among computer programmers, ovarian cancer and leukemia. among secretaries, and lymphatic cancer and multiple myeloma among child care workers. These findings should be further investigated with epidemiologic and environmental studies, Am. J. Ind. Med. 36:1.86-192, 1999. Published 1999 Wiley-Liss, Inc.dagger C1 NIOSH, Div Surveillance Hazard Evaluat & Field Studies, Cincinnati, OH 45226 USA. RP Robinson, CF (reprint author), NIOSH, Div Surveillance Hazard Evaluat & Field Studies, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 44 TC 21 Z9 21 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD JUL PY 1999 VL 36 IS 1 BP 186 EP 192 DI 10.1002/(SICI)1097-0274(199907)36:1<186::AID-AJIM26>3.0.CO;2-H PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 201YM UT WOS:000080624900026 PM 10361605 ER PT J AU McDonnell, SM Hover, A Gloe, D Ou, CY Cogswell, ME Grummer-Strawn, L AF McDonnell, SM Hover, A Gloe, D Ou, CY Cogswell, ME Grummer-Strawn, L TI Population-based screening for hemochromatosis using phenotypic and DNA testing among employees of health maintenance organizations in Springfield, Missouri SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID DEPENDENT DIABETES-MELLITUS; FEMALE BLOOD-DONORS; LONG-TERM SURVIVAL; HEREDITARY HEMOCHROMATOSIS; SERUM FERRITIN; IRON STORES; TRANSFERRIN SATURATION; UNITED-STATES; GENETIC HEMOCHROMATOSIS; EARLY DIAGNOSIS AB BACKGROUND: Hemochromatosis reportedly affects 3 to 8 persons per 1,000 and is associated with an elevated risk of morbidity and mortality. We sought to ascertain its prevalence in a community and to assess the association between phenotype and genotype. METHODS: All health maintenance organization employees were invited to participate in hemochromatosis screening using a repeated elevation of the transferrin saturation test as the case definition (greater than or equal to 50% in women and greater than or equal to 60% in men with no other cause). Iron overload from hemochromatosis was defined as serum ferritin concentration greater than or equal to 95th percentile and mobilizable iron greater than or equal to 99th percentile for age and sex, or hepatic iron index greater than or equal to 1.9. The HFE gene was analyzed for mutations. RESULTS: Participation among employees,vas 28% (1,653 of 6,000); 83% were women. The prevalence of hemochromatosis was 8 per 1,000 (13 of 1,653), and the prevalence of iron overload from hemochromatosis was 4 per 1,000 (5 of 1,653). Compared with those who had no HFE mutation, the relative risk (RR) for hemochromatosis was greatest for C282Y homozygotes (RR = 147), compound heterozygotes (RR = 19), and H63D homozygotes (RR = 9). Overall, 38% of participants had at least one HFE mutation. Screening based on an initial elevated transferrin saturation rest had the best sensitivity, whereas DNA testing offered the Lest specificity and predictive value positive for iron overload disease. CONCLUSIONS: In this population, we found a greater than expected prevalence of hemochromatosis and demonstrated a clear association with the HFE genotype, Promotion of screening is complicated by controversies in case definition and the large number of persons who will be detected before they have clinically significant iron lending, in whom the risk of clinical disease is unknown. Larger screening studies in more diverse populations are necessary to characterize the burden of disease and to follow those at risk (based on HFE or iron status measures) to establish the natural history of hemochromatosis, (C) 1999 by Excerpta Medica, Inc. C1 Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, Mat & Child Nutr Branch, Atlanta, GA USA. St Johns Hlth Reg Hlth Syst, Dept Qual Resources, Springfield, MO USA. Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hlth Lab Sci, Mol Biol Branch, Atlanta, GA USA. RP McDonnell, SM (reprint author), CDC, Mail Stop C-08,1600 Clifton Rd, Atlanta, GA 30333 USA. FU PHS HHS [1700] NR 62 TC 77 Z9 77 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUL PY 1999 VL 107 IS 1 BP 30 EP 37 DI 10.1016/S0002-9343(99)00163-1 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 215RJ UT WOS:000081396100006 PM 10403350 ER PT J AU Butler, JC Shapiro, ED Carlone, GM AF Butler, Jay C. Shapiro, Eugene D. Carlone, George M. TI Pneumococcal Vaccines: History, Current Status, and Future Directions SO AMERICAN JOURNAL OF MEDICINE LA English DT Article AB Streptococcus pneumoniae is the leading cause of community-acquired pneumonia and bacterial meningitis. Although effective antimicrobial drugs have reduced case fatality, the pneumococcus remains a leading global cause of morbidity and mortality. Therefore, prevention of infection by vaccination with the pneumococcal polysaccharide vaccine is recommended for persons at high risk for serious pneumococcal disease, such as the elderly and individuals with certain underlying medical conditions. Pneumococcal polysaccharide vaccines are safe and effective for the prevention of invasive infection among immunocompetent children and adults but are not immunogenic in infants. Conjugation of pneumococcal polysaccharides to a carrier protein improves immune responses among infants, and conjugate vaccines are currently being evaluated in large efficacy trials. The role of pneumococcal conjugate vaccines in adults has not been determined. Pneumococcal vaccines directed against pneumococcal proteins and DNA vaccines that induce anti-pneumococcal antibodies have been evaluated in animal models and may someday provide complementary or alternative methods for preventing pneumococcal infection. Improved utilization of the pneumococcal polysaccharide vaccine and continued development of improved vaccines are essential, and the emergence of drug-resistant strains of S. pneumoniae highlights the importance of preventing pneumococcal infections by vaccination. Am J Med. 1999; 107(1A):69S-76S. (C) 1999 by Excerpta Medica, Inc. C1 [Butler, Jay C.; Carlone, George M.] Ctr Dis Control & Prevent, Resp Dis Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA USA. [Shapiro, Eugene D.] Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA. RP Butler, JC (reprint author), Ctr Dis Control & Prevent, Arctic Invest Program, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. NR 72 TC 39 Z9 42 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 EI 1555-7162 J9 AM J MED JI Am. J. Med. PD JUL PY 1999 VL 107 IS 1 SU 1 BP 69 EP 76 AR PII S0002-9343(99)00105-9 DI 10.1016/S0002-9343(99)00105-9 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA V17XO UT WOS:000207970100011 ER PT J AU Johnson, BL AF Johnson, BL TI A review of the effects of hazardous waste on reproductive health SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article; Proceedings Paper CT 2nd Annual Womens Health Conference on Threatened Pregnancy - Environment and Reproduction at Risk CY OCT 03, 1997 CL ATLANTA, GEORGIA DE congenital malformations; environmental health; hazardous waste ID LOW-BIRTH-WEIGHT; CONGENITAL-MALFORMATIONS; ENVIRONMENTAL CONTAMINATION; LANDFILL; SITES; RISK; PROXIMITY; WATER AB Approximately 1 in 4 Americans lives within 4 miles of a hazardous waste site according to the Environmental Protection Agency. In light of this large proportion and the public's high level of concern that hazardous waste causes health problems, it is important for primary care physicians and other health care providers to know that residential proximity to some kinds of hazardous waste sites is associated with adverse reproductive effects. Findings from both state-based surveillance programs and studies of individual hazardous waste sites have shown increased risk of congenital malformations and reductions in birth weight among infants born to parents living near hazardous waste sites. This article summarizes salient literature on human health effects of hazardous waste and suggests actions for primary care providers to consider. C1 Publ Hlth Serv, Agcy Toxic Subst & Dis Registry, US Dept HHS, Atlanta, GA 30333 USA. RP Johnson, BL (reprint author), Publ Hlth Serv, Agcy Toxic Subst & Dis Registry, US Dept HHS, 1600 Clifton Rd NE,MS E28, Atlanta, GA 30333 USA. NR 19 TC 10 Z9 11 U1 0 U2 4 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD JUL PY 1999 VL 181 IS 1 BP S12 EP S16 DI 10.1016/S0002-9378(99)70466-7 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 218NK UT WOS:000081558500054 PM 10411784 ER PT J AU Wallace, BJ Guzewich, JJ Cambridge, M Altekruse, S Morse, DL AF Wallace, BJ Guzewich, JJ Cambridge, M Altekruse, S Morse, DL TI Seafood-associated disease outbreaks in New York, 1980-1994 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE disease outbreaks; food poisoning; seafood; New York ID VIBRIO-VULNIFICUS; FISH CONSUMPTION; NORWALK VIRUS; GASTROENTERITIS; BOTULISM AB Background: Seafood-associated disease outbreaks in New York were examined to describe their epidemiology and to identify areas for prevention and control efforts. Methods: We reviewed reports submitted to the New York State Department of Health (NYSDOH) of seafood-associated outbreaks occurring from January 1, 1980, through December 31, 1994. Results: During 1980-1994, 339 seafood-associated outbreaks were reported, resulting in 3959 illnesses, 76 hospitalizations, and 4 deaths. During this period, seafood-associated outbreaks accounted for 19% of all reported foodborne outbreaks and 10% of foodborne illnesses. Shellfish, the most frequently implicated seafood item, accounted far 64% of seafood outbreaks, followed by finfish (31% of outbreaks). Of the 148 seafood-associated outbreaks with a confirmed etiologic agent, Norwalk virus and scombrotoxin were the most frequently identified agents: Norwalk virus accounted for 42% of outbreaks and 42% of illnesses, and scombrotoxin accounted for 44% of outbreaks and 19% of illnesses; Three of the 4 seafood-associated deaths were caused by Clostridium botulinum; the remaining death was caused by Vibrio vulnificus. Conclusions: Reducing the number of seafood outbreaks will require continued and coordinated efforts by many different agencies, including those involved with water quality; disease surveillance; consumer education; and seafood harvesting, processing, and marketing. New York's foodborne disease surveillance data highlight potential areas on which to focus prevention efforts, including: (1) commodities and associated pathogens causing the largest number of seafood-associated outbreaks and illnesses, namely shellfish-associated viral gastroenteritis and finfish-associated scombroid fish poisoning and (2) venues at which seafood were most frequently consumed in reported outbreaks, such as commercial food establishments and catered events. C1 New York State Dept Hlth, Bur Communicable Dis Control, Albany, NY 12237 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. New York State Dept Hlth, Bur Community Sanitat & Food Protect, Albany, NY 12237 USA. SUNY Albany, Sch Publ Hlth, Dept Epidemiol, Albany, NY 12222 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Foodborne & Diarrheal Dis Branch, Atlanta, GA USA. New York State Dept Hlth, Wadsworth Ctr, Albany, NY 12237 USA. RP Wallace, BJ (reprint author), New York State Dept Hlth, Bur Communicable Dis Control, Room 651 Corning Tower,Empire State Pl, Albany, NY 12237 USA. NR 27 TC 45 Z9 48 U1 0 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 1999 VL 17 IS 1 BP 48 EP 54 DI 10.1016/S0749-3797(99)00037-9 PG 7 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 216VQ UT WOS:000081465500008 PM 10429753 ER PT J AU Stayner, L AF Stayner, L TI Protecting public health in the face of uncertain risks: The example of diesel exhaust SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID LUNG-CANCER; RAILROAD WORKERS; EXPOSURE; RATS C1 NIOSH, Cincinnati, OH USA. RP Stayner, L (reprint author), NIOSH, Cincinnati, OH USA. NR 22 TC 3 Z9 4 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUL PY 1999 VL 89 IS 7 BP 991 EP 993 DI 10.2105/AJPH.89.7.991 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 209QG UT WOS:000081059100001 PM 10394303 ER PT J AU Aral, S AF Aral, S TI Elimination and reintroduction of a sexually transmitted disease: Lessons to be learned? SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID CONDOM USE; MEN; SEX; GAY; BEHAVIORS; AIDS C1 Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA 30333 USA. RP Aral, S (reprint author), Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA 30333 USA. NR 19 TC 9 Z9 9 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUL PY 1999 VL 89 IS 7 BP 995 EP 997 DI 10.2105/AJPH.89.7.995 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 209QG UT WOS:000081059100003 PM 10394305 ER PT J AU Guo, HR Tanaka, S Halperin, WE Cameron, LL AF Guo, HR Tanaka, S Halperin, WE Cameron, LL TI Back pain prevalence in US industry and estimates of lost workdays SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID UNITED-STATES; PREVENTION; WORKERS; INJURY; EPIDEMIOLOGY; POPULATION; DISABILITY; RISK AB Objectives. Back pain is the most common reason for filing workers' compensation claims and often causes lost workdays. Data from the 1988 National Health Interview Survey were analyzed to identify high-risk industries and to estimate the prevalence of work-related back pain and number of workdays lost. Methods. Analyses included 30074 respondents who worked during the 12 months before the interview. A case patient was defined as a respondent who had back pain every day for a week or more during that period. Results. The prevalence of lost workday back pain was 4.6%, and individuals with work-related cases lost 101.8 million workdays owing to back pain. Male and female case patients lost about the same number of workdays. Industries in high-risk categories were also identified for future research and intervention, including those seldom studied. Conclusions. This study provides statistically reliable national estimates of the prevalence of back pain among workers and the enormous effect of this condition on American industry in terms of lost workdays. C1 Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth, Tainan 70428, Taiwan. Ctr Dis Control & Prevent, NIOSH, Div Surveillance Hazard Evaluat & Field Studi, Cincinnati, OH USA. RP Guo, HR (reprint author), Natl Cheng Kung Univ, Coll Med, Dept Environm & Occupat Hlth, 138 Sheng Li Rd, Tainan 70428, Taiwan. NR 44 TC 151 Z9 157 U1 0 U2 6 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUL PY 1999 VL 89 IS 7 BP 1029 EP 1035 DI 10.2105/AJPH.89.7.1029 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 209QG UT WOS:000081059100009 PM 10394311 ER PT J AU Klevens, RM Diaz, T Fleming, PL Mays, MA Frey, R AF Klevens, RM Diaz, T Fleming, PL Mays, MA Frey, R TI Trends in AIDS among Hispanics in the United States, 1991-1996 SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID BEHAVIORS; ADULTS; WOMEN AB Objectives. This article describes recent trends in AIDS among US Hispanics. Methods. Incidence rates were calculated from AIDS surveillance data for persons diagnosed from 1991 through 1996. Increases in the number of cases among Hispanics were calculated by linear regression. Results. Of the 415 864 persons diagnosed with AIDS from 1991 through 1996, 19% were Hispanic. Among Hispanics with AIDS, 67% were born in the United States or Puerto Rico. The relative risk (RR) of AIDS for Hispanics compared with Whites was highest for women (RR = 7.0), followed by children (RR = 6.2) and men (RR = 2.8). Increases in the number of cases were higher among foreign-born Hispanics. Conclusions. An understanding of which Hispanic subgroups are at greatest risk for HIV infection is important for prevention efforts. C1 Ctr Dis Control & Prevent, NCHSTP Off Commun, Atlanta, GA 30333 USA. RP Klevens, RM (reprint author), Ctr Dis Control & Prevent, NCHSTP Off Commun, Mail Stop E-06, Atlanta, GA 30333 USA. NR 16 TC 20 Z9 20 U1 0 U2 3 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUL PY 1999 VL 89 IS 7 BP 1104 EP 1106 DI 10.2105/AJPH.89.7.1104 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 209QG UT WOS:000081059100024 PM 10394326 ER PT J AU Schantz, PM Wilkins, PP Tsang, VCW AF Schantz, PM Wilkins, PP Tsang, VCW TI Untitled SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Letter C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. RP Schantz, PM (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. NR 2 TC 3 Z9 3 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 BP 1 EP 1 PG 1 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 220MQ UT WOS:000081670100001 PM 10432045 ER PT J AU Collins, WE Jeffery, GM AF Collins, WE Jeffery, GM TI A retrospective examination of sporozoite- and trophozoite-induced infections with Plasmodium falciparum: Development of parasitologic and clinical immunity during primary infection SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB A retrospective analysis was made of the parasitologic and fever records of 318 patients who had been infected with the El Limon, Santee Cooper, or McLendon strains of Plasmodium falciparum for treatment of neurosyphilis between 1940 and 1963 to determine the development of parasitologic and clinical immunity during primary infection. The presence of fever greater than or equal to 101 degrees F and greater than or equal to 104 degrees F, asexual parasite counts greater than or equal to 1,000 and greater than or equal to 10,000/mu l, and gametocyte counts greater than or equal to 100/mu l and greater than or equal to 1,000/mu l are presented. The frequency of fever (number of patients with fever/number of patients remaining in study) for the first 100 days of patent parasitemia, the frequency of parasite counts greater than or equal to 1,000 and greater than or equal to 10,000/mu l during the first 100 days of patent parasitemia, and the frequency of gametocyte counts greater than or equal to 100 and greater than or equal to 1,000/mu l during the first 100 days of patent parasitemia are presented for 4 groups of patients: 1) sporozoite-induced and 2) trophozoite-induced infections requiring treatment during their primary attack, and 3) sporozoite-induced and 4) trophozoite-induced infections not requiring treatment during the primary attack. For each sporozoite-induced infection, the route of inoculation (bites or syringe), the species of mosquito used, the number of mosquito glands or bites, the intensity of salivary gland infection, and the length of the prepatent period are recorded. Prepatent periods for 109 sporozoite-induced infections ranged from 6 to 28 days. Patients with parasitologic or clinical findings that required suppressive, but non-curative treatment, during the primary attack had higher frequency of fever, parasitemia, and gametocytemia than patients not so treated. Fever was concentrated in the first 2 weeks of patent parasitemia although instances of fever were reported >100 days after infection. High-density parasitemia was also concentrated early in the infection; instances of parasite counts greater than or equal to 10,000/mu l occurred > 75 days after infection. In conclusion, immunity to infection with P. falciparum was shown to develop rapidly. Following primary infection, clinical and parasitologic immunity was evident within 2-3 weeks following the detection of parasites in the peripheral circulation. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Publ Hlth Serv, Decatur, GA 30033 USA. RP Collins, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Mailstop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. NR 29 TC 87 Z9 87 U1 1 U2 5 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 SU 1 BP 4 EP 19 PG 16 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 222RM UT WOS:000081798600002 PM 10432041 ER PT J AU Gramzinski, RA Obaldia, N Jones, TR Rossan, RN Collins, WE Garrett, DO Lal, AA Hoffman, SL AF Gramzinski, RA Obaldia, N Jones, TR Rossan, RN Collins, WE Garrett, DO Lal, AA Hoffman, SL TI Susceptibility of Panamanian Aotus lemurinus lemurinus to sporozoite-induced Plasmodium falciparum (Santa Lucia) infection SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID RECOMBINANT SERA PROTEIN; ASEXUAL BLOOD STAGES; PROTECTIVE IMMUNITY; SYNTHETIC VACCINE; OWL MONKEYS; IMMUNIZATION; MALARIA; STRAIN; ANTIGENS; ADJUVANT AB Aotus monkeys are good models for erythrocyte-induced Plasmodium falciparum and P. vivax infections and have been extensively used in malarial drug and vaccine development. Recently, it has been shown that certain species of Aotus can be infected with sporozoites, and that the degree of susceptibility varies among species. We demonstrate here that Panamanian Aotus lemurinus lemurinus are susceptible to a sporozoite-induced infection, opening the possibility that this species of Aotus could be used as models for testing the efficacy of pre-erythrocytic P. falciparum vaccines and drug candidates directed at the pre-erythrocytic stages of P. falciparum and P. vivax malaria. In this species, we compared sporozoite infection rates. Two of four animals splenectomized prior to infection with sporozoites developed patent parasitemias. Seven of eight animals splenectomized either 7 or 35 days after infection became parasitemic. Additionally, we used a P. falciparum-specific polymerase chain reaction (PCR) method to detect the early appearance of parasitized erythrocytes in the blood prior to detection by conventional microscopy, and found that the parasitemia was detected first in five animals by the PCR method, first in three animals by blood film, with one parasitemia detected simultaneously. We also demonstrated the feasibility of infecting monkeys located in Panama with sporozoites isolated at an insectary in Atlanta, thus documenting the feasibility of similar studies where the insectary and monkey colony are not in the same location. A subsequent attempt to infect these monkeys using sporozoites was not successful, suggesting that this model of human malaria is not yet ready for routine use in vaccine or drug efficacy screening. This model merits further study because of the importance of testing pre-erythrocytic P. falciparum malaria vaccines and drugs in animals. C1 USN, Med Res Ctr, Malaria Program, Rockville, MD 20852 USA. ProMed Inc, Panama City, Panama. Gorgas Mem Lab, Panama City, Panama. Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. RP Hoffman, SL (reprint author), USN, Med Res Ctr, Malaria Program, 12300 Washington Ave, Rockville, MD 20852 USA. RI Obaldia, Nicanor/O-8460-2015; OI Obaldia, Nicanor/0000-0002-3711-9449 NR 23 TC 14 Z9 14 U1 0 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 BP 19 EP 25 PG 7 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 220MQ UT WOS:000081670100006 PM 10432049 ER PT J AU Collins, WE Jeffery, GM AF Collins, WE Jeffery, GM TI A retrospective examination of secondary sporozoite- and trophozoite-induced infections with Plasmodium falciparum: Development of parasitologic and clinical immunity following secondary SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB A retrospective study was made of clinical records to determine parasitemia and episodes of fever of 59 patients reinfected with Plasmodium falciparum for treatment of neurosyphilis, which was considered standard medical care at the time. Records were collected at the National Institutes of Health laboratories in Columbia, South Carolina and Milledgeville, Georgia during the period 1940 to 1963. Nineteen patients were infected via the bites of Anopheles albimanus, An. quadrimaculatus, or An. freeborni mosquitoes; the median prepatent period was 11.5 days. It was evident that clinical immunity, as measured by the frequency of fever particularly high intensity fever (greater than or equal to 104 degrees F), was increased following reinfection. The parasitologic immunity, as measured by the frequency of asexual parasite counts and gametocyte counts, was also evident. In general, in secondary infections with homologous and/or heterologous strains of P. falciparum, fever episodes greater than or equal to 101 degrees F and greater than or equal to 104 degrees F were reduced in number, parasitemia was reduced, and gametocyte production was reduced. However, despite long courses of parasitemia during their primary infections, most patients developed fever and, in some cases, high-density parasitemia and gametocytemia following reinfection. The intensity of the secondary response did not appear to be associated with the length of the previous course of parasitemia. in addition, current infection with heterologous strain parasites did not prevent the development of fever or higher density parasite counts following imposition of the new strain of parasite. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Publ Hlth Serv, Decatur, GA 30033 USA. RP Collins, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Mailstop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. NR 10 TC 63 Z9 66 U1 1 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 SU 1 BP 20 EP 35 PG 16 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 222RM UT WOS:000081798600003 PM 10432042 ER PT J AU Collins, WE Jeffery, GM AF Collins, WE Jeffery, GM TI A retrospective examination of sporozoite- and trophozoite-induced infections with Plasmodium falciparum in patients previously infected with heterologous species of Plasmodium: Effect on development of parasitologic and clinical immunity SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB A retrospective examination was made to determine parasitemia and episodes of fever in 97 patients, previously infected with Plasmodium malariae, P. ovale, and/or P. vivax, who were reinfected with P. falciparum for treatment of neurosyphilis, the standard treatment at the time. Data were collected at the National Institutes of Health laboratories in Columbia, South Carolina and Milledgeville, Georgia during the period 1940 to 1963. Results were compared with observations recorded for patients following primary infection with P. falciparum. The mean daily percentage of patients with fever greater than or equal to 101 degrees F during the first 20 days of primary infection with P. falciparum was 42.4; the percentage with fever greater than or equal to 104 degrees F was 19.9%. Those previously infected with P, ol nle, P. vivax and P. malariae had mean daily percentages of fever greater than or equal to 101 degrees F and greater than or equal to 104 degrees F of 39.1% and 14.8%, 39.1% and 19.4%, and 28.4%, and 11.3%, respectively. Previous infection with P. ovale or P. vivax had little, if any, effect on subsequent clinical malaria due to P. falciparum, whereas infection with P. malariae resulted in reduced frequencies of ever. A similar comparison was made for parasite counts greater than or equal to 1,000/mu l and > 10,000/mu l. The percentages for 268 patients during the first 20 days of primary infection with P. falciparum parasite counts greater than or equal to 1,000/mu l and greater than or equal to 10,000/mu l were 58.2% and 29.9%, respectively. Those previously infected with P. ovale, P. vivax, and P. malariae had mean daily percentages of parasitemia greater than or equal to 1,000/mu l and greater than or equal to 10,000/mu l of 58.0% and 24.3%, 57.3% and 31.1%, and 45.9% and 19.0%, respectively. Previous infection with P. malariae resulted in a reduction in the frequency of high-density parasitemia (greater than or equal to 10,000/mu l) as well as an asexual parasite count greater than or equal to 1,000/mu l. These results suggest that P. falciparum and P. malariae share common antigens that are able to induce parasitologic and clinical protection when infection with P. falciparum follows that with P. malariae. The results did not suggest that protection to P. falciparum is provided by previous infection with P. ovale or P. vivax. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Publ Hlth Serv, Decatur, GA 30033 USA. RP Collins, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Mailstop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. NR 7 TC 49 Z9 50 U1 0 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 SU 1 BP 36 EP 43 PG 8 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 222RM UT WOS:000081798600004 PM 10432043 ER PT J AU Collins, WE Jeffery, GM AF Collins, WE Jeffery, GM TI A retrospective examination of the patterns of recrudescence in patients infected with Plasmodium falciparum SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB A retrospective examination was made to determine median intervals between recrudescences of Plasmodium falciparum in 343 neurosyphilitic patients who were given malariatherapy, which was routine care at that time. Data were collected at the National Institutes of Health laboratories in Columbia, South Carolina and Milledgeville, Georgia during the period 1940 to 1963. The geometric mean days of peak parasite count for the patients were 8, 26.5, 43.5, 62, 78.5, and 95.5 days, respectively. The intervals between these peaks of 18.5, 17, 18.5, 16.5, and 17 days suggest a fixed time frame for the appearance of different dominant parasite populations during the first 100 days of patent infection. When the data from these same patients were examined for mean peak parasite counts, the patterns indicated a consistent decrease in parasite count suggestive of increasing immunity, which was sufficient to reduce bur not eliminate subsequent parasite populations. The geometric mean peak parasite counts for the 343 patients during the primary attack and the first 5 recrudescences were 40,350, 6,975, 5,090, 3,820, 3,455, and 2,375/mu l, respectively. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Publ Hlth Serv, Decatur, GA 30033 USA. RP Collins, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Mailstop F-12,4770 Buford Highway, Atlanta, GA 30341 USA. NR 5 TC 49 Z9 50 U1 0 U2 5 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 SU 1 BP 44 EP 48 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 222RM UT WOS:000081798600005 PM 10432044 ER PT J AU Eberhard, ML Busillo, C AF Eberhard, ML Busillo, C TI Human Gongylonema infection in a resident of New York City SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB A case of infection with Gongylonema is described in a 41-year-old woman living in New York City. The patient sought medical attention with the complaint of a sensation of 1-year duration of something moving in her mouth. On two occasions she removed worms from her mouth, once from her lip, once from the gum. One of the specimens submitted for examination was an adult female Gongylonema. It is not possible to say whether the infection was acquired in New York City, or elsewhere, since the patient traveled frequently to Mississippi to visit relatives. As cases of delusional parasitosis continue to increase, clinicians and laboratorians alike need to be alert to the possibility that foreign objects removed from the mouth, or elsewhere, may indeed represent unusual parasitic infections, and that these objects should be examined before being discarded. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. NYU, New York, NY 10038 USA. Downtown Hosp, New York, NY 10038 USA. RP Eberhard, ML (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Mailstop F-13,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 11 TC 19 Z9 21 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 BP 51 EP 52 PG 2 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 220MQ UT WOS:000081670100012 PM 10432055 ER PT J AU Ong, CSL Eisler, DL Goh, SH Tomblin, J Awad-El-Kariem, FM Beard, CB Xiao, LH Sulaiman, I Lal, A Fyfe, M King, A Bowie, WR Isaac-Renton, JL AF Ong, CSL Eisler, DL Goh, SH Tomblin, J Awad-El-Kariem, FM Beard, CB Xiao, LH Sulaiman, I Lal, A Fyfe, M King, A Bowie, WR Isaac-Renton, JL TI Molecular epidemiology of cryptosporidiosis outbreaks and transmission in British Columbia, Canada SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID FRAGMENT-LENGTH-POLYMORPHISM; PARVUM; OOCYSTS; GIARDIA; BOVINE; DIFFERENTIATION; COMMUNITY; HOSTS; GENE AB Isolates from 25 (13 sporadic and 12 outbreak) cryptosporidiosis cases, 24 of which were from British Columbia, Canada, were characterized using nested polymerase chain reaction amplification of the polymorphic internal transcribed spacer I locus. Two predominant Cryptosporidium parvum genotypes were found. Twelve (8 sporadic and 4 outbreak) isolates amplified with the cry7/cry21 primer pair and 12 (5 sporadic and 7 outbreak) isolates amplified with the cry7/cryITS1 primer pair. Multi-locus gene analysis using sequence polymorphisms on 3 other loci, i.e., the thrombospondin-related adhesion protein gene, the dihydrofolate reductase gene, and the 18S rRNA gene on 8 (4 outbreak and 4 sporadic) isolates showed non-random association among the human and animal alleles of the 4 different C. parvum gene loci. Associations between these 2 parasite genotypes and different routes of cryptosporidiosis transmission such as zoonotic, anthroponotic, and waterborne transmission were studied using municipal population and agricultural information, as well as detection of C. parvum oocysts in municipal drinking water specimens of the residential communities of sporadic and outbreak cases. C1 Univ British Columbia, Dept Pathol & Lab Med, Provincial Lab, Vancouver, BC V5Z 4R4, Canada. Univ British Columbia, Fac Med, Div Infect Dis, Vancouver, BC V5Z 1M9, Canada. BC Biomed Labs Ltd, Surrey, BC V3W 1H8, Canada. Univ London Imperial Coll Sci Technol & Med, Dept Biol, London SW7 2AZ, England. Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. British Columbia Ctr Dis Control Soc, Provincial Lab, Vancouver, BC V5Z 4R4, Canada. British Columbia Ctr Dis Control Soc, Epidemiol Serv, Vancouver, BC V5Z 4R4, Canada. RP Ong, CSL (reprint author), Univ British Columbia, Dept Pathol & Lab Med, Provincial Lab, 655 W 12th Ave, Vancouver, BC V5Z 4R4, Canada. RI Xiao, Lihua/B-1704-2013 OI Xiao, Lihua/0000-0001-8532-2727 FU Wellcome Trust NR 27 TC 51 Z9 54 U1 0 U2 3 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 BP 63 EP 69 PG 7 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 220MQ UT WOS:000081670100015 PM 10432058 ER PT J AU Lutwama, JJ Kayondo, J Savage, HM Burkot, TR Miller, BR AF Lutwama, JJ Kayondo, J Savage, HM Burkot, TR Miller, BR TI Epidemic o'nyong-nyong fever in southcentral Uganda, 1996-1997: Entomologic studies in Bbaale village, Rakai district SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID VIRUS AB Entomologic studies were conducted between January 27 and February 2, 1997, in Bbaale village in southcentral Uganda during an o'nyong-nyong (ONN) virus epidemic, which began in mid 1996 and continued into 1997. The objectives were to confirm the role of anophelines in ONN virus transmission and to examine other mosquito species as epidemic vectors of ONN virus. Of 10,050 mosquitoes collected using light traps and pyrethrum knockdown sprays, Anopheles (Cellia) funestus Giles was presumed to be the principal vector because it was the most abundant mosquito species from which a strain of ONN virus was isolated. This virus was isolated for the first time from a culicine species. Mansonia (Mansonioides) uniformis Theobald. Bwamba virus and Nyando virus were also isolated from An. funestus. C1 Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Natl Ctr Infect Dis, Ft Collins, CO 80522 USA. Uganda Virus Res Inst, Entebbe, Uganda. RP Miller, BR (reprint author), Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Natl Ctr Infect Dis, POB 2087, Ft Collins, CO 80522 USA. RI Burkot, Thomas/C-6838-2013 NR 39 TC 20 Z9 21 U1 2 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUL PY 1999 VL 61 IS 1 BP 158 EP 162 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 220MQ UT WOS:000081670100030 PM 10432073 ER PT J AU Weed, DL Coughlin, SS AF Weed, DL Coughlin, SS TI New ethics guidelines for epidemiology: Background and rationale SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE epidemiology; ethics; guidelines; professional practice; values ID HEALTH AB In the past decade, at least four sets of ethics guidelines for epidemiologists have been prepared by various national and international organizations. None, however, have been officially adopted by the American College of Epidemiology (ACE). Recently, the ACE asked its Ethics and Standards of Practice (ESOP) Committee to produce ethics guidelines. In this paper, we explain the context and rationale for this effort, describe the purpose and content of ethics guidelines in epidemiology, and discuss their strengths and weaknesses. Three issues that are central to the mission of ACE-education, policy, and advocacy-are inadequately addressed in existing ethics guidelines. In addition, ethics guidelines are not static documents; they should reflect the changing role of epidemiologists in society, including issues arising in emerging subspecialty areas. New, more dynamic, guidelines that emphasize core values, obligations, and virtues, may help to further define and legitimize the profession of epidemiology and will provide a foundation for the discussion of specific ethical issues in the classroom and in professional practice. Guidelines however, do not provide the final word on ethical issues. Specific degrees cisions in particular cases require judgments made upon reflection of the core values, obligations, and virtues described in the guidelines. From our review, we conclude that a new set of guidelines is reasonable and warranted. Published by Elsevier Science Inc. C1 NCI, EPS, Bethesda, MD 20892 USA. Ctr Dis Control & Prevent, Div Canc Prevent & Control NCCDPHP, Atlanta, GA USA. RP Weed, DL (reprint author), NCI, EPS, Suite T-41,6130 Execut Blvd,MSC 7105, Bethesda, MD 20892 USA. NR 23 TC 14 Z9 14 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD JUL PY 1999 VL 9 IS 5 BP 277 EP 280 DI 10.1016/S1047-2797(99)00012-5 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 210BL UT WOS:000081085200001 PM 10976852 ER PT J AU Giles, WH Kittner, SJ Croft, JB Wozniak, MA Wityk, RJ Stern, BJ Sloan, MA Price, TR McCarter, RJ Macko, RF Johnson, CJ Feeser, BR Earley, CJ Buchholz, DW Stolley, PD AF Giles, WH Kittner, SJ Croft, JB Wozniak, MA Wityk, RJ Stern, BJ Sloan, MA Price, TR McCarter, RJ Macko, RF Johnson, CJ Feeser, BR Earley, CJ Buchholz, DW Stolley, PD TI Distribution and correlates of elevated total homocyst(e)ine: The Stroke Prevention in Young Women Study SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE homocysteine; women; race; correlates ID CORONARY-ARTERY DISEASE; PLASMA HOMOCYSTEINE CONCENTRATIONS; RISK FACTOR; METHYLENETETRAHYDROFOLATE REDUCTASE; VASCULAR-DISEASE; COMMON MUTATION; FOLIC-ACID; HORDALAND HOMOCYSTEINE; FOLATE; DETERMINANTS AB PURPOSE: To determine the distribution and correlates of elevated total homocyst(e)ine (tHcy) concentration in a population of premenopausal black and white women. METHODS: Data from the Stroke Prevention in Young Women Study (N = 304), a population-based study of risk factors for stroke in women aged 15-44 years of age, were used to determine the distribution and correlates of elevated tHcy in black (N = 103) and white women (N = 201). RESULTS: The mean tHcy level for the population was 6.58 mu mol/L (range 2.89-26.5 mu mol/L). Mean tHcy levels increased with age, cholesterol level, alcohol intake, and number of cigarettes smoked tall: (p < 0.05). There were no race differences (mean tHcy 6.72 mu mol/L among blacks and 6.51 mu mol/L among whites; p = 0.4346). Regular use of multivitamins and increasing education was associated with significant reductions in tHcy concentration. Approximately 13% of the sample had elevated tHcy levels, defined as a tHcy concentration greater than or equal to 10.0 mu mol/L. Multivariate-adjusted correlates of elevated tHcy included education > 12 vs. less than or equal to 12 (odds ratio [OR] = 0.4, 95% confidence interval [CI] = 0.2-0.8); smoking greater than or equal to 20 cigarettes/day vs. nonsmokers (OR = 2.8, 95% CI = 1.1-7.3); and the regular use of multivitamins (OR = 0.4, 95% CI = 0.2-0.9). CONCLUSIONS: These results suggest that a substantial proportion of healthy young premenopausal women have tHcy levels that increase their risk for vascular disease. A number of potentially modifiable behavioral and environmental factors appear to be significantly related to elevated tHcy levels in young women. C1 Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Cardiovasc Hlth Branch, Atlanta, GA 30333 USA. Univ Maryland, Dept Neurol, College Pk, MD 20742 USA. Univ Maryland, Ctr Geriatr Res Educ & Clin, College Pk, MD 20742 USA. Univ Maryland, Dept Epidemiol & Prevent Med, College Pk, MD 20742 USA. Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA. Emory Univ, Dept Neurol, Atlanta, GA 30322 USA. RP Giles, WH (reprint author), Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Cardiovasc Hlth Branch, Atlanta, GA 30333 USA. FU NINDS NIH HHS [NS16332-11, K08-NS01764-01A1] NR 39 TC 21 Z9 22 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD JUL PY 1999 VL 9 IS 5 BP 307 EP 313 DI 10.1016/S1047-2797(99)00006-X PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 210BL UT WOS:000081085200006 PM 10976857 ER PT J AU Burg, JR Gist, GL AF Burg, JR Gist, GL TI Health effects of environmental contaminant exposure: An intrafile comparison of the trichloroethylene subregistry SO ARCHIVES OF ENVIRONMENTAL HEALTH LA English DT Article ID TYPEWRITER CORRECTION FLUID; FREQUENCY HEARING-LOSS; LONG-TERM EXPOSURE; DRINKING-WATER; RATS; INHALATION; MICE; SOLVENTS; WORKERS; PERSPECTIVE AB The establishment of the National Exposure Registry represents the first major effort toward longitudinal surveillance of general populations exposed long-term to low levels of specific substances in the environment. The authors investigated the National Exposure Registry's Trichloroethylene Subregistry intrasubregistry differences with respect to health outcomes and the possible relationships with types and levels of chemical exposure. Investigators divided the 4 041 living members of the Trichloroethylene Subregistry into 4 subgroups, by type(s) of exposures (chemicals) and duration and level of exposures. The authors compared the reporting rates for 25 hearth outcomes across subgroups. The authors used logistic regression, in which age, sex, education, smoking history, and occupational history were the covariates. Statistically significant increases in reporting rates were seen with (a) increased maximum trichloroethylene exposures for the outcome stroke, (b) increased cumulative chemical exposure for respiratory allergies, and (c) duration of exposure for hearing impairment. Consistently elevated reporting rates across the exposure subgroups were seen for hearing impairment, speech impairment, asthma and emphysema, respiratory allergies, and stroke. Reporting rates for urinary tract disorders were related only to cumulative chemical levels. The authors noted that there appeared to be a relationship between trichloroethylene and reporting rates fbr speech impairment, hearing impairment, and stroke and between volatile organic compounds and asthma and emphysema, respiratory allergies, and urinary tract disorders. C1 Publ Hlth Serv, Exposure & Dis Registry Branch, Div Hlth Studies,Agcy Tox Subst & Dis Registry, US Dept Heath & Human Serv, Atlanta, GA 30333 USA. RP Burg, JR (reprint author), Publ Hlth Serv, Exposure & Dis Registry Branch, Div Hlth Studies,Agcy Tox Subst & Dis Registry, US Dept Heath & Human Serv, 1600 Clifton Rd,Mailstop E-31, Atlanta, GA 30333 USA. NR 63 TC 11 Z9 12 U1 0 U2 1 PU HELDREF PUBLICATIONS PI WASHINGTON PA 1319 EIGHTEENTH ST NW, WASHINGTON, DC 20036-1802 USA SN 0003-9896 J9 ARCH ENVIRON HEALTH JI Arch. Environ. Health PD JUL-AUG PY 1999 VL 54 IS 4 BP 231 EP 241 PG 11 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 221JB UT WOS:000081723000001 PM 10433181 ER PT J AU Armstrong, LR Derkay, CS Reeves, WC AF Armstrong, LR Derkay, CS Reeves, WC CA RRP Task Force TI Initial results from the national registry for juvenile-onset recurrent respiratory papillomatosis SO ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY LA English DT Article; Proceedings Paper CT 13th Annual Meeting of the American-Society-of-Pediatric-Otolaryngology CY MAY 12-14, 1998 CL PALM BEACH, FLORIDA SP Amer Soc Pediatr Otolaryngol ID LARYNGEAL PAPILLOMAS AB Objective: To characterize the spectrum of juvenile onset recurrent respiratory papillomatosis (RRP) in the United States and to obtain data about the natural course of the disease and its response to treatment. Setting: Twenty tertiary-care pediatric otolaryngology centers throughout the United States. Patients: All patients with active RRP aged less than 18 years at the participating sites. Main Outcome Measures: Number of surgical procedures performed per year, progression of papillomas to previously nondiseased anatomical sites, drug interventions and other adjuvant therapy, and need for tracheostomy. Results: Data were collected from 399 children enrolled from January 1, 1997, through December 31, 1998. There were 51.9% male; 62.7% white, 28.3% black, 9.0% other or unknown racial group; 10.8% Hispanic ethnicity. Mean age at diagnosis was 3.8 years (range, 0.1-16.3 years) and mean duration of disease was 4.4 years (range, 0.03-18.9 years). The mean number of surgical procedures per child was 4.4 per year (range, 0.2-19.3 per year). Children whose RRP was diagnosed at younger ages (<3.0 years) were 3.6 times more likely to have more than 4 surgical procedures per year (P =.001) and almost 2 times more likely to have 2 or more anatomical sites affected (P =.008) than were children whose RRP was diagnosed at later ages (greater than or equal to 3.0 years), after adjusting for sex, race, and years of treatment. Conclusions: Children whose disease was diagnosed before age 3 years were more likely than children aged 3 years or older to have more severe disease as measured by the mean number of surgical procedures performed and by the number of anatomical sites affected. The registry will form the basis for future analysis on the outcome of disease, natural course of RRP under management strategies, prevention strategies, and public health importance. C1 Ctr Dis Control & Prevent, Viral Exanthems & Herpesvirus Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Eastern Virginia Med Sch, Dept Otolaryngol Head & Neck Surg, Norfolk, VA 23501 USA. RP Armstrong, LR (reprint author), Ctr Dis Control & Prevent, Viral Exanthems & Herpesvirus Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Mail Stop A-15,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 9 TC 93 Z9 99 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0886-4470 J9 ARCH OTOLARYNGOL JI Arch. Otolaryngol. Head Neck Surg. PD JUL PY 1999 VL 125 IS 7 BP 743 EP 748 PG 6 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 215ZX UT WOS:000081416800004 PM 10406310 ER PT J AU Steindel, SJ Novis, DA AF Steindel, SJ Novis, DA TI Using outlier events to monitor test turnaround time - A College of American pathologists Q-Probes study in 496 laboratories SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article ID TIMELINESS AB Objectives.-To determine the causes of excessive test turnaround time (TAT) and to identify methods of improvement by studying reasons for those tests reported in excess of 70 minutes from the time the test was ordered tie, outliers). Design.-Self-directed data-gathering of stat outlier TAI events from intensive care units and emergency departments, with descriptive parameters associated with each event and additional descriptive parameters associated with the participant. Participants.-Laboratories enrolled in the 1996 College of American Pathologists Q-Probes program. Main Outcome Measures.-Components associated with outlier TAT events and outlier TAT rates. Results.-Four hundred ninety-six hospital laboratories returned data on 218 551 stat tests, of which 10.6% had TATs in excess of 70 minutes. Ten percent of stat emergency department tests and 14.7% of stat intensive care unit tests were outliers. Major areas in which delays occurred were test ordering, 29.9%; within-laboratory (analytic) phase, 28.2%; collection of the specimen, 27.4%; postanalytic phase, 1.9%; and undetermined, 12.5%. The type of test performed was a significant factor and was independent of location: Chemistry-Multiple Test appeared most frequently (similar to 40%), followed closely by Hematology-Complete Blood Count (similar to 20%) and Chemistry-Single Test (similar to 18%). Factors of outlier TAT components for intensive care unit specimens were identified using statistical modeling and included hour of day, type of health care personnel collecting specimen, performing the test in a stat laboratory, and reason for delay. Outlier rates were not associated with any identified factors. The practice parameters of laboratories with outlier rates in the lowest 10th percentile significantly differed from those with rates in the top 10th percentile in test request computerization, report methods, and ordering methods. Conclusions.-We observed that outlier analysis yields new information, such as type of test and reason for delay, concerning test delays when compared with TAT determination alone. Laboratories experiencing stat test TAT problems should use this tool as an adjunct to routine TAT monitoring for identifying unique causes of delay. C1 Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Div Lab Syst, Lab Performance Assessment Branch, Chamblee, GA 30341 USA. Wentworth Douglass Hosp, Dept Pathol, Dover, NH USA. RP Steindel, SJ (reprint author), Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Div Lab Syst, Lab Performance Assessment Branch, MS G-23,4770 Buford Hwy, Chamblee, GA 30341 USA. NR 21 TC 32 Z9 35 U1 0 U2 0 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 USA SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD JUL PY 1999 VL 123 IS 7 BP 607 EP 614 PG 8 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA 212FQ UT WOS:000081207000012 PM 10388917 ER PT J AU Garrity, GM Boone, DR Brenner, DJ Krieg, NR Staley, JT AF Garrity, GM Boone, DR Brenner, DJ Krieg, NR Staley, JT TI The need for a new division of Environmental Prokaryotic Biology in the NSF SO ASM NEWS LA English DT Letter C1 Michigan State Univ, Dept Microbiol, E Lansing, MI 48824 USA. Portland State Univ, Dept Environm Biol, Portland, OR USA. Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Lab Sect, Atlanta, GA USA. Virginia Polytech Inst & State Univ, Dept Biol, Blacksburg, VA USA. Univ Washington, Seattle, WA USA. NR 1 TC 2 Z9 2 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0044-7897 J9 ASM NEWS JI ASM News PD JUL PY 1999 VL 65 IS 7 BP 459 EP 459 PG 1 WC Microbiology SC Microbiology GA 213UZ UT WOS:000081292800002 ER PT J AU Bratanich, A Lairmore, M Heneine, W Konoby, C Harding, J West, K Vasquez, G Allan, G Ellis, J AF Bratanich, A Lairmore, M Heneine, W Konoby, C Harding, J West, K Vasquez, G Allan, G Ellis, J TI Lack of evidence of conserved lentiviral sequences in pigs with post weaning multisystemic wasting syndrome SO CANADIAN JOURNAL OF VETERINARY RESEARCH-REVUE CANADIENNE DE RECHERCHE VETERINAIRE LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; ENDOGENOUS RETROVIRUS; HUMAN-CELLS; INFECTION; PATHOGENESIS; IDENTIFICATION; DISEASE AB In order to investigate the role of retroviruses in the recently described porcine postweaning multisystemic wasting syndrome (PMWS) serum and leukocytes were screened for reverse transcriptase (RT) activity, and tissues were examined for the presence of conserved lentiviral sequences using degenerate primers in a polymerase chain reaction (PCR), Serum and stimulated leukocytes from the blood and lymph nodes from pigs with PMWS, as well as from control pigs had RT activity that was detected by the sensitive Amp-RT assay. A 257-bp fragment was amplified from DNA from the blood and bone marrow of pigs with PMWS, This fragment was identical in size to conserved lentiviral sequences that were amplified from plasmids containing DNA from several lentiviruses, Cloning and sequencing of the fragment from affected pigs, however, did not reveal homology with the recognized lentiviruses, Together the results of these analyses suggest that the RT activity present in tissues from control and affected pigs is the result of endogenous retrovirus expression, and that a lentivirus is not a primary pathogen in PMWS. C1 Univ Saskatchewan, Western Coll Vet Med, Dept Vet Microbiol, Saskatoon, SK S7N 5B4, Canada. Ohio State Univ, Coll Vet Med, Dept Vet Biosci, Columbus, OH 43210 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Retrovirus Dis Branch, Atlanta, GA 30333 USA. Harding Swine Vet Serv Inc, Humboldt, SK S7N 5E3, Canada. Vet Sci Div, Dept Agr, Belfast BT4 3SD, Antrim, North Ireland. RP Ellis, J (reprint author), Univ Saskatchewan, Western Coll Vet Med, Dept Vet Microbiol, 52 Campus Dr, Saskatoon, SK S7N 5B4, Canada. NR 20 TC 2 Z9 3 U1 0 U2 0 PU CANADIAN VET MED ASSOC PI OTTAWA PA 339 BOOTH ST ATTN: KIMBERLY ALLEN-MCGILL, OTTAWA, ONTARIO K1R 7K1, CANADA SN 0830-9000 J9 CAN J VET RES JI Can. J. Vet. Res.-Rev. Can. Rech. Vet. PD JUL PY 1999 VL 63 IS 3 BP 207 EP 211 PG 5 WC Veterinary Sciences SC Veterinary Sciences GA 219TC UT WOS:000081622300008 PM 10480463 ER PT J AU Yood, MU McCarthy, BD Lee, NC Jacobsen, G Johnson, CC AF Yood, MU McCarthy, BD Lee, NC Jacobsen, G Johnson, CC TI Patterns and characteristics of repeat mammography among women 50 years and older SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID SCREENING MAMMOGRAPHY; BREAST-CANCER; FOLLOW-UP; POPULATION AB Whereas efforts encouraging women to obtain initial mammograms are laudable, the importance of returning for subsequent routine mammograms cannot be minimized. The purpose of this study was to measure the timing, patterns, and characteristics of repeat screening mammography over time in a defined population of health maintenance organization members for whom mammography was a fully covered benefit, We identified all women ages 50-74 years who were enrolled in a southeastern Michigan health maintenance organization, assigned to a large medical group, and received at least one screening mammogram with a normal result between January 1, 1989 and December 31, 1996, Using administrative and radiology data, we calculated the proportion of women who received a subsequent mammogram within 2 Sears and the time to subsequent screening, both overall and stratified by demographic characteristics. We also examined screening patterns over a 5-year period. Of the 8749 women included in this study, 66.0% [95% confidence interval (CI), 65.0-67.0%] were subsequently screened within 2 years. We found slightly higher rates among Caucasians and married women. The proportion of women who received repeat mammography increased with estimated household income [9.5% difference between the highest and lowest categories (95% CI, 6.5-12.5%)]. The median time to subsequent screening was 17.7 months, and the probability of repeat screening was higher for women whose initial mammogram was between January 1992 and December 1994 compared to those receiving an initial mammogram between January 1989 and December 1991 (9.6% difference; 95% CI, 7.5-11.7%). Repeat mammography has improved over time; however, socioeconomic status could contribute to longer-than-intended intervals between screening when translated into real-world clinical practice. In a setting where most physicians recommended annual screening, we found that the median time to subsequent screening was delayed by 6 months. If annual mammography is the goal, recommendations should be made with the understanding of how the timing of repeat screening occurs in clinical practice. C1 Josephine Ford Canc Ctr, Henry Ford Hlth Syst, Detroit, MI 48202 USA. Henry Ford Hlth Sci Ctr, Dept Biostat & Res Epidemiol, Detroit, MI 48202 USA. Ctr Dis Control & Prevent, Div Canc Prevent & Control, Atlanta, GA 30341 USA. RP Yood, MU (reprint author), Josephine Ford Canc Ctr, Henry Ford Hlth Syst, 1 Ford Pl,5C, Detroit, MI 48202 USA. OI Johnson, Christine Cole/0000-0002-6864-6604 NR 16 TC 45 Z9 46 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD JUL PY 1999 VL 8 IS 7 BP 595 EP 599 PG 5 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 217TW UT WOS:000081515900003 PM 10428196 ER PT J AU Allison, KW Burton, L Marshall, S Perez-Febles, A Yarrington, J Kirsh, LB Merriwether-DeVries, C AF Allison, KW Burton, L Marshall, S Perez-Febles, A Yarrington, J Kirsh, LB Merriwether-DeVries, C TI Life experiences among urban adolescents: Examining the role of context SO CHILD DEVELOPMENT LA English DT Article; Proceedings Paper CT Society-for-Child-Development Biannual Conference CY MAR, 1995 CL INDIABAPOLIS, IN SP Soc Child Dev ID SOCIAL SUPPORT; PSYCHOLOGICAL DISTRESS; PSYCHIATRIC-DISORDERS; SOCIOECONOMIC-STATUS; EVENTS; STRESS; VULNERABILITY; SYMPTOMS; FAMILY; CHILD AB Interest in the influence of context on the psychosocial development of adolescents led to the examination of neighborhood effects on the experience of adolescent life stress. Because of concerns regarding the population and ecological validity of existing measures of adolescent life events, the research group developed a scale for the measurement of life events among urban adolescents based on data from focus group interviews in the community of interest. Investigators utilized three strategies to examine the impact of neighborhood on adolescents' perceptions of life stress in a sample of 114 adolescents (mean age = 15). Results indicated that life stress in the peer domain varied by the adolescent's neighborhood of residence. In addition, family/community stress was linearly related to neighborhood indices of economic resources. C1 Virginia Commonwealth Univ, Dept Psychol, Richmond, VA 23284 USA. Penn State Univ, University Pk, PA 16802 USA. Ctr Dis Control, Atlanta, GA 30333 USA. Brown Univ, Providence, RI 02912 USA. RP Allison, KW (reprint author), Virginia Commonwealth Univ, Dept Psychol, 808 W Franklin St,Box 842018, Richmond, VA 23284 USA. EM kallison@vcu.edu FU NIMH NIH HHS [R29 MH46057-01] NR 59 TC 70 Z9 70 U1 5 U2 7 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0009-3920 J9 CHILD DEV JI Child Dev. PD JUL-AUG PY 1999 VL 70 IS 4 BP 1017 EP 1029 DI 10.1111/1467-8624.00074 PG 13 WC Psychology, Educational; Psychology, Developmental SC Psychology GA 221PH UT WOS:000081735100017 PM 10446733 ER PT J AU Martinez, JE Romero-Steiner, S Pilishvili, T Barnard, S Schinsky, J Goldblatt, D Carlone, GM AF Martinez, JE Romero-Steiner, S Pilishvili, T Barnard, S Schinsky, J Goldblatt, D Carlone, GM TI A flow cytometric opsonophagocytic assay for measurement of functional antibodies elicited after vaccination with the 23-valent pneumococcal polysaccharide vaccine SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID STREPTOCOCCUS-PNEUMONIAE; CONJUGATE VACCINES; PHAGOCYTOSIS; IGG; OPSONIZATION; PROTEIN; INVITRO; ADULTS; SERUM AB Opsonophagocytosis is the primary mechanism for clearance of pneumococci from the host, and the measurement of opsonophagocytic antibodies appears to correlate with vaccine-induced protection. We developed a semiautomated flow cytometric opsonophagocytosis assay using HL-60 granulocytes as effector cells and nonviable 5,6-carboxyfluorescein, succinimidyl ester-labeled Streptococcus pneumoniae (serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F) as bacterial targets. The flow cytometric opsonophagocytosis assay was highly reproducible (for 87% of repetitive assays the titers were within 1 dilution of the median titer) and serotype specific, with greater than or equal to 97% inhibition of opsonophagocytic titer by addition of homologous serotype-specific polysaccharide. In general, opsonophagocytic titers were not significantly inhibited by the presence of either heterologous pneumococcal polysaccharide or penicillin in the serum. The flow cytometric assay could reproducibly measure functional antibody activity in prevaccination (n = 28) and postvaccination (n = 36) serum specimens from healthy adult volunteers vaccinated with the 23-valent pneumococcal polysaccharide vaccine. When compared with a standardized manual viable opsonophagocytic assay, a high correlation (r = 0.89; P less than or equal to 0.01) was found between the two assays for the seven serotypes tested. The dow cytometric assay is rapid (similar to 4 h) with high throughput (similar to 50 serum samples per day per technician) and provides a reproducible measurement of serotype-specific functional antibodies, making it a highly suitable assay for the evaluation of the immune responses elicited by pneumococcal vaccines. C1 Ctr Dis Control & Prevent, Resp Dis Branch, Immunol Sect, Div Bacterial & Mycot Dis,Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Inst Child Hlth, London, England. RP Romero-Steiner, S (reprint author), Ctr Dis Control & Prevent, Resp Dis Branch, Immunol Sect, Div Bacterial & Mycot Dis,Natl Ctr Infect Dis, Mailstop A-36, Atlanta, GA 30333 USA. RI Goldblatt, David/C-5972-2008; OI Goldblatt, David/0000-0002-0769-5242; Romero-Steiner, Sandra/0000-0003-4128-7768 NR 28 TC 55 Z9 56 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD JUL PY 1999 VL 6 IS 4 BP 581 EP 586 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 215LA UT WOS:000081382100027 PM 10391867 ER PT J AU Agerton, TB Valway, SE Blinkhorn, RJ Shilkret, KL Reves, R Schluter, WW Gore, B Pozsik, CJ Plikaytis, BB Woodley, C Onorato, IM AF Agerton, TB Valway, SE Blinkhorn, RJ Shilkret, KL Reves, R Schluter, WW Gore, B Pozsik, CJ Plikaytis, BB Woodley, C Onorato, IM TI Spread of strain W, a highly drug-resistant strain of Mycobacterium tuberculosis, across the United States SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID OUTBREAK; TRANSMISSION AB Strain W, a highly drug-resistant strain of Mycobacterium tuberculosis, was responsible for large nosocomial outbreaks in New York in the early 1990s, To describe the spread of strain W outside New York, we reviewed data from epidemiologic investigations, national tuberculosis surveillance, regional DNA fingerprint laboratories, and the Centers for Disease Control and Prevention Mycobacteriology Laboratory to identify potential cases of tuberculosis due to strain W. From January 1992 through February 1997, 23 cases were diagnosed in nine states and Puerto Rico; 8 were exposed to strain W in New York before their diagnosis; 4 of the 23 transmitted disease to 10 others. Eighty-six contacts of the 23 cases are presumed to be infected with strain W; 11 completed alternative preventive therapy. Strain W tuberculosis cases will occur throughout the United States as persons infected in New York move elsewhere. To help track and contain this strain, health departments should notify the Centers for Disease Control and Prevention of cases of tuberculosis resistant to isoniazid, rifampin, streptomycin, and kanamycin. C1 Ctr Dis Control & Prevent, Field Serv Branch, Div TB Eliminat, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidemiol & Surveillance Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div AIDS STD & TB Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Metrohlth Med Ctr, Dept Internal Med, Div Infect Dis, Cleveland, OH USA. New Jersey Dept Hlth & Senior Serv, TB Program, Trenton, NJ USA. Dept Hlth & Hosp, Denver Metro TB Clin, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. S Carolina Dept Hlth & Environm Control, TB Control Program, Columbia, SC 29201 USA. RP Agerton, TB (reprint author), Ctr Dis Control & Prevent, Field Serv Branch, Div TB Eliminat, Mailstop E-10,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 18 TC 91 Z9 100 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 1999 VL 29 IS 1 BP 85 EP 92 DI 10.1086/520187 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 220UF UT WOS:000081685300015 PM 10433569 ER PT J AU Marx, A Gary, HW Marston, BJ Erdman, DD Breiman, RF Torok, TJ Plouffe, JF File, TM Anderson, L AF Marx, A Gary, HW Marston, BJ Erdman, DD Breiman, RF Torok, TJ Plouffe, JF File, TM Anderson, L TI Parainfluenza virus infection among adults hospitalized for lower respiratory tract infection SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 07-16, 1997 CL SAN FRANCISCO, CALIFORNIA SP Infect Dis Soc Amer ID COMMUNITY-ACQUIRED PNEUMONIA; REQUIRING HOSPITALIZATION; ENZYME-IMMUNOASSAY; VIRAL-INFECTIONS; ETIOLOGY; CHILDREN; PATTERNS AB To better define the contribution of human parainfluenza viruses (HPIVs) to lower respiratory tract infection in adults, we tested acute- and convalescent-phase serum specimens from hospitalized adults participating in a population-based prospective study of lower respiratory tract infection during 1991-1992. We tested all available specimens from the epidemic seasons for each virus and similar to 300 randomly selected specimens from the corresponding off-seasons for antibodies to HPIV-1, HPIV-2, or HPIV-3. During the respective epidemic season, HPIV-1 infection was detected in 18 (2.5%) of 721 and HPIV-3 infection in 22 (3.1%) of 705 patients with lower respiratory tract infection. Only 2 (0.2%) of 1,057 patients tested positive for HPIV-2 infection. No HPIV-1 infections and only 2 (0.7% of 281 patients tested) HPIV-3 infections were detected during the off-seasons. HPIV-1 and HPIV-3 were among the four most frequently identified infections associated with lower respiratory tract infection during their respective outbreak seasons. C1 Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30333 USA. Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA USA. Ohio State Univ, Div Infect Dis, Columbus, OH 43210 USA. Summa Hlth Syst, Div Infect Dis, Akron, OH USA. RP Anderson, L (reprint author), Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, 1600 Clifton Rd,Mailstop A-34, Atlanta, GA 30333 USA. NR 31 TC 58 Z9 58 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL PY 1999 VL 29 IS 1 BP 134 EP 140 DI 10.1086/520142 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 220UF UT WOS:000081685300023 PM 10433576 ER PT J AU Krieg, EF Kesner, JS Knecht, EA AF Krieg, EF Kesner, JS Knecht, EA TI An algorithm for detecting features of the hormone profiles of the human menstrual cycle SO COMPUTERS IN BIOLOGY AND MEDICINE LA English DT Article DE algorithm; fuzzy set; signal detection; menstrual cycle; hormone ID PROGESTERONE METABOLITES; URINARY ESTROGEN; OVULATION; RATIO; WOMEN AB An algorithm for detecting features of the cycles of the gonadotropic and ovarian hormones in women is described. The algorithm can detect hormone peaks and normal cycles defined in terms of the peaks in sequences of measurements that have an arbitrary starting point in the menstrual cycle and are of arbitrary length. The algorithm makes use of fuzzy set theory and is optimized using signal detection theory. Published by Elsevier Science Ltd. C1 NIOSH, Div Biomed & Behav Sci, Cincinnati, OH 45226 USA. RP Krieg, EF (reprint author), NIOSH, Div Biomed & Behav Sci, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 10 TC 2 Z9 2 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0010-4825 J9 COMPUT BIOL MED JI Comput. Biol. Med. PD JUL PY 1999 VL 29 IS 4 BP 229 EP 242 DI 10.1016/S0010-4825(99)00007-4 PG 14 WC Biology; Computer Science, Interdisciplinary Applications; Engineering, Biomedical; Mathematical & Computational Biology SC Life Sciences & Biomedicine - Other Topics; Computer Science; Engineering; Mathematical & Computational Biology GA 221BY UT WOS:000081705300001 PM 10439893 ER PT J AU Hughes, JM AF Hughes, JM TI The emerging threat of bioterrorism SO EMERGING INFECTIOUS DISEASES LA English DT Editorial Material C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Hughes, JM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, 1600 Clifton Rd NE,Mail Stop C12, Atlanta, GA 30333 USA. NR 1 TC 8 Z9 10 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUL-AUG PY 1999 VL 5 IS 4 BP 494 EP 495 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 225WE UT WOS:000081988300003 PM 10458949 ER PT J AU Aviles, G Rangeon, G Vorndam, V Briones, A Baroni, P Enria, D Sabattini, MS AF Aviles, G Rangeon, G Vorndam, V Briones, A Baroni, P Enria, D Sabattini, MS TI Dengue reemergence in Argentina SO EMERGING INFECTIOUS DISEASES LA English DT Article ID INFECTIONS; VIRUSES AB Aedes aegypti, eradicated from Argentina in 1963, has now reinfested the country as far south as Buenos Aires. In 1997, four persons with travel histories to Brazil, Ecuador, or Venezuela had confirmed dengue, and surveillance for indigenous transmission allowed the detection of 19 dengue cases in Salta Province. These cases of dengue are the first in Argentina since 1916 and represent a new southern extension of dengue virus. C1 Inst Nacl Enfermedades Virales Humanas Dr Julio I, Adm Nacl Lab, RA-2700 Pergamino, Argentina. Inst Nacl Enfermedades Virales Humanas Dr Julio I, Inst Salud Dr C Malbran, RA-2700 Pergamino, Argentina. Minist Salud, Salta, Argentina. Ctr Dis Control & Prevent, San Juan, PR USA. Delegac Sanitaria Fed, Salta, Argentina. RP Aviles, G (reprint author), Inst Nacl Enfermedades Virales Humanas Dr Julio I, Adm Nacl Lab, Monteagudo 2510, RA-2700 Pergamino, Argentina. NR 12 TC 37 Z9 42 U1 1 U2 2 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUL-AUG PY 1999 VL 5 IS 4 BP 575 EP 578 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 225WE UT WOS:000081988300024 PM 10460181 ER PT J AU Carpenter, C Fayer, R Trout, J Beach, MJ AF Carpenter, C Fayer, R Trout, J Beach, MJ TI Chlorine disinfection of recreational water for Cryptosporidium parvum SO EMERGING INFECTIOUS DISEASES LA English DT Article ID SWIMMING POOL; OOCYSTS; OUTBREAK; INACTIVATION AB We examined the effects of chlorine on oocyst viability, under the conditions of controlled pH and elevated calcium concentrations required for most community swimming pools. We found that fecal material may alter the Ct values (chlorine concentration in mg/L, multiplied by time in minutes) needed to disinfect swimming pools or other recreational water for Cryptosporidium parvum. C1 USDA ARS, LPSI, Beltsville, MD 20705 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Carpenter, C (reprint author), USDA ARS, LPSI, 10300 Baltimore Ave,Bldg 1040, Beltsville, MD 20705 USA. NR 34 TC 57 Z9 59 U1 0 U2 9 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUL-AUG PY 1999 VL 5 IS 4 BP 579 EP 584 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 225WE UT WOS:000081988300025 PM 10458969 ER PT J AU McDade, JE AF McDade, JE TI Addressing the potential threat of bioterrorism - Value added to an improved public health infrastructure SO EMERGING INFECTIOUS DISEASES LA English DT Editorial Material C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP McDade, JE (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 8 TC 13 Z9 13 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUL-AUG PY 1999 VL 5 IS 4 BP 591 EP 592 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 225WE UT WOS:000081988300028 PM 10458972 ER PT J AU LeDuc, JW Becher, J AF LeDuc, JW Becher, J TI Current status of smallpox vaccine SO EMERGING INFECTIOUS DISEASES LA English DT Letter C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP LeDuc, JW (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 2 TC 13 Z9 13 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JUL-AUG PY 1999 VL 5 IS 4 BP 593 EP 594 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 225WE UT WOS:000081988300029 PM 10458973 ER PT J AU Romieu, I Ramirez, M Meneses, F Ashley, D Lemire, S Colome, S Fung, K Hernandez-Avila, M AF Romieu, I Ramirez, M Meneses, F Ashley, D Lemire, S Colome, S Fung, K Hernandez-Avila, M TI Environmental exposure to volatile organic compounds among workers in Mexico city as assessed by personal monitors and blood concentrations SO ENVIRONMENTAL HEALTH PERSPECTIVES LA English DT Article DE benzene; blood benzene levels; Mexico; personal exposure; volatile organic compounds; worker ID OXYGENATED FUEL; BENZENE; FAIRBANKS; ALASKA AB Benzene, an important component in gasoline, is a widely distributed environmental contaminant that has been linked to known health effects in animals and humans, including leukemia. In Mexico City, environmental benzene levels, which may be elevated because of the heavy traffic and the poor emission control devices of older vehicles, may pose a health risk to the population. To assess the potential risk, portable passive monitors and blood concentrations were used to survey three different occupational groups in Mexico City. Passive monitors measured the personal exposure of 45 workers to benzene, ethylbenzene, toluene, o-xylene and m-/p-xylene during a work shift. Blood concentrations of the above volatile organic compounds (VOCs), methyl tert-butyl ether, and styrene were measured at the beginning and the end of a work shift. Passive monitors showed significantly higher (p > 0.0001) benzene exposure levels among service station attendants (median = 330 mu g/m(3); range 130-770) as compared to street vendors (median = 62 mu g/m(3); range 49-180) and office workers (median = 44 mu g/m(3), range 32-67). Baseline blood benzene levels (BBLs) for these groups were higher than those reported for similar populations from Western countries (median = 0.63 mu g/L, n = 24 for service station attendants; median = 0.30 mu g/L, n = 6 for street vendors; and median = 0.17 mu g/L, n = 7 for office workers). Nonsmoking office workers who were nonoccupationally exposed to VOCs had BBLs that were more than five times higher than those observed in a nonsmoking U.S. population. BBLs of participants did not increase during the work shift, suggesting that because the participants were chronically exposed to benzene, complex pharmacokinetic mechanisms were involved. Our results highlight the need for more complete studies to assess the potential benefits of setting environmental standards for benzene and other VOCs in Mexico. C1 HSB, Natl Ctr Environm Hlth, Ctr Dis Control & Prevent, CDC,NCEH,EHHE, Atlanta, GA 30341 USA. Inst Nacl Salud Publ, Cuernavaca, Morelos, Mexico. Integrated Environm Serv, Irvine, CA USA. AtmAA, Calabasas, CA USA. Pan Amer Hlth Org, Mexico City, DF, Mexico. RP Romieu, I (reprint author), HSB, Natl Ctr Environm Hlth, Ctr Dis Control & Prevent, CDC,NCEH,EHHE, MS-F46,4770 Buford Highway, Atlanta, GA 30341 USA. EM IAR9@CDC.GOV FU FIC NIH HHS [TW00623] NR 29 TC 21 Z9 21 U1 1 U2 7 PU US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE PI RES TRIANGLE PK PA NATL INST HEALTH, NATL INST ENVIRONMENTAL HEALTH SCIENCES, PO BOX 12233, RES TRIANGLE PK, NC 27709-2233 USA SN 0091-6765 J9 ENVIRON HEALTH PERSP JI Environ. Health Perspect. PD JUL PY 1999 VL 107 IS 7 BP 511 EP 515 DI 10.2307/3434391 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 216DX UT WOS:000081426900019 PM 10378996 ER PT J AU Ting, BG Paschal, DC Jarrett, JM Pirkle, JL Jackson, RJ Sampson, EJ Miller, DT Caudill, SP AF Ting, BG Paschal, DC Jarrett, JM Pirkle, JL Jackson, RJ Sampson, EJ Miller, DT Caudill, SP TI Uranium and thorium in urine of United States residents: Reference range concentrations SO ENVIRONMENTAL RESEARCH LA English DT Article DE metals; urine; uranium; thorium; radionuclide ID PLASMA-MASS-SPECTROMETRY; BLOOD; SERUM AB We measured uranium and thorium in urine of 500 U.S. residents to establish reference range concentrations using a magnetic-sector inductively coupled argon plasma mass spectrometer (ICP-MS). We found uranium at detectable concentrations in 96.6% of the urine specimens and thorium in 39.6% of the specimens. The 95th percentile concenetration for uranium was 34.5 ng/L (parts per trillion); concentrations ranged up to 4080 ng/L. Thorium had a 95th percentile concentration of 3.09 ng/L; concentrations ranged up to 7.7 ng/L. (C) 1999 Academic Press. C1 Ctr Dis Control & Prevent, Div Environm Hlth Lab Sci, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Ting, BG (reprint author), Ctr Dis Control & Prevent, Div Environm Hlth Lab Sci, Natl Ctr Environm Hlth, 4770 Butford Highway, Atlanta, GA 30341 USA. OI Jarrett, Jeffery/0000-0001-5755-3552 NR 23 TC 44 Z9 44 U1 0 U2 1 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0013-9351 J9 ENVIRON RES JI Environ. Res. PD JUL PY 1999 VL 81 IS 1 BP 45 EP 51 DI 10.1006/enrs.1998.3951 PG 7 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 210PF UT WOS:000081113300005 PM 10361025 ER PT J AU Abu-Hashish, M Safi, J El-Haj, S Sansur, R Jaqhabir, M Fischbein, A Ben-Michael, E Choudhri, Y Richter, ED Rosenblum, L AF Abu-Hashish, M Safi, J El-Haj, S Sansur, R Jaqhabir, M Fischbein, A Ben-Michael, E Choudhri, Y Richter, ED Rosenblum, L TI Lead exposure in children: A project in trans-border epidemiology SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Bir Zeit Univ, Birzeit, Israel. Univ Appl Sci, Amman, Jordan. Hebrew Univ Jerusalem, Jerusalem, Israel. Bar Ilan Univ, Ramat Gan, Israel. CDC, Atlanta, GA 30333 USA. RI Friedman, Lee/G-9799-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 168O BP S73 EP S73 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100198 ER PT J AU Balluz, L Philen, R Brock, J Falter, K Kiefer, M Hart, R Hill, RH AF Balluz, L Philen, R Brock, J Falter, K Kiefer, M Hart, R Hill, RH TI Health complaints related to pesticide stored at a public health clinic SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 358P BP S124 EP S124 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100389 ER PT J AU Barr, DB Driskell, WJ Beeson, MD Harmon, IR Needham, LL AF Barr, DB Driskell, WJ Beeson, MD Harmon, IR Needham, LL TI Biological monitoring of dialkyl phosphates in urine as indicators of cumulative exposure to organophosphate insecticides SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. RI Needham, Larry/E-4930-2011; Barr, Dana/E-2276-2013; Barr, Dana/E-6369-2011 NR 0 TC 0 Z9 0 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 356O BP S123 EP S123 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100386 ER PT J AU Barr, JR Barr, DB Needham, LL AF Barr, JR Barr, DB Needham, LL TI Quantification of methyleugenol in human serum. SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. RI Needham, Larry/E-4930-2011; Barr, Dana/E-2276-2013; Barr, Dana/E-6369-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 478O BP S159 EP S159 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100508 ER PT J AU Lebowitz, MD O'Rourke, MK Needham, LL Robertson, G Rogan, SR Reses, J Pirkle, JL Ashley, DA Paschal, DC AF Lebowitz, MD O'Rourke, MK Needham, LL Robertson, G Rogan, SR Reses, J Pirkle, JL Ashley, DA Paschal, DC TI Distributions of biomarkers and concentrations of metals, pesticides & vocs on the US-Mexico border. SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Univ Arizona, Tucson, AZ USA. US EPA, Las Vegas, NV 89193 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RI Needham, Larry/E-4930-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 357O BP S124 EP S124 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100387 ER PT J AU Needham, LL Pirkle, JL Ashley, DL Patterson, DG Barr, JR Barr, DB Sampson, EJ AF Needham, LL Pirkle, JL Ashley, DL Patterson, DG Barr, JR Barr, DB Sampson, EJ TI Role of biomonitoring in human exposure assessment SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Sci Lab, Atlanta, GA 30341 USA. RI Needham, Larry/E-4930-2011; Barr, Dana/E-2276-2013; Barr, Dana/E-6369-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 162O BP S71 EP S71 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100193 ER PT J AU Posada, M Philen, R Schurtz, H Blount, B Ruiz, MV Hill, RH Gimene, O Gomez, A Abaitua, I AF Posada, M Philen, R Schurtz, H Blount, B Ruiz, MV Hill, RH Gimene, O Gomez, A Abaitua, I TI Epidemiology and laboratory production of a new class of compounds associated with toxic oil syndrome. SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Inst Salud Carlos III, Ctr Invest Para El Sidrome Aceite Toxico, Madrid, Spain. Ctr Dis Control & Prevent, Atlanta, GA USA. OI Posada, Manuel/0000-0002-8372-4180 NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 481O BP S159 EP S159 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100511 ER PT J AU Stokes, L McNeill, FE Chettle, DR Kaye, WE AF Stokes, L McNeill, FE Chettle, DR Kaye, WE TI Anemia and increased bone lead 20 years after childhood exposure to lead: The Bunker Hill experience SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 McMaster Univ, Hamilton, ON, Canada. CDC, ATSDR, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 172O BP S74 EP S74 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100202 ER PT J AU Stone, AE Wong, LY Lin, B Lynberg, M Correa, A AF Stone, AE Wong, LY Lin, B Lynberg, M Correa, A TI Assessing exposure to trihalomethanes in tap water in studies of pregnancy outcome. SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 371P BP S127 EP S127 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100401 ER PT J AU Wagner, RM Henriques, WD Brewer, BD Albano, JP Rao, RA Thomas, BE White, MC AF Wagner, RM Henriques, WD Brewer, BD Albano, JP Rao, RA Thomas, BE White, MC TI Use of GIS to evaluate proximity of schools to hazardous waste sites SO EPIDEMIOLOGY LA English DT Meeting Abstract C1 Agcy & Tox Subst & Dis Registry, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD JUL PY 1999 VL 10 IS 4 MA 386O BP S132 EP S132 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 208JK UT WOS:000080987100416 ER PT J AU Kegler, MC Kingsley, B Malcoe, LH Cleaver, V Reid, J Solomon, G AF Kegler, MC Kingsley, B Malcoe, LH Cleaver, V Reid, J Solomon, G TI The functional value of smoking and nonsmoking from the perspective of American Indian youth SO FAMILY & COMMUNITY HEALTH LA English DT Article DE adolescent smoking; American Indian; qualitative methods; tobacco ID PARENTAL SMOKING; ADOLESCENT SMOKING; CIGARETTE-SMOKING; RISK-FACTORS; TOBACCO; FRIENDS; ONSET; DRUG AB In spite of having the highest rate of smoking among major racial/ethnic groups in the U.S., very little research has been conducted on the initiation of smoking among American Indians. This research used focus groups to explore the functional value of smoking and nonsmoking from the perspective of American Indian youth. For smokers, the functional Value of smoking was associated with peers, mood, image, addiction, family, and sensory pleasure. For nonsmokers, the functional value of nonsmoking was related to sensory aspects, health consequences, physical performance, physiologic response, and family. Subtleties associated with each of these themes highlight the complexity of designing interventions to prevent American Indian youth from smoking. C1 Univ Oklahoma, Hlth Sci Ctr, Coll Publ Hlth, Dept Hlth Promot Sci, Oklahoma City, OK 73104 USA. Ctr Dis Control & Prevent, Off Smoking & Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. Univ Oklahoma, Hlth Sci Ctr, Coll Publ Hlth, Dept Biostat & Epidemiol, Oklahoma City, OK 73104 USA. Cherokee Nat, Tahlequah, OK 74464 USA. Childrens Hosp Oklahoma, Oklahoma City, OK USA. RP Kegler, MC (reprint author), Univ Oklahoma, Hlth Sci Ctr, Coll Publ Hlth, Dept Hlth Promot Sci, Oklahoma City, OK 73104 USA. NR 30 TC 18 Z9 19 U1 1 U2 3 PU ASPEN PUBL INC PI FREDERICK PA 7201 MCKINNEY CIRCLE, FREDERICK, MD 21704 USA SN 0160-6379 J9 FAM COMMUNITY HEALTH JI Fam. Community Health PD JUL PY 1999 VL 22 IS 2 BP 31 EP 42 PG 12 WC Family Studies; Public, Environmental & Occupational Health SC Family Studies; Public, Environmental & Occupational Health GA 204WL UT WOS:000080788300005 ER PT J AU Meltzer, M Messonnier, ML AF Meltzer, M Messonnier, ML TI Economic models of hepatitis A virus immunization SO HEPATOLOGY LA English DT Letter C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Prevent Effectiveness Branch, Atlanta, GA 30333 USA. RP Meltzer, M (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 6 TC 2 Z9 2 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JUL PY 1999 VL 30 IS 1 BP 343 EP 343 DI 10.1002/hep.510300129 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 211FW UT WOS:000081151000052 PM 10428626 ER PT J AU Marston, EL Sumner, JW Regnery, RL AF Marston, EL Sumner, JW Regnery, RL TI Evaluation of intraspecies genetic variation within the 60 kDa heat-shock protein gene (groEL) of Bartonella species SO INTERNATIONAL JOURNAL OF SYSTEMATIC BACTERIOLOGY LA English DT Article DE Bartonella; groEL; 16S rRNA; maximum-likelihood; parsimony analysis ID CITRATE SYNTHASE GENE; VIRUS-POSITIVE PATIENT; CAT-SCRATCH DISEASE; SP-NOV; NUCLEOTIDE-SEQUENCE; ESCHERICHIA-COLI; RIBOSOMAL-RNA; EVOLUTIONARY RELATIONSHIPS; AGROBACTERIUM-TUMEFACIENS; PHYLOGENETIC ANALYSIS AB A phylogenetic investigation was done on the members of the genus Bartonella, based on the DNA sequence analysis of the groEL gene, which encodes the 60 kDa heat-shock protein GroEL. Nucleotide sequence data were determined for a near full-length fragment (1368 bp) of the groEL gene of the established Bartonella species and used to infer intraspecies phylogenetic relationships. Phylogenetic trees were inferred from multiple sequence alignments by using both distance and parsimony methods, which demonstrated an architecture composed of six well-supported lineages. The results are consistent with relationships deduced from recent sequence analysis studies based upon citrate synthase (gltA) sind previously observed genotypic and phenotypic characteristics; however, they showed greater statistical support at the intragenus level. This suggests that groEL may be a more robust tool for phylogenetic analysis of Bartonella lineages. C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Marston, EL (reprint author), Ctr Dis Control & Prevent, Mailstop G-05,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 65 TC 48 Z9 50 U1 0 U2 1 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING, BERKS, ENGLAND RG7 1AE SN 0020-7713 J9 INT J SYST BACTERIOL JI Int. J. Syst. Bacteriol. PD JUL PY 1999 VL 49 BP 1015 EP 1023 PN 3 PG 9 WC Microbiology SC Microbiology GA 216ND UT WOS:000081448000010 PM 10425758 ER PT J AU Feresu, SB Steigerwalt, AG Brenner, DJ AF Feresu, SB Steigerwalt, AG Brenner, DJ TI DNA relatedness of Leptospira strains isolated from beef cattle in Zimbabwe SO INTERNATIONAL JOURNAL OF SYSTEMATIC BACTERIOLOGY LA English DT Article DE DNA relatedness; Leptospira borgpetersenii; Leptospira kirschneri ID RESTRICTION-ENDONUCLEASE ANALYSIS; FRAGMENT-LENGTH-POLYMORPHISMS; POLYMERASE CHAIN-REACTION; ARBITRARILY PRIMED PCR; SEROVAR HARDJO; RAPID IDENTIFICATION; RIBOSOMAL DNA; INTERROGANS; SEROGROUP; HYBRIDIZATION AB The DNA relatedness of 17 Leptospira strains isolated from beef cattle in Zimbabwe was determined using the hydroxyapatite method. Similarly to previously speciated African strains, all Zimbabwe isolates belonged to either Leptospira borgpetersenii or Leptospira kirschneri. All serovars within serogroups Pyrogenes (kwale, mombe and a strain closely related to serovar nigeria), Hebdomadis (marondera and mhou), Tarassovi (ngavi) and Sejroe (balcanica and hardjo) were L. borgpetersenii. L. kirschneri contained all strains in serovars of serogroups Icterohaemorrhagiae (zimbabwe), Australis (fugis), Bataviae (paidjan) and Pomona (a strain closely related to mozdok). The species designations of the Zimbabwe fugis and paidjan strains were different from those of the reference strains of these two serovars, both of which belong to Leptospira interrogans. C1 Univ Zimbabwe, Dept Biol Sci, Harare, Zimbabwe. Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Feresu, SB (reprint author), Univ Zimbabwe, Dept Biol Sci, MP 167, Harare, Zimbabwe. NR 45 TC 9 Z9 9 U1 0 U2 0 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING, BERKS, ENGLAND RG7 1AE SN 0020-7713 J9 INT J SYST BACTERIOL JI Int. J. Syst. Bacteriol. PD JUL PY 1999 VL 49 BP 1111 EP 1117 PN 3 PG 7 WC Microbiology SC Microbiology GA 216ND UT WOS:000081448000020 PM 10425768 ER PT J AU Lansky, A Jones, JL Burkham, S Reynolds, K Bohannon, B Bertolli, J AF Lansky, A Jones, JL Burkham, S Reynolds, K Bohannon, B Bertolli, J TI Adequacy of prenatal care and prescription of zidovudine to prevent perinatal HIV transmission SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE AIDS; HIV; pregnancy; prenatal care; zidovudine ID HUMAN-IMMUNODEFICIENCY-VIRUS; UNITED-STATES; WOMEN; PREGNANCY; INFECTION; SPECTRUM; DISEASE; TRENDS; TYPE-1; RISK AB In 1994, data were published on the effectiveness of zidovudine in pre venting perinatal transmission of HIV infection. Using data from surveillance projects in San Antonio, Dallas, and Houston, Texas, U.S.A., we linked records of children born from 1987 through 1996 with records of their HIV-infected mothers. Prenatal care was measured by Kotelchuck's Adequacy of Prenatal Care Utilization (APNCU) Index. We examined the association between adequacy of prenatal care and four measures of zidovudine prescription: prenatal, intrapartum, neonatal, and the complete regimen. Inclusion criteria was that the mother's HIV infection was diagnosed before a live birth; 221 mother-infant pairs were included in the analysis. Overall. 68% received inadequate or no prenatal care. Over time, the proportion of mother-infant pairs with adequate prenatal care doubled (24%-48%; relative risk [RR], 2.0; 95% confidence interval [CI], 1.3-3.0), and the proportion prescribed prenatal zidovudine tripled (20%-67%; RR, 3.3; 95% CI, 2.4-4.9). In logistic regression, APNCU (adjusted odds ratio [aOR], 2.6, 95% CI, 1.1-6.2) and time period (aOR, 19.9; 95% CI, 8.1-48.7) were associated with prenatal prescription of zidovudine. The benefits of prenatal care, including HIV testing and zidovudine treatment, underscore the urgent need to improve access to and use of prenatal care services. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA 30333 USA. Texas Dept Hlth, Hlth Care Financing Div, Bur Informat Resources, Houston, TX USA. Houston Dept Hlth & Human Serv, HIV AIDS Surveillance Program, Houston, TX USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv Program, Atlanta, GA 30333 USA. RP Lansky, A (reprint author), Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, 1600 Clifton Rd,Mailstop E-47, Atlanta, GA 30333 USA. NR 23 TC 9 Z9 9 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD JUL 1 PY 1999 VL 21 IS 3 BP 223 EP 227 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 216YY UT WOS:000081473100007 PM 10421246 ER PT J AU Kaplan, JE Parham, DL Soto-Torres, L van Dyck, K Greaves, JA Rauch, K Ellis, B Amandus, HE AF Kaplan, JE Parham, DL Soto-Torres, L van Dyck, K Greaves, JA Rauch, K Ellis, B Amandus, HE TI Adherence to guidelines for antiretroviral therapy and for preventing opportunistic infections in HIV-infected adults and adolescents in Ryan White-funded facilities in the United States SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV; guidelines; adherence; antiretroviral therapy; opportunistic infections AB To determine adherence by health care providers to guidelines for antiretroviral therapy and for prevention of opportunistic infections (OIs) in adults with HIV infection in federally funded facilities in the United States, we reviewed records of HIV-infected adults (>13 years) in 11 Ryan White Title III facilities in four states for information on eight standard-of-care recommendations during November 1996 through September 1997. Eligibility required a visit to the facility within 6 months before record abstraction and a lowest CD4(+) lymphocyte count <500 cells/mu l. Reviews were completed for 148 patients in Maryland, 355 in New York, 370 in Georgia, and 538 in Illinois. Adherence to prevention measures by health care providers was >85% for HIV plasma RNA testing, prescription of antiretroviral therapy, Pneumocystis carinii pneumonia (PCP) prophylaxis, anti-Toxoplasma antibody testing, and obtaining Papanicolaou (Pap) smears but lower (69%-80%) for Mycobacterium avium complex (MAC) prophylaxis, tuberculin skin testing (TST), and pneumococcal vaccination. Adherence was similar by patient age, gender, racial/ethnic group, urban versus rural, and hospital versus clinic setting but was generally lower for injecting drug users (IDUs) than for patients with other HIV exposures (p < .05 by multivariate analysis for TST, anti-Toxoplasma antibody testing, Pap smear, and measurement of HIV plasma RNA). Adherence by health care providers to guidelines for preventing OIs in these federally funded facilities is generally high but could be improved for some prevention measures, for instance, MAC prophylaxis, TST, and pneumococcal vaccination, especially for IDUs. C1 Ctr Dis Control & Prevent, Div HIV AIDS Prenvent Surveillance & Epidemiol, Natl Ctr HIV Sexually Transmitted Dis & TB Preven, Atlanta, GA 30333 USA. US Hlth Resources & Serv Adm, Div Community Based Programs, HIV AIDS Bur, Rockville, MD 20857 USA. Battelle, Ctr Publ Hlth Res & Evaluat, Arlington, VA USA. RP Kaplan, JE (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prenvent Surveillance & Epidemiol, Natl Ctr HIV Sexually Transmitted Dis & TB Preven, Mailstop G-29, Atlanta, GA 30333 USA. NR 14 TC 28 Z9 28 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD JUL 1 PY 1999 VL 21 IS 3 BP 228 EP 235 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 216YY UT WOS:000081473100008 PM 10421247 ER PT J AU MacQueen, KM Vanichseni, S Kitayaporn, D Lin, LS Buavirat, A Naiwatanakul, T Raktham, S Mock, P Heyward, WL Des Jarlais, DC Choopanya, K Mastro, TD AF MacQueen, KM Vanichseni, S Kitayaporn, D Lin, LS Buavirat, A Naiwatanakul, T Raktham, S Mock, P Heyward, WL Des Jarlais, DC Choopanya, K Mastro, TD TI Willingness of injection drug users to participate in an HIV vaccine efficacy trial in Bangkok, Thailand SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE vaccine; drug users; knowledge; attitudes; HIV-1; Thailand ID HIGH-RISK POPULATIONS; SUBTYPE-E; INFECTION AB We assessed willingness to participate in an HIV recombinant gp120 bivalent subtypes B/E candidate vaccine efficacy trial among 193 injection drug users (IDUs) attending drug treatment clinics in Bangkok;, Thailand. IDUs previously enrolled in a prospective cohort study were invited to group sessions describing a potential trial, then completed questionnaires assessing comprehension and willingness to participate. A week later, they completed a follow-up questionnaire that again assessed comprehension and willingness to participate, as well as barriers to and positive motives for participation, with whom (if anyone) they talked about the information, and whether others thought participation was a good, bad, or neutral idea. At baseline, 51% were definitely willing to participate, and at follow-up 54%; only 3% were not willing to participate at either time. Comprehension was high at baseline and improved at follow-up. Participants who viewed altruism, regular HIV tests, and family support for participation as important were more willing to volunteer. Frequency of incarceration and concerns about the length of the trial, possible vaccine-induced accelerated disease progression, and lack of family support were negatively associated with willingness. Overall, IDUs comprehended the information needed to make a fully informed decision about participating in an rgp120 vaccine efficacy trial and expressed a high level of willingness to participate in such a trial. C1 Ctr Dis Control & Prevent, Natl Cr HIV STD & TB Prevent, Off Commun, Div HIV AIDS Prevent, Atlanta, GA 30333 USA. Bangkok Metropolitan Adm, Bangkok, Thailand. Mahidol Univ, Fac Trop Med, Bangkok, Thailand. Beth Israel Med Ctr, New York, NY 10003 USA. HIV AIDS Collaborat, Nonthaburi, Thailand. RP MacQueen, KM (reprint author), Ctr Dis Control & Prevent, Natl Cr HIV STD & TB Prevent, Off Commun, Div HIV AIDS Prevent, Mail Stop E-06,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 22 TC 49 Z9 49 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD JUL 1 PY 1999 VL 21 IS 3 BP 243 EP 251 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 216YY UT WOS:000081473100010 PM 10421249 ER PT J AU Alonso-Echanove, J Robles, B Jarvis, WR AF Alonso-Echanove, J Robles, B Jarvis, WR CA Spanish VRE Study Grp TI Proficiency of clinical laboratories in spain in detecting vancomycin-resistant Enterococcus spp. SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID ANTIMICROBIAL SUSCEPTIBILITY; OUTBREAK; FAECIUM; ABILITY AB Studies in a variety of U.S. clinical laboratories have demonstrated difficulty in detecting intermediate and low-level vancomycin-resistant enterococci (VRE), The misclassification of "at least intermediate resistant isolates" as vancomycin susceptible may hale both clinical implications and a negative impact on measures to control the spread of VRE, No published study has assessed the ability of clinical laboratories in Europe to detect VRE. So, the apparent low prevalence of VRE in European hospitals may be, in part, secondary to the inability of these laboratories to detect all VRE. In an effort to assess European laboratories' proficiency in detecting VRE, we identified 22 laboratories in Spain and asked them to test four VRE strains and one susceptible enterococcal strain from the Centers for Disease Control and Prevention collection. Each organism was tested by the routine antimicrobial susceptibility testing method used by each laboratory. Overall, VRE were correctly identified in 61 of 88 (69.1%) instances. The accuracy of VRE detection varied with the level of resistance and the antimicrobial susceptibility method. The high-level resistant strain (Enterococcus faecium; MIC, 512 mu g/ml) was accurately detected in 20 of 22 (91.3%) instances, whereas the intermediate-resistant isolate (Enterococcus gallinarum; MIC, 8 mu g/ml) was accurately detected in only 11 of 22 (50%) instances. Classification errors occurred in 27 of 88 (30.9%) instances. Misclassification as vancomycin susceptible was the most common error (16 of 27 [59.3%] instances). Our study shows that the participating Spanish laboratories had an overall acceptable proficiency in detecting VRE but that a substantial proportion of VRE isolates with low or intermediate levels of resistance were not detected. We recommend that studies be conducted to validate laboratory proficiency testing as an important step in the prevention and control of the spread of antimicrobial resistance. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Atlanta, GA 30333 USA. Consejeria Serv Sociales, Oviedo 33005, Asturias, Spain. RP Jarvis, WR (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, MS E69,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 17 TC 13 Z9 14 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUL PY 1999 VL 37 IS 7 BP 2148 EP 2152 PG 5 WC Microbiology SC Microbiology GA 206FR UT WOS:000080867100004 PM 10364577 ER PT J AU Maslanka, SE Kerr, JG Williams, G Barbaree, JM Carson, LA Miller, JM Swaminathan, B AF Maslanka, SE Kerr, JG Williams, G Barbaree, JM Carson, LA Miller, JM Swaminathan, B TI Molecular subtyping of Clostridium perfringens by pulsed-field gel electrophoresis to facilitate food-borne-disease outbreak investigations SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID UNITED-STATES; ENTEROTOXIN; INFECTIONS; STRAINS; GENE AB Clostridium perfringens is a common cause of food-borne illness, The illness is characterized by profuse diarrhea and acute abdominal pain. Since the illness is usually self-limiting, many cases are undiagnosed and/or not reported. Investigations are often pursued after an outbreak involving large numbers of people in institutions, at restaurants, or at catered meals. Serotyping has been used in the past to assist epidemiologic investigations of C. perfringens outbreaks, However, serotyping reagents are not widely available, and many isolates are often untypeable with existing reagents. me developed a pulsed-field gel electrophoresis (PFGE) method for molecular subtyping of C. perfringens isolates to aid in epidemiologic investigations of food-borne outbreaks, Six restriction endonucleases (SmaI, ApaI, FspI, MluI, KspI, and;XbaI) were evaluated with a select panel of C. perfringens strains. SmaI was chosen for further studies because it produced 11 to 13 well-distributed bands of 40 to similar to 1,100 kb which provided good discrimination between isolates. Seventeen distinct patterns were obtained with 62 isolates from seven outbreak investigations or control strains, In general, multiple isolates from a single individual had indistinguishable PFGE patterns. Epidemiologically unrelated isolates (outbreak or control strains) had unique patterns; isolates from different individuals within an outbreak had similar, if not identical, patterns. PFGE identifies clonal relationships of isolates which will assist epidemiologic investigations of food-borne-disease outbreaks caused by C. perfringens. C1 Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Foodborne & Diarrheal Dis Branch, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Hosp Infect Program, Atlanta, GA 30333 USA. Auburn Univ, Auburn, AL 36849 USA. RP Maslanka, SE (reprint author), Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Foodborne & Diarrheal Dis Branch, Natl Ctr Infect Dis, 1600 Clifton Rd,Mailstop C03, Atlanta, GA 30333 USA. NR 32 TC 46 Z9 52 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUL PY 1999 VL 37 IS 7 BP 2209 EP 2214 PG 6 WC Microbiology SC Microbiology GA 206FR UT WOS:000080867100014 PM 10364587 ER PT J AU Moura, H Sodre, FC Bornay-Llinares, FJ Leitch, GJ Navin, T Wahlquist, S Bryan, R Meseguer, I Visvesvara, GS AF Moura, H Sodre, FC Bornay-Llinares, FJ Leitch, GJ Navin, T Wahlquist, S Bryan, R Meseguer, I Visvesvara, GS TI Detection by an immunofluorescence test of Encephalitozoon intestinalis spores in routinely formalin-fixed stool samples stored at room temperature SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; SUBUNIT RIBOSOMAL-RNA; MICROSPORIDIAN SEPTATA-INTESTINALIS; VIRUS-INFECTED PATIENTS; ENTEROCYTOZOON-BIENEUSI; AIDS PATIENT; MONOCLONAL-ANTIBODIES; CLINICAL-SAMPLES; WESTERN-BLOT; N. SP. AB Of the several microsporidia that infect humans, Enterocytozoon bieneusi is known to cause a gastrointestinal disease whereas Encephalitozoon intestinalis causes both a disseminated and an intestinal disease. Although several different staining techniques, including the chromotrope technique and its modifications, Uvitex 2B, and the quick-hot Gram-chromotrope procedure, detect microsporidian spores in fecal smears and other clinical samples, they do not identify the species of microsporidia. A need for an easily performed test therefore exists. We reevaluated 120 stool samples that had been found positive for microsporidia previously, using the quick-hot Gram-chromotrope technique, and segregated them into two groups on the basis of spore size. We also screened the smears by immunofluorescence microscopy, using a polyclonal rabbit anti-E. intestinalis serum at a dilution of 1:400. Spores in 29 (24.1%) of the 120 samples fluoresced brightly, indicating that they were E. intestinalis spores. No intense background or cross-reactivity with bacteria, yeasts, or other structures in the stool samples was seen. Additionally, the numbers of spores that fluoresced in seven of these samples were substantially smaller than the numbers of spores that were present in the stained smears, indicating that these samples were probably derived from patients with mixed infections of Enterocytozoon bieneusi and E. intestinalis. Because a 1:400 dilution of this serum does not react with culture-grown Encephalitozoon hellem, Encephalifozoon cuniculi, or Vittaforma corneae or with Enterocytozoon bieneusi spores in feces, we concluded that an immunofluorescence test using this serum is a good alternative for the specific identification of E. intestinalis infections. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,Dept Hlth & Human Serv, Atlanta, GA 30341 USA. Morehouse Sch Med, Dept Physiol, Atlanta, GA 30310 USA. Univ Estado Rio de Janeiro, Fac Ciencias Med, DPL, Rio De Janeiro, Brazil. Hosp Evandro Chagas, Inst Oswaldo Cruz, FIOCRUZ, BR-21045900 Rio De Janeiro, Brazil. Univ Fed Fluminense, Fac Med, Dept Patol, Niteroi, RJ, Brazil. Univ Miguel Hernandez, Ctr Bioingn, Unidad Biotecnol Microbiana, Alicante, Spain. RP Visvesvara, GS (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,Dept Hlth & Human Serv, M-S-F-13,4770 Buford Hwy NE, Atlanta, GA 30341 USA. FU NCRR NIH HHS [G12 RR003034] NR 47 TC 12 Z9 16 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUL PY 1999 VL 37 IS 7 BP 2317 EP 2322 PG 6 WC Microbiology SC Microbiology GA 206FR UT WOS:000080867100031 PM 10364604 ER PT J AU Gentsch, JR Glass, RI AF Gentsch, JR Glass, RI TI Detection and characterization of novel rotavirus strains in the United States - Authors' reply SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Letter ID SEROTYPES; JAPAN C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Atlanta, GA 30333 USA. RP Gentsch, JR (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Atlanta, GA 30333 USA. NR 18 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUL PY 1999 VL 37 IS 7 BP 2385 EP 2386 PG 2 WC Microbiology SC Microbiology GA 206FR UT WOS:000080867100054 ER PT J AU Ramachandran, M Gentsch, JR Parashar, UD Jin, S Woods, PA Holmes, JL Kirkwood, CD Bishop, RF Greenberg, HB Urasawa, S Gerna, G Coulson, BS Taniguchi, K Bresee, JS Glass, RI AF Ramachandran, M Gentsch, JR Parashar, UD Jin, S Woods, PA Holmes, JL Kirkwood, CD Bishop, RF Greenberg, HB Urasawa, S Gerna, G Coulson, BS Taniguchi, K Bresee, JS Glass, RI CA Natl Rotavirus Strain Surveillance Syst TI Detection and characterization of novel rotavirus strains in the United States (vol 36, pg 3223, 1998) SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Correction C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Epidem Intelligence Serv, Atlanta, GA 30333 USA. Royal Childrens Hosp, Dept Gastroenterol, Melbourne, Vic, Australia. Univ Melbourne, Dept Immunol & Microbiol, Parkville, Vic 3052, Australia. Stanford Univ, Sch Med, Div Gastroenterol, Stanford, CA 94305 USA. Palo Alto Vet Adm Hosp, Palo Alto, CA USA. Sapporo Med Univ, Dept Hyg, Virus Lab, Sapporo, Hokkaido, Japan. Fujita Hlth Univ, Sch Med, Dept Virol & Parasitol, Aichi, Japan. IRCCS, Policlin San Matteo, Viral Diagnost Serv, Pavia, Italy. RP Ramachandran, M (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUL PY 1999 VL 37 IS 7 BP 2392 EP 2392 PG 1 WC Microbiology SC Microbiology GA 206FR UT WOS:000080867100062 ER PT J AU Calafat, AM Barr, DB Pirkle, JL Ashley, DL AF Calafat, AM Barr, DB Pirkle, JL Ashley, DL TI Reference range concentrations of N-acetyl-S-(2-hydroxyethyl)-L-cysteine, a common metabolite of several volatile organic compounds, in the urine of adults in the United States SO JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY LA English DT Article ID ETHYLENE-OXIDE EXPOSURE; MERCAPTURIC ACIDS; MASS-SPECTROMETRY; SENSITIVE METHOD; TOXIC-CHEMICALS; VINYL-CHLORIDE; US POPULATION; BLOOD; RISK; ACRYLONITRILE AB N-acetyl-S-(2-hydroxyethyl)-L-cysteine (2-hydroxyethyl mercapturic acid, HEMA) is a urinary metabolite of several hazardous chemicals, including vinyl chloride (VC), ethylene oxide (EO), and ethylene dibromide (EDB). Information about the levels of HEMA in the general population is useful for assessing human exposures to HEMA parent compounds, including VC, EO, and EDB. To establish reference range concentrations for HEMA, we analyzed urine samples from 412 adult participants in the Third National Health and Nutrition Examination Survey (NHANES III) by using isotope-dilution high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). HEMA was detected in 71% of the samples examined. Creatinine-corrected concentrations ranged from less than 0.68 mu g/g creatinine to 58.7 mu g/g creatinine; the 95th percentile concentration was 11.2 mu g/g creatinine; and the geometric mean and median creatinine-corrected concentrations were both 1.6 mu g/g creatinine. We observed a statistically significant difference (P=.0001) in the creatinine-corrected geometric mean concentration values of HEMA between smokers (2.8 mu g/g creatinine) and nonsmokers (1.1 mu g/g creatinine). The high levels of HEMA seen among smokers likely originated from HEMA-producing chemicals known to be present in tobacco smoke. C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hlth Lab Sci, Toxicol Branch, Atlanta, GA 30341 USA. RP Barr, DB (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hlth Lab Sci, Toxicol Branch, Atlanta, GA 30341 USA. RI Barr, Dana/E-2276-2013; Barr, Dana/E-6369-2011 NR 36 TC 13 Z9 13 U1 0 U2 7 PU STOCKTON PRESS PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 USA SN 1053-4245 J9 J EXPO ANAL ENV EPID JI J. Expo. Anal. Environ. Epidemiol. PD JUL-AUG PY 1999 VL 9 IS 4 BP 336 EP 342 DI 10.1038/sj.jea.7500032 PG 7 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 297VM UT WOS:000086103400007 PM 10489158 ER PT J AU Palmer, RB Alakija, P Baca, JEC Nolte, KB AF Palmer, RB Alakija, P Baca, JEC Nolte, KB TI Fatal brodifacoum rodenticide poisoning: Autopsy and toxicologic findings SO JOURNAL OF FORENSIC SCIENCES LA English DT Article DE forensic science; brodifacoum; rodenticide; tissue distribution; hemorrhage; anticoagulant; pathology; toxicology; poisoning ID SUPERWARFARIN RODENTICIDE; FLUORESCENCE DETECTION; LIQUID-CHROMATOGRAPHY; ALVEOLAR HEMORRHAGE; INGESTION; WARFARIN; LIVER; PHARMACOKINETICS; ANTICOAGULANTS; DIFENACOUM AB This report details the pathologic and toxicologic findings in the case of a 15-year-old girl who deliberately and fatally ingested brodifacoum, a commonly used rodenticide. The mechanism of death, massive pulmonary hemorrhage, has not been previously reported. Brodifacoum was quantitated in liver, spleen, lung, brain, bile, vitreous humor, heart blood, and femoral blood using HPLC with fluorescence detection. The highest brodifacoum concentrations were detected in bile (4276 ng/mL) and femoral blood (3919 ng/mL). No brodifacoum was detected in brain or vitreous humor. A brodifacoum concentration of 50 ng/g was observed in frozen liver while formalin fixed liver exhibited a concentration of 820 ng/g. A very high blood:liver brodifacoum concentration ratio suggested acute poisoning but the historical and pathologic findings suggested a longer period of anticoagulation. Though most cases of brodifacoum poisoning in humans are non-fatal, this compound can be deadly because of its very long half-life. Forensic pathologists and toxicologists should suspect superwarfarin rodenticides when confronted with cases of unexplained bleeding. Anticoagulant poisoning can mimic fatal leukemia or infectious diseases such as bacterial sepsis, rickettsioses, plague, and leptospirosis. A thorough death scene investigation may provide clues that a person has ingested these substances. C1 Univ New Mexico, Hlth Sci Ctr, Toxicol Program, Coll Pharm, Albuquerque, NM 87131 USA. Univ New Mexico, Sch Med, Dept Pathol, Off Med Investigator, Albuquerque, NM 87131 USA. Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hazards & Hlth Effects, Surveillance & Programs Branch,Coroner Informat S, Atlanta, GA USA. RP Palmer, RB (reprint author), Univ New Mexico, Hlth Sci Ctr, Toxicol Program, Coll Pharm, 2502 Marble SE, Albuquerque, NM 87131 USA. NR 26 TC 17 Z9 21 U1 0 U2 4 PU AMER SOC TESTING MATERIALS PI W CONSHOHOCKEN PA 100 BARR HARBOR DR, W CONSHOHOCKEN, PA 19428-2959 USA SN 0022-1198 J9 J FORENSIC SCI JI J. Forensic Sci. PD JUL PY 1999 VL 44 IS 4 BP 851 EP 855 PG 5 WC Medicine, Legal SC Legal Medicine GA 293AY UT WOS:000085830400037 PM 10432620 ER PT J AU Bankamp, B Bellini, WJ Rota, PA AF Bankamp, B Bellini, WJ Rota, PA TI Comparison of L proteins of vaccine and wild-type measles viruses SO JOURNAL OF GENERAL VIROLOGY LA English DT Article ID REPUBLIC-OF-CHINA; NUCLEOTIDE-SEQUENCE; RNA-POLYMERASE; TS PHENOTYPE; L-GENES; CANDIDATE; STRAINS; ELIMINATION; RESCUE AB The nucleotide sequences of the large (L) genes of ten measles virus (MV) strains were determined. These strains included the Moraten and Rubeovax vaccine strains and their Edmonston wild-type (wt) progenitor, two additional vaccine strains and five genotypically divergent wt isolates. The nucleotide and predicted amino acid sequences were compared with six previously sequenced L genes and the number and location of variable amino acid positions were characterized. The recent wt isolates demonstrated the greatest amount of variability found to date in the highly conserved L protein. Three full-length wt L proteins were expressed in mammalian cells and their ability to form a complex with the MV phosphoprotein was demonstrated. While no set of amino acid substitutions associated consistently with wt or vaccine strains was identified, these data will provide a basis for the analysis of the activity of L proteins from vaccine and wt viruses in a functional assay. C1 Ctr Dis Control & Prevent, Resp & Enter Viruses Branch, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Bankamp, B (reprint author), Ctr Dis Control & Prevent, Resp & Enter Viruses Branch, Natl Ctr Infect Dis, MS-C22,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 34 TC 15 Z9 15 U1 0 U2 1 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING, BERKS, ENGLAND RG7 1AE SN 0022-1317 J9 J GEN VIROL JI J. Gen. Virol. PD JUL PY 1999 VL 80 BP 1617 EP 1625 PN 7 PG 9 WC Biotechnology & Applied Microbiology; Virology SC Biotechnology & Applied Microbiology; Virology GA 213ZV UT WOS:000081303900008 PM 10423129 ER PT J AU Meissner, JD AF Meissner, JD TI Nucleotide sequences and further characterization of human papillomavirus DNA present in the CaSki, SiHa and HeLa cervical carcinoma cell lines SO JOURNAL OF GENERAL VIROLOGY LA English DT Article ID TYPE-16 DNA; MOLECULAR ANALYSIS; VIRAL INTEGRATION; EARLY GENES; E7 GENE; CANCER; GENOME; TRANSCRIPTION; POLYMERASE; EXPRESSION AB The complete nucleotide sequences of the human papillomavirus type 16 (HPV-16) variants present in the CaSki and SiHa cervical carcinoma cell lines and the primary subgenomic HPV-18 variant present in the HeLa cervical carcinoma cell line were determined using overlapping bulk PCR products as templates. PCR-based methods were also used to characterize five previously unreported CaSki HPV-16 genomic disruptions and the 5' cellular-viral junction common to all HeLa HPV-18 subgenomic structures. C1 Ctr Dis Control & Prevent, Human Papillomavirus Sect, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. RP Meissner, JD (reprint author), Sequinox Labs, 751 Heinz Pkwy, Estes Pk, CO 80517 USA. NR 60 TC 118 Z9 122 U1 1 U2 5 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING, BERKS, ENGLAND RG7 1AE SN 0022-1317 J9 J GEN VIROL JI J. Gen. Virol. PD JUL PY 1999 VL 80 BP 1725 EP 1733 PN 7 PG 9 WC Biotechnology & Applied Microbiology; Virology SC Biotechnology & Applied Microbiology; Virology GA 213ZV UT WOS:000081303900020 PM 10423141 ER PT J AU Karron, RA Singleton, RJ Bulkow, L Parkinson, A Kruse, D DeSmet, I Indorf, C Petersen, KM Leombruno, D Hurlburt, D Santosham, M Harrison, LH AF Karron, RA Singleton, RJ Bulkow, L Parkinson, A Kruse, D DeSmet, I Indorf, C Petersen, KM Leombruno, D Hurlburt, D Santosham, M Harrison, LH CA RSV Alaska Study Grp TI Severe respiratory syncytial virus disease in Alaska native children SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID MATERNAL ANTIBODY; NORTHEAST ENGLAND; PRIMARY INFECTION; RISK-FACTORS; INFANTS; EPIDEMIOLOGY; BRONCHIOLITIS; GLYCOPROTEIN; REINFECTION; PNEUMONIA AB Hospitalization rates for respiratory syncytial virus (RSV) infection range from 1 to 20/1000 infants. To determine the rate and severity of RSV infections requiring hospitalization for infants in the Yukon-Kuskokwim (YK) Delta of Alaska, a 3-year prospective surveillance study was conducted. The annual rate of RSV hospitalization for YK Delta infants <1 year of age was 53-249/1000, RSV infection was the most frequent cause of infant hospitalization. RSV disease severity did not differ among non-high-risk infants in the YK Delta and at Johns Hopkins Hospital (JHH), On average, 1/125 infants born in the YK Delta required mechanical ventilation for RSV infection. During the peak season, similar to$1034/child <3 years of age was spent on RSV hospitalization in the YK Delta. In YK Delta infants less than or equal to 6 months old, RSV micro-neutralizing antibody titers <1200 were associated with severe disease (odds ratio = 6.2, P = .03), In the YK Delta and at JHH, newborns may be at greater risk for severe RSV illness than previously thought. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Ctr Immunizat Res, Div Dis Control,Dept Int Hlth, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Med, Dept Pediat, Baltimore, MD 21205 USA. Johns Hopkins Univ, Ctr Amer Indian & Alaska Native Hlth, Baltimore, MD 21205 USA. Alaska Area Native Hlth Serv, Anchorage, AK USA. Ctr Dis Control & Prevent, Arct Invest Program, Anchorage, AK USA. Yukon Kuskokwim Hlth Corp, Bethel, AK USA. Massachusetts Publ Hlth Biol Labs, Boston, MA USA. Univ Pittsburgh, Dept Epidemiol, Grad Sch Publ Hlth, Pittsburgh, PA 15260 USA. RP Karron, RA (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Ctr Immunizat Res, Div Dis Control,Dept Int Hlth, Hampton St 117,615 N Broadway, Baltimore, MD 21205 USA. NR 40 TC 88 Z9 89 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL PY 1999 VL 180 IS 1 BP 41 EP 49 DI 10.1086/314841 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 210YA UT WOS:000081132100006 PM 10353859 ER PT J AU Archibald, LK McDonald, LC Rheanpumikankit, S Tansuphaswadikul, S Chaovanich, A Eampokalap, B Banerjee, SN Reller, LB Jarvis, WR AF Archibald, LK McDonald, LC Rheanpumikankit, S Tansuphaswadikul, S Chaovanich, A Eampokalap, B Banerjee, SN Reller, LB Jarvis, WR TI Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients >= 15 years old, Bangkok SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 37th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 28-OCT 03, 1997 CL TORONTO, CANADA ID POSITIVE BLOOD CULTURES; TUBERCULOSIS BACTEREMIA; CLINICAL-SIGNIFICANCE; HIV-INFECTION; ADULTS; NAIROBI; KENYA; EXTRAPULMONARY; THAILAND; FUNGEMIA AB To determine the etiology of bloodstream infections (BSIs) in hospitalized patients greater than or equal to 15 years old in Thailand, prospectively enrolled, consecutive febrile (greater than or equal to 38 degrees C) patients were admitted to one hospital during February-April 1997, After a patient history was taken and a physical examination was performed, blood was obtained for comprehensive culture and human immunodeficiency virus (HIV) testing. Of 246 study patients, 119 (48%) had BSIs, and 182 (74%) were infected with HIV, The 2 most common pathogens were Cryptococcus neoformans and Mycobacterium tuberculosis (30 and 27 patients, respectively). HIV-positive patients were more likely than HIV-negative patients to have mycobacteremia (57/182 vs. 0/64, P<.0001), fungemia (38/182 vs. 2/64, P<.001), or polymicrobial BSIs (19/182 vs. 0/64, P<.002), Clinical predictors of BSIs included HIV infection, chronic diarrhea, lymphadenopathy, or splenomegaly. Mortality was higher among patients with than those without BSIs (P<.001). Cohort-based microbiologic studies are critically important to diagnose emerging pathogens and to develop algorithms for empirical treatment of BSIs in developing countries. C1 Ctr Dis Control, Hosp Infect Program, Atlanta, GA 30333 USA. Bamrasnaradura Hosp, Bangkok, Thailand. Duke Univ, Med Ctr, Clin Microbiol Lab, Durham, NC 27706 USA. RP Archibald, LK (reprint author), Ctr Dis Control, Hosp Infect Program, Mailstop E-69,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 27 TC 53 Z9 56 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL PY 1999 VL 180 IS 1 BP 87 EP 92 DI 10.1086/314836 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 210YA UT WOS:000081132100012 PM 10353865 ER PT J AU Johnson, SE Rubin, L Romero-Steiner, S Dykes, JK Pais, LB Rizvi, A Ades, E Carlone, GM AF Johnson, SE Rubin, L Romero-Steiner, S Dykes, JK Pais, LB Rizvi, A Ades, E Carlone, GM TI Correlation of opsonophagocytosis and passive protection assays using human anticapsular antibodies in an infant mouse model of bacteremia for Streptococcus pneumoniae SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 17-22, 1995 CL SAN FRANCISCO, CALIFORNIA SP Amer Soc Microbiol ID INFLUENZAE TYPE-B; CAPSULAR POLYSACCHARIDE; SERUM ANTIBODIES; INFECTION; MICE; RADIOIMMUNOASSAY; VACCINE; LEVEL; RATS AB An infant mouse assay system for assessment of protective concentrations of human serum pneumococcal anticapsular antibodies is described. Passive immunization of anticapsular antibodies was evaluated for protection of infant mice challenged with Streptococcus pneumoniae serotypes 1, 4, 5, 6B, 18C, and 23A, with bacteremia as an end point. Protection was defined as no detectable bacteremia in 70% of mice 48 h after challenge. Type-specific anticapsular concentrations required for protection varied with serotype (less than or equal to 0.05 to >0.4 mu g/mL). Across serotypes, there was no significant correlation between human IgG concentration in mouse serum and protection from bacteremia or between IgG concentration and opsonophagocytic titer. Significant correlation (r = .84, P<.001) was observed between opsonophagocytic titer of human IgG antibody in mouse sera and protection from bacteremia. Thus, protective concentrations of anticapsular antibodies against bacteremia are serotype dependent. Opsonophagocytosis is a better predictor of in vivo protective capacity of pneumococcal anticapsular antibodies than are ELISA IgG antibody concentrations. C1 Long Isl Jewish Med Ctr, Schneider Childrens Hosp, Div Infect Dis, New Hyde Park, NY 11042 USA. CDC, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Atlanta, GA 30333 USA. RP Johnson, SE (reprint author), CDC, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Mailstop A-36, Atlanta, GA 30333 USA. RI Ades, Edwin/A-9931-2009; OI Romero-Steiner, Sandra/0000-0003-4128-7768 NR 31 TC 69 Z9 69 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL PY 1999 VL 180 IS 1 BP 133 EP 140 DI 10.1086/314845 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 210YA UT WOS:000081132100018 PM 10353871 ER PT J AU Ellis, BA Regnery, RL Beati, L Bacellar, F Rood, M Glass, GG Marston, E Ksiazek, TG Jones, D Childs, JE AF Ellis, BA Regnery, RL Beati, L Bacellar, F Rood, M Glass, GG Marston, E Ksiazek, TG Jones, D Childs, JE TI Rats of the genus Rattus are reservoir hosts for pathogenic Bartonella species: An Old World origin for a New World disease? SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 1st Euro-American Mammal Congress CY JUL 19-24, 1998 CL SANTIAGO COMPOSTE, SPAIN ID CITRATE SYNTHASE GENE; SP-NOV; SPECIFICITY; GRAHAMELLA; RODENTS AB Bartonella species were isolated from the blood of 63 of 325 Rattus norvegicus and Ii of 92 Rattus rattus from 13 sites in the United States and Portugal. Infection in both Rattus species ranged from 0% (e.g., 0/87) to similar to 60% (e.g., 35/62), A 337-bp fragment of the citrate synthase (gltA) gene amplified by polymerase chain reaction was sequenced from all 74 isolates. Isolates from R. norvegicus were most similar to Bartonella elizabethae, isolated previously from a patient with endocarditis (93%-100% sequence similarity), followed by Bartonella grahamii and other Bartonella species isolated from Old World rodents (Clethrionomys species, Mus musculus, and Rattus species). These data suggest that Rattus species are a reservoir host for pathogenic Bartonella species and are consistent with a hypothesized Old World origin for Bartonella species recovered from Rattus species introduced into the Americas. C1 Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Inst Nacl Saude, Ctr Estudos Vectores & Doencas Infecciosas, Aguas De Moura, Portugal. Los Angeles Cty Dept Hlth Serv, Environm Hlth Vector Management Program, Monterey Pk, CA USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Mol Microbiol & Immunol, Baltimore, MD USA. RP Ellis, BA (reprint author), Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, MS G 13,1600 Clifton Rd NE, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 15 TC 125 Z9 132 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL PY 1999 VL 180 IS 1 BP 220 EP 224 DI 10.1086/314824 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 210YA UT WOS:000081132100032 PM 10353885 ER PT J AU Rechav, Y Zyzak, M Fielden, LJ Childs, JE AF Rechav, Y Zyzak, M Fielden, LJ Childs, JE TI Comparison of methods for introducing and producing artificial infection of Ixodid ticks (Acari : Ixodidae) with Ehrlichia chaffeensis SO JOURNAL OF MEDICAL ENTOMOLOGY LA English DT Article DE Ehrliclia chaffeensis; Ixodid ticks; artificial infection; capillary feeding ID ETIOLOGIC AGENT; FEEDING TICKS; LIFE-CYCLE; TRANSMISSION; INFUSION AB Only 29.5 +/- 8.91% of engorged Amblyomma americanum (L.) nymphs that we inoculated with Ehrlichia chaffeensis molted successfully to adults compared with 75.8 +/- 7.46% of engorged nymphs that were not inoculated. However, 65.4 +/- 6.02% of unfed nymphs of this species were exposed for 2 h to E. chaffeensis suspension introduced to them through glass capillaries gained weight. These nymphs were placed on rabbits, and approximate to 50% of them completed their feeding and molted successfully to adults. Weight gained was higher (71.8 +/- 17.33% and 69.8 +/- 23.26%) for unfed A. americanum females that fed from capillaries for 2 and 24, h respectively, than for nymphs. Similar values were recorded for Dermacentor variabilis (Say) (61.0 +/- 16.23%) and Rhipicephalus sanguineus (Latreille) (59.0 +/- 18.62%) females after 24 h of capillary feeding. The amount of E. chaffeensis suspension taken in by females of A. americanum, D. variabilis, and R. sanguineus during 24 h of feeding was 11.2 +/- 3.56, 10.9 +/- 4.29 and 6.3 +/- 2.35 mu l, respectively. This volume is equivalent to approximate to 12,969, 12,622, and 7,295 infected cells ingested by the species mentioned above. Positive correlation between the volume taken in by the ticks and the weight gained by the females was found, but the initial weight of the unfed females did not effect the weight they gained. The pathogen was found in the females of all 3 species by polymerase chain reaction procedures for at least 7 d, indicating that the capillary feeding method can be successfully used for infecting unfed ticks. The potential use of this method is discussed. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Berry Coll, Dept Biol, Mt Berry, GA 30149 USA. RP Rechav, Y (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Mailstop G-13,1600 Clifton Rd, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 30 TC 14 Z9 15 U1 0 U2 5 PU ENTOMOL SOC AMER PI LANHAM PA 9301 ANNAPOLIS RD, LANHAM, MD 20706 USA SN 0022-2585 J9 J MED ENTOMOL JI J. Med. Entomol. PD JUL PY 1999 VL 36 IS 4 BP 414 EP 419 PG 6 WC Entomology; Veterinary Sciences SC Entomology; Veterinary Sciences GA 219HL UT WOS:000081601800003 PM 10467766 ER PT J AU Serwint, JR Damokosh, AI Berger, OG Chisolm, JJ Gunter, EW Jones, RL Rhoads, GG Rogan, W AF Serwint, JR Damokosh, AI Berger, OG Chisolm, JJ Gunter, EW Jones, RL Rhoads, GG Rogan, W CA Treatment Lead-Exposed Children Trial TI No difference in iron status between children with low and moderate lead exposure SO JOURNAL OF PEDIATRICS LA English DT Article; Proceedings Paper CT National American-Pediatric-Society/Society-for-Pediatric-Research/Ambulatory-Ped iatric-Association Meeting CY MAY 03-04, 1997 CL WASHINGTON, D.C. SP Amer Pediat Soc, Soc Pediat Res, Ambulatory Pediat Assoc ID DEFICIENCY AB We compared the iron status between children 11 to 33 months old with confirmed blood lead levels of 20 to 44 mu g/dL and demographically similar children with blood lead levels of <10 mu g/dL. There were no differences. Laboratory investigation or empirical treatment for iron deficiency is not justified on the basis of moderately elevated blood lead levels alone. C1 Johns Hopkins Univ, Dept Pediat, Baltimore, MD 21218 USA. Childrens Hosp, Med Ctr, Cincinnati, OH 45229 USA. Kennedy Krieger Inst, Baltimore, MD USA. Harvard Univ, Sch Publ Hlth, Dept Environm Hlth, Boston, MA 02115 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Environm & Occupat Hlth Sci Inst, Piscataway, NJ USA. Natl Inst Environm Hlth Sci, Res Triangle Pk, NC USA. RP Serwint, JR (reprint author), Johns Hopkins Hosp, 600 N Wolfe St CMSC 143, Baltimore, MD 21287 USA. RI Rogan, Walter/I-6034-2012 OI Rogan, Walter/0000-0002-9302-0160 NR 12 TC 28 Z9 31 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-3476 EI 1097-6833 J9 J PEDIATR-US JI J. Pediatr. PD JUL PY 1999 VL 135 IS 1 BP 108 EP 110 DI 10.1016/S0022-3476(99)70338-0 PG 3 WC Pediatrics SC Pediatrics GA 215JQ UT WOS:000081378900023 PM 10393615 ER PT J AU Tsang, SX Switzer, WM Shanmugam, V Johnson, JA Goldsmith, C Wright, A Fadly, A Thea, D Jaffe, H Folks, TH Heneine, W AF Tsang, SX Switzer, WM Shanmugam, V Johnson, JA Goldsmith, C Wright, A Fadly, A Thea, D Jaffe, H Folks, TH Heneine, W TI Evidence of avian leukosis virus subgroup E and endogenous avian virus in measles and mumps vaccines derived from chicken cells: Investigation of transmission to vaccine recipients SO JOURNAL OF VIROLOGY LA English DT Article ID REVERSE-TRANSCRIPTASE ACTIVITY; HOST RANGE; ENV GENE; ANTIGENIC VARIANTS; RETROVIRUS; SARCOMA; ASSAY; ANTIBODIES; INFECTION; SEQUENCES AB Reverse transcriptase (RT) activity has been detected recently in all chicken cell-derived measles and mumps vaccines. A study of a vaccine manufactured in Europe indicated that the RT is associated with particles containing endogenous avian retrovirus (EAV-0) RNA and originates from the chicken embryonic fibroblasts (CEF) used as a substrate for propagation of the vaccine. We investigated the origin of RT in measles and mumps vaccines from a U.S. manufacturer and confirm the presence of RT and EAV RNA. Additionally, we provide new evidence for the presence of avian leukosis virus (ALV) in both CEF supernatants and vaccines. ALV pol sequences were first identified in particle-associated RNA by amplification with degenerate retroviral pal primers. ALV RNA sequences from bath the gag and Env regions were also detected. Analysis of hypervariable region 2 of env revealed a subgroup E sequence, an endogenous-type ALV. Both CEF- and vaccine-derived RT activity could be blocked by antibodies to ALV RT. Release of ALV-like virus particles from uninoculated CEF was also documented by electron microscopy. Nonetheless, infectivity studies on susceptible 15B(1) chicken cells gave no evidence of infectious ALV,which is consistent with the phenotypes of the ev loci identified in the CEF. PCR analysis of ALV and EAV proviral sequences in peripheral blood mononuclear cells from 33 children after measles and mumps vaccination yielded negative results. Our data indicate that the sources of RT activity in all RT-positive measles and mumps vaccines may not be similar and depend on the particular endogenous retroviral loci present in the chicken cell substrate used. The present data do not support transmission of either ALV or EAV to recipients of the U.S.-made vaccine and provide reassurance for current immunization policies. C1 Ctr Dis Control & Prevent, HIV & Retrovirol Branch, Div AIDS STD & TB Lab Res, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Infect Dis Pathol Activ, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. USDA, Avian Dis & Oncol Lab, E Lansing, MI 48823 USA. Harvard Univ, Inst Int Dev, Cambridge, MA 02138 USA. RP Heneine, W (reprint author), Ctr Dis Control & Prevent, HIV & Retrovirol Branch, Div AIDS STD & TB Lab Res, 1600 Clifton Rd,Mail Stop G-19, Atlanta, GA 30333 USA. NR 45 TC 42 Z9 43 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0022-538X J9 J VIROL JI J. Virol. PD JUL PY 1999 VL 73 IS 7 BP 5843 EP 5851 PG 9 WC Virology SC Virology GA 205GT UT WOS:000080813500067 PM 10364336 ER PT J AU Lu, XH Tumpey, TM Morken, T Zaki, SR Cox, NJ Katz, JM AF Lu, XH Tumpey, TM Morken, T Zaki, SR Cox, NJ Katz, JM TI A mouse model for the evaluation of pathogenesis and immunity to influenza A (H5N1) viruses isolated from humans SO JOURNAL OF VIROLOGY LA English DT Article ID A VIRUSES; NATURAL INFECTION; VACCINE; HEMAGGLUTININ; REPLICATION; RESPONSES; VIRULENT; DISEASE AB During 1997 in Dong Kong, 18 human cases of respiratory illness, including 6 fatalities, were caused by highly pathogenic avian influenza A (H5N1) viruses. Since H5 viruses had previously been isolated only from avian species, the outbreak raised questions about the ability of these viruses to cause severe disease and death in humans. To better understand the pathogenesis and immunity to these viruses, we have used the BALB/c mouse model. Four H5N1 viruses replica,ted equally well in the lungs of mice without prior adaptation but differed in lethality for mice. H5N1 viruses that were highly lethal for mice were detected in multiple organs, including the brain. This is the first demonstration of an influenza A virus that replicates systemically in a mammalian species and is neurotropic without prior adaptation. The mouse model was also used to evaluate a strategy of vaccination against the highly pathogenic avian H5N1 viruses, using an inactivated vaccine prepared from nonpathogenic A/Duck/Singapore-Q/F119-3/97 (H5N3) virus that was antigenically related to the human H5N1 viruses. Mice administered vaccine intramuscularly, with or without alum, were completely protected from lethal challenge with H5N1 virus. Protection from infection was also observed in 70% of animals administered vaccine alone and 100% of mice administered vaccine with alum. The protective effect of vaccination correlated with the level of virus-specific serum antibody. These results suggests a strategy of vaccine preparedness for rapid intervention in future influenza, pandemics that uses antigenically related nonpathogenic viruses as vaccine candidates. C1 Ctr Dis Control & Prevent, NCID, DVRD, Influenza Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, NCID, DVRD, Infect Dis Pathol Act, Atlanta, GA 30333 USA. RP Katz, JM (reprint author), Ctr Dis Control & Prevent, NCID, DVRD, Influenza Branch, Mailstop G-16,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 31 TC 288 Z9 316 U1 2 U2 17 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0022-538X J9 J VIROL JI J. Virol. PD JUL PY 1999 VL 73 IS 7 BP 5903 EP 5911 PG 9 WC Virology SC Virology GA 205GT UT WOS:000080813500073 PM 10364342 ER PT J AU Maruyama, T Rodriguez, LL Jahrling, PB Sanchez, A Khan, AS Nichol, ST Peters, CJ Parren, PWHI Burton, DR AF Maruyama, T Rodriguez, LL Jahrling, PB Sanchez, A Khan, AS Nichol, ST Peters, CJ Parren, PWHI Burton, DR TI Ebola virus can be effectively neutralized by antibody produced in natural human infection SO JOURNAL OF VIROLOGY LA English DT Article ID HUMAN MONOCLONAL-ANTIBODIES; COMBINATORIAL LIBRARIES; VIRION GLYCOPROTEINS; IMMUNIZATION; PATHOGENS; MICE; GP AB The activity of antibodies against filoviruses is poorly understood but has important consequences for vaccine design and passive prophylaxis. To investigate this activity,. panel of recombinant human monoclonal antibodies to Ebola virus antigens was isolated from phage display libraries constructed from RNA from donors who recovered from infection in the 1995 Ebola virus outbreak in Kikwit, Democratic Republic of Congo. Antibodies reactive with nucleoprotein (NP), envelope glycoprotein (GP), and secreted envelope glycoprotein (sGP) were characterized by immunofluorescence and radioimmunoprecipitation assays. Four antibodies reacting strongly with sGP and weakly with GP and two antibodies reacting with NP were not neutralizing. An antibody specific for GP neutralized Ebola virus to 50% at 0.4 mu g/ml as the recombinant Fab fragment and to 50% at 0.3 mu g/ml (90% at 2.6 mu g/ml) as the corresponding whole immunoglobulin G1 molecule. The studies indicate that neutralizing antibodies are produced in infection by Ebola virus although probably at a relatively low frequency. The neutralizing antibody may be useful in vaccine design and as a prophylactic agent against Ebola virus infection. C1 Scripps Res Inst, Dept Immunol, La Jolla, CA 92037 USA. Scripps Res Inst, Dept Mol Biol, La Jolla, CA 92037 USA. Ctr Dis Control & Prevent, Special Pathogens Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. USA, Med Res Inst Infect Dis, Div Pathol, Ft Detrick, MD 21702 USA. RP Burton, DR (reprint author), Scripps Res Inst, Dept Immunol, IMM2,10550 N Torrey Pines Rd, La Jolla, CA 92037 USA. OI Parren, Paul/0000-0002-4365-3859 FU NIAID NIH HHS [AI39808] NR 32 TC 157 Z9 166 U1 0 U2 22 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0022-538X J9 J VIROL JI J. Virol. PD JUL PY 1999 VL 73 IS 7 BP 6024 EP 6030 PG 7 WC Virology SC Virology GA 205GT UT WOS:000080813500085 PM 10364354 ER PT J AU Floyd, RL Ebrahim, SH Boyle, CA AF Floyd, RL Ebrahim, SH Boyle, CA TI Observations from the CDC - Preventing alcohol-exposed pregnancies among women of childbearing age: The necessity of a preconceptional approach SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Article ID CONSUMPTION C1 Ctr Dis Control & Prevent, Div Child Dev Disabil & Hlth Proposed, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Floyd, RL (reprint author), Ctr Dis Control & Prevent, Div Child Dev Disabil & Hlth Proposed, Natl Ctr Environm Hlth, MS-F49,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 13 TC 29 Z9 31 U1 1 U2 2 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD JUL-AUG PY 1999 VL 8 IS 6 BP 733 EP 736 DI 10.1089/152460999319048 PG 4 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 232GB UT WOS:000082361600005 PM 10495253 ER PT J AU Vulule, JM Beach, RF Atieli, FK McAllister, JC Brogdon, WG Roberts, JM Mwangi, RW Hawley, WA AF Vulule, JM Beach, RF Atieli, FK McAllister, JC Brogdon, WG Roberts, JM Mwangi, RW Hawley, WA TI Elevated oxidase and esterase levels associated with permethrin tolerance in Anopheles gambiae from Kenyan villages using permethrin-impregnated nets SO MEDICAL AND VETERINARY ENTOMOLOGY LA English DT Article DE Anopheles gambiae; bednets; bioassays; biochemical assays; esterases; insecticide tolerance; oxidases; permethrin; Kenya ID INSECTICIDE RESISTANCE; MOSQUITOS; CURTAINS AB The permethrin tolerance (PT) of a population of the mosquito Anopheles gambiae (Diptera: Culicidae) increased following the introduction of permethrin-impregnated nets for malaria control in certain villages near Kisumu, western Kenya. Using a biochemical test that indirectly measures oxidases associated with permethrin resistance, we found that this population had higher oxidase levels than a comparison population from villages without impregnated nets. Mosquitoes from a colony of An. gambiae selected for PT, the RSP (reduced susceptibility to permethrin) strain, were exposed to permethrin with or without the oxidase inhibitor piperonyl butoxide (PB). Significantly higher mortality rates occurred when permethrin was synergized by PB, presumably by suppression of oxidases responsible for PT. An unselected (UNS) colony of An. gambiae that was more susceptible than RSP in a permethrin-susceptibility bioassay (i.e. LT50 22 min for UNS, vs. 42 min for RSP) was compared with the RSP colony for levels of oxidases and esterases. The levels of both enzymes were very significantly higher in the RSP strain (P < 0.0001). We speculate that use of impregnated nets selected for higher oxidase and esterase levels in An. gambiae to metabolize permethrin acquired from the nets. Both oxidase and esterase mechanisms could confer cross-resistance to other pyrethroids. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. Kenya Med Res Inst, Vector Biol & Control Res Ctr, Kisumu, Kenya. Univ Nairobi, Dept Zool, Nairobi, Kenya. RP Beach, RF (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, 4770 Buford Highway NE,M-S F13, Atlanta, GA 30341 USA. NR 18 TC 129 Z9 142 U1 4 U2 16 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0269-283X J9 MED VET ENTOMOL JI Med. Vet. Entomol. PD JUL PY 1999 VL 13 IS 3 BP 239 EP 244 DI 10.1046/j.1365-2915.1999.00177.x PG 6 WC Entomology; Veterinary Sciences SC Entomology; Veterinary Sciences GA 241NF UT WOS:000082888900003 PM 10514048 ER PT J AU Soares, IS Barnwell, JW Ferreira, MU Da Cunha, MG Laurino, JP Castilho, BA Rodrigues, MM AF Soares, IS Barnwell, JW Ferreira, MU Da Cunha, MG Laurino, JP Castilho, BA Rodrigues, MM TI A Plasmodium vivax vaccine candidate displays limited allele polymorphism, which does not restrict recognition by antibodies SO MOLECULAR MEDICINE LA English DT Article ID MEROZOITE SURFACE PROTEIN-1; CARBOXYL-TERMINAL FRAGMENT; PROTECTIVE IMMUNE-RESPONSE; B-CELL EPITOPES; MONOCLONAL-ANTIBODIES; RECOMBINANT PROTEINS; T-CELL; FALCIPARUM MEROZOITES; RONDONIA BRAZIL; AOTUS MONKEYS AB Background: The 19 kDa C-terminal region of the merozoite surface protein 1 (MSP1(19)) has been suggested as candidate for part of a subunit vaccine against malaria. A major concern in vaccine development is the polymorphism observed in different plasmodial strains. The present study examined the extension and immunological relevance of the allelic polymorphism of the MSP1(19) from Plasmodium vivax, a major human malaria parasite. Materials and Methods: We cloned and sequenced 88 gene fragments representing the MSP1(19) from 28 Brazilian isolates of P. vivax. subsequently, we evaluated the reactivity of rabbit polyclonal antibodies, a monoclonal antibody, and a panel of 80 human sera to bacterial and yeast recombinant proteins representing the two allelic forms of P. vivax MSP19 described thus far. Results: We observed that DNA sequences encoding MSP1(19) were not as variable as the equivalent region of other species of Plasmodium, being conserved among Brazillian isolates of P. vivax. Also, we found that antibodies are directed mainly to conserved epitopes present in both allelic forms of the protein. Conclusions: Our findings suggest that the use of MSP1(19) as part of a subunit vaccine against P, vivax might be greatly facilitated by the limited genetic polymorphism and predominant recognition of conserved epitopes by antibodies. C1 Univ Fed Sao Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, BR-04023062 Sao Paulo, Brazil. Fed Univ Para, Ctr Ciencias Biol, Dept Patol, BR-66059 Belem, Para, Brazil. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA USA. Univ Sao Paulo, Dept Parasitol, Sao Paulo, Brazil. RP Rodrigues, MM (reprint author), Univ Fed Sao Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, Rua Botucatu 862,6th Floor, BR-04023062 Sao Paulo, Brazil. RI Castilho, Beatriz/C-2503-2012; Ferreira, Marcelo/G-8289-2011; Rodrigues, Mauricio/B-8512-2012; Soares, Irene/C-5974-2012 OI Castilho, Beatriz/0000-0003-4509-5237; Ferreira, Marcelo/0000-0002-5293-9090; NR 49 TC 28 Z9 29 U1 0 U2 1 PU SPRINGER VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 USA SN 1076-1551 J9 MOL MED JI Mol. Med. PD JUL PY 1999 VL 5 IS 7 BP 459 EP 470 PG 12 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA 227MM UT WOS:000082084200004 PM 10449807 ER PT J AU McGuire, MT Wing, RR Klem, ML Hill, JO AF McGuire, MT Wing, RR Klem, ML Hill, JO TI Behavioral strategies of individuals who have maintained long-term weight losses SO OBESITY RESEARCH LA English DT Article DE weight loss maintenance; obesity; diet; exercise; restraint ID RESTING ENERGY-EXPENDITURE; OBESE WOMEN; FOLLOW-UP; PHYSICAL-ACTIVITY; CONTROL PROGRAM; POST-OBESE; US ADULTS; MAINTENANCE; FAT; DIET AB Objective: The purpose of the present study was to compare the behaviors of individuals who have achieved long-term weight loss maintenance with those of regainers and weight-stable controls. Research Methods and Procedures: Subjects for the present study were participants in a random-digit dial telephone survey that used a representative sample of the U.S. adult population. Eating, exercise, self-weighing, and dietary restraint characteristics were compared among weight-loss maintainers: individuals who had intentionally lost greater than or equal to 10% of their weight and maintained it for greater than or equal to 1 year (n = 69), weight-loss regainers: individuals who intentionally lost greater than or equal to 10% of their weight but had not maintained it (n = 56), and weight-stable controls: individuals who had never lost greater than or equal to 10% of their maximum weight and had maintained their current weight (+/-10 pounds) within the past 5 years (n = 113). Results: Weight-loss maintainers had lost an average of 37 pounds and maintained it for over 7 years. These individuals reported that they currently used more behavioral strategies to control dietary fat intake, have higher levels of physical activity (especially strenuous activity), and greater frequency of self-weighing than either the weight-loss regainers or weight-stable controls. Maintainers and regainers did not differ in reported levels of dietary restraint, but both had higher levels of restraint than the weight-stable controls. Discussion: These results suggest that weight-loss maintainers use more behavioral strategies to control their weight than either regainers or weight-stable controls. It would thus appear that long-term weight maintenance requires ongoing adherence to a low-fat diet and an exercise regimen in addition to continued attention to body weight. C1 Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15213 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO 80262 USA. RP McGuire, MT (reprint author), Ctr Dis Control & Prevent, Div Nutr & Phys Act, Mailstop K-46,4770 Buford Highway, Atlanta, GA 30341 USA. FU NIDDK NIH HHS [DK-46204, DK-48520] NR 52 TC 150 Z9 152 U1 2 U2 6 PU NORTH AMER ASSOC STUDY OBESITY PI ROCHESTER PA C/O DR MICHAEL JENSEN, MAYO MEDICAL CENTER, MAYO CLIN 200 FIRST ST, SW, ROCHESTER, MN 55905 USA SN 1071-7323 J9 OBES RES JI Obes. Res. PD JUL PY 1999 VL 7 IS 4 BP 334 EP 341 PG 8 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 217UC UT WOS:000081516500003 PM 10440589 ER PT J AU Allison, DB Faith, MS Heo, M Townsend-Butterworth, D Williamson, DF AF Allison, DB Faith, MS Heo, M Townsend-Butterworth, D Williamson, DF TI Meta-analysis of the effect of excluding early deaths on the estimated relationship between body mass index and mortality SO OBESITY RESEARCH LA English DT Article DE longevity; mortality; obesity; body mass index (BMI); meta-analysis ID SERUM TOTAL CHOLESTEROL; ISCHEMIC-HEART-DISEASE; ALL-CAUSE MORTALITY; U-SHAPED RELATION; WEIGHT-LOSS; BLOOD-PRESSURE; RISK-FACTORS; MEN; POPULATION; WOMEN AB Objectives: Prospective cohort studies typically observe U-or J-shaped relationships between body mass index (BMI) (kg/m(2)) and mortality. However, some studies suggest that the elevated mortality at lower BMIs is due to confounding by pre-existing occult disease and recommend eliminating subjects who die during the first several (k) years of followup. This meta-analysis tests the effects of such early death exclusion on the BMT-mortality association. Research Methods and Procedures; Studies identified from MEDLINE,review articles, ancestry analyses, and the "invisible college." Included studies: 1) measured relative body weight at baseline; 2) included at least 1000 subjects; 3) reported results with and without early-death exclusion, or relevant data; and 4) did not study exclusively diseased populations. Blank tables were mailed to 131 investigators covering 59 databases. Completed tables (n = 16 databases), electronic raw data (n = 7 databases), and original articles (n = 6 databases) provided final data. Meta-analytic regressions compared the BMI-mortality association with and without early death exclusion. The sample included 29 studies and 1,954,345 subjects, Results: The effect of eliminating early deaths was statistically significant but minuscule in magnitude. Implementation of early death exclusion was estimated to shift the BMI associated with minimum mortality only 0.4 units for men and 0.6 units for women at age 50. Even at a BMI 16, the estimated relative risk (compared to BMI 25) decreased only 0.008 units for men and 0.076 units for women at age 50. Discussion: Results indicate that either pre-existing disease does not confound the BMI-mortality association or eliminating early deaths is inefficient For reducing that confounding. C1 Columbia Univ, St Lukes Roosevelt Hosp, Obes Res Ctr, Coll Phys & Surg, New York, NY 10025 USA. Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. RP Allison, DB (reprint author), Columbia Univ, St Lukes Roosevelt Hosp, Obes Res Ctr, Coll Phys & Surg, 1090 Amsterdam Ave,14th Floor, New York, NY 10025 USA. OI Allison, David/0000-0003-3566-9399 FU NIDDK NIH HHS [P30DK26687, R01DK51716, R29DK47526] NR 57 TC 69 Z9 69 U1 0 U2 7 PU NORTH AMER ASSOC STUDY OBESITY PI ROCHESTER PA C/O DR MICHAEL JENSEN, MAYO MEDICAL CENTER, MAYO CLIN 200 FIRST ST, SW, ROCHESTER, MN 55905 USA SN 1071-7323 J9 OBES RES JI Obes. Res. PD JUL PY 1999 VL 7 IS 4 BP 342 EP 354 PG 13 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 217UC UT WOS:000081516500004 PM 10440590 ER PT J AU Adams, MM AF Adams, MM TI Maternal birthweight and newborn status - Commentary SO PAEDIATRIC AND PERINATAL EPIDEMIOLOGY LA English DT Editorial Material ID MOTHERS BIRTH-WEIGHT C1 Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30333 USA. RP Adams, MM (reprint author), Ctr Dis Control & Prevent, Div Reprod Hlth, MS E-52,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 5 TC 4 Z9 4 U1 0 U2 0 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0269-5022 J9 PAEDIATR PERINAT EP JI Paediatr. Perinat. Epidemiol. PD JUL PY 1999 VL 13 IS 3 BP 369 EP 371 PG 3 WC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Pediatrics SC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Pediatrics GA 220GT UT WOS:000081657000013 PM 10440055 ER PT J AU Shi, LY Huang, YJ Kelly, K Zhao, MM Solomon, SL AF Shi, LY Huang, YJ Kelly, K Zhao, MM Solomon, SL TI Gastrointestinal symptoms and use of medical care associated with child day care and health care plan among preschool children SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE child care; day care; health plans; gastrointestinal symptoms; medical care; utilization ID INFECTIOUS-DISEASES; ILLNESS; RISK; ARRANGEMENTS; DIARRHEA AB Objectives. This study examined whether out-of-home day care increases the risk of gastrointestinal symptoms for children <6 years of age and whether there is an association between gastrointestinal symptoms and medical care utilization. Methods. The study population comprised members of 2 health plans residing in 2 South Carolina counties: 417 families from an health maintenance organization (HMO) plan; and 643 families from a Medicaid plan. Participants were followed for 18 months by either bimonthly telephone interviews or personal interviews. The survey/interview collected familial, personal, day-care and disease-related information and medical care utilization, The analyses controlled for both family characteristics and the type of health care plan. Results. Children attending out-of-home day care had higher incidence rates for most gastrointestinal symptoms studied than did children staying at home (2.51 vs. 1.61 episodes of mild gastrointestinal symptoms and 1.63 vs. 1.08 episodes of moderate gastrointestinal symptoms for the HMO group; 1.72 vs. 1.28 episodes of moderate gastrointestinal symptoms for the Medicaid group). Nearly one-fourth of the annual physician visits by children younger than 6 years were attributed to gastrointestinal symptoms, and more than one-fourth of the children with gastro-intestinal symptoms were prescribed antibiotics. When displaying gastrointestinal symptoms, children in the Medicaid group were significantly more likely to visit a doctor and receive antibiotics than those in the HMO group. Conclusions, Although the type of health plan has negligible influence on the frequency of reported gastrointestinal symptoms, it exerts a strong influence on medical care utilization. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21205 USA. Univ S Carolina, Sch Publ Hlth, Columbia, SC 29208 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA USA. RP Shi, LY (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Hlth Policy & Management, 624 N Broadway,Room 409, Baltimore, MD 21205 USA. FU PHS HHS [U501CCU412341] NR 23 TC 3 Z9 3 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUL PY 1999 VL 18 IS 7 BP 596 EP 603 DI 10.1097/00006454-199907000-00006 PG 8 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA 219KP UT WOS:000081606700005 PM 10440434 ER PT J AU Kellerman, S Saiman, L Soto-Irizarry, M San Gabriel, P Larsen, CA Besser, R Catanzaro, A Jarvis, W AF Kellerman, S Saiman, L Soto-Irizarry, M San Gabriel, P Larsen, CA Besser, R Catanzaro, A Jarvis, W TI Costs associated with tuberculosis control programs at hospitals caring for children SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE Mycobacterium tuberculosis; pediatric; children; multidrug-resistant tuberculosis; cost analysis; infection control; environmental controls; nosocomial Mycobacterium tuberculosis; transmission ID RESISTANT MYCOBACTERIUM-TUBERCULOSIS; HEALTH-CARE WORKERS; INFECTION-CONTROL PROGRAMS; CDC TB SURVEY; NOSOCOMIAL TRANSMISSION; UNITED-STATES; MEMBER HOSPITALS; OUTBREAK; RESPIRATORS; EFFICACY AB Objective. No data are available on the costs of implementing infection control measures for the control of Mycobacterium tuberculosis (MTB) in pediatric settings. In this study we determined the cost of MTB control measures at three hospitals caring for children. Design. Infection control and tuberculosis (TB) coordinators obtained cost data retrospectively for the years 1994 to 1995 for tuberculin skin test programs, respiratory protection programs and the retrofit or new construction of environmental controls in pediatric settings. Setting. Two pediatric hospitals and one pediatric ward in a large tertiary care hospital. Results. Total expenditures for TB controls ranged from $15 270 to $28 158 for the a-year study period. Engineering controls involved the largest capital outlay at two of three facilities. Average yearly tuberculin slr;in test costs ranged from $949 to $12 504/hospital. Respiratory protection programs cost from $480 to $1680 during the a-year study period. Conclusions. Costs associated with implementing control measures varied slightly by hospital but were less than those incurred by hospitals caring for adults. These costs represent improvements made to upgrade selected aspects of hospital TB control programs, not the cost of an optimal TB control program. Optimal TB control programs in pediatric settings have yet to be described. C1 Ctr Dis Control & Prevent, Invest & Prevent Branch, Hosp Infect Program, Atlanta, GA 30333 USA. New York Presbyterian Med Ctr, Dept Pediat, New York, NY USA. Univ Calif San Diego, Dept Pulm Med, San Diego, CA 92103 USA. Univ Calif San Diego, Dept Pediat, San Diego, CA 92103 USA. RP Jarvis, W (reprint author), Ctr Dis Control & Prevent, Invest & Prevent Branch, Hosp Infect Program, Mailstop E-69, Atlanta, GA 30333 USA. NR 36 TC 9 Z9 9 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUL PY 1999 VL 18 IS 7 BP 604 EP 608 DI 10.1097/00006454-199907000-00007 PG 5 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA 219KP UT WOS:000081606700006 PM 10440435 ER PT J AU Vitek, CR Aduddell, M Brinton, MJ Hoffman, RE Redd, SC AF Vitek, CR Aduddell, M Brinton, MJ Hoffman, RE Redd, SC TI Increased protections during a measles outbreak of children previously vaccinated with a second dose of measles-mumps-rubella vaccine SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE measles epidemiology; measles prevention and control; measles vaccine; administration and dosage; disease outbreaks; elementary schools; vaccination ID UNITED-STATES AB Background. In 1989 a second dose of measles vaccine was recommended for US children to prevent school outbreaks of measles, Coverage of school age children with a second dose remains incomplete, and data on the effectiveness of this recommendation are limited. We investigated a measles outbreak in Mesa County, CO, in December, 1994, and evaluated the efficacy of preout-break immunizations at an elementary school (School A) where many students had received two doses. Methods, All reported suspected cases of measles were investigated; cases that met a clinical case definition were tested by a measles IgM antibody assay. A confirmed case required laboratory confirmation or had to meet the clinical case definition and be epidemiologically linked to a confirmed case. Vaccination records of students at School A were reviewed. The effectiveness of one and two doses of measles vaccine was estimated using logistic regression. Results. Sixty-two confirmed cases were reported, including 17 at School A. At School A the attack rate in unvaccinated children (7 of 16, 44%) was higher than in those with 1 dose (10 of 320, 3%) or 2 doses (0 of 289, 0%). Estimated vaccine effectiveness was 92% for 1 dose and 100% for 2 doses. Two doses were better than one dose in decreasing the likelihood of acquiring measles (P = 0.003). Conclusions. The lower attack, rate among two dose recipients provides evidence that a two dose strategy can help prevent measles in schools. Administering the second dose at elementary school entry can help prevent the persistence of susceptible cohorts of children and is likely to be important in sustaining elimination of indigenous transmission of measles in the United States. C1 Ctr Dis Control & Prevent, Epidemiol & Surveillance Div, Natl Immunizat Program, Atlanta, GA 30333 USA. Mesa Cty Hlth Dept, Grand Junction, CO USA. Colorado Dept Publ Hlth & Environm, Grand Junction, CO USA. Colorado Dept Publ Hlth & Environm, Denver, CO USA. RP Vitek, CR (reprint author), Ctr Dis Control & Prevent, Epidemiol & Surveillance Div, Natl Immunizat Program, Mailstop E-61,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 16 TC 34 Z9 34 U1 1 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUL PY 1999 VL 18 IS 7 BP 620 EP 623 DI 10.1097/00006454-199907000-00010 PG 4 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA 219KP UT WOS:000081606700009 PM 10440438 ER PT J AU Kenyon, TA Driver, C Haas, E Valway, SE Moser, KS Onorato, IM AF Kenyon, TA Driver, C Haas, E Valway, SE Moser, KS Onorato, IM TI Immigration and tuberculosis among children on the United States-Mexico border, County of San Diego, California SO PEDIATRICS LA English DT Article DE tuberculosis; children; border health; drug-resistant tuberculosis; immigration AB Objective. To identify factors contributing to a 400% increase in tuberculosis among children in San Diego County, California, from 1985 to 1993. Design. Review of medical records of reported cases in 1989, 1991, and 1993 and their source case. Results. Of 192 children with tuberculosis, the largest increase was observed in children younger than 5 years old, of whom 77.4% were born in the United States, 67.8% had a foreign-born parent, 73.1% came from a non-English-speaking household, and 46.2% were known to visit Mexico. Of 28 source cases, 82.1% were born outside the United States, primarily in Mexico (67.9%). Resistance to at least one first-line antituberculous drug was identified in 27.5% of isolates from children and in 33.3% of isolates from source cases. Conclusions. The increase in tuberculosis and high level of drug-resistance among children born in the United States may be attributed to transmission outside of the United States or within the United States from household contacts born in countries in which tuberculosis is highly endemic. C1 Ctr Dis Control & Prevent, Div TB Eliminat, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Cty San Diego, Dept Hlth Serv, San Diego, CA USA. RP Onorato, IM (reprint author), Ctr Dis Control & Prevent, Div TB Eliminat, Natl Ctr HIV STD & TB Prevent, 1600 Clifton Rd,Mailstop E-10, Atlanta, GA 30333 USA. NR 14 TC 14 Z9 14 U1 0 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD JUL PY 1999 VL 104 IS 1 AR e8 DI 10.1542/peds.104.1.e8 PG 6 WC Pediatrics SC Pediatrics GA 213EC UT WOS:000081258700023 PM 10390294 ER PT J AU Kaslow, RA McNicholl, JM AF Kaslow, RA McNicholl, JM TI Genetic determinants of HIV-1 infection and its manifestations SO PROCEEDINGS OF THE ASSOCIATION OF AMERICAN PHYSICIANS LA English DT Article DE AIDS; chemokine; HLA; receptor ID IMMUNODEFICIENCY-VIRUS TYPE-1; TUMOR-NECROSIS-FACTOR; DISEASE PROGRESSION; AIDS PATHOGENESIS; DELETION ALLELE; VIRAL LOAD; CCR5 GENE; TRANSMISSION; ASSOCIATION; VARIANT AB The human immunodeficiency virus type 1 (HIV-1), which has become pandemic within a single generation, has encountered an immune system in which genetically encoded elements have evolved gradually under different environmental pressures in diverse populations. Important heritable differences in genes that alter susceptibility to HIV-1 infection or the rate of deterioration of immunity, or both, have been discovered in cohorts carefully defined for intensity of exposure to the virus, viral subtype characteristics, and onset and course of infection. For the highly polymorphic human leukocyte antigen (HLA) antigen processing and presenting system, the principle that small contributions of multiple interactive HLA marker combinations (primarily in the class I pathway) significantly modulate the course of HIV-1 infection has now been confirmed in several independently evaluated groups of patients. Variants of HLA genes probably also play some role in the acquisition of infection by the various routes of transmission. Genes for an elaborate set of circulating chemokine molecules and their cell-surface receptors clearly regulate cell attachment and penetration of HIV. Certain allelic forms of one, the CCR5 gene, alter susceptibility to infection and the rate of progression of disease; in the homozygous state, a deleted form (Delta 32 CCR5) strongly protects against infection, and in infected heterozygotes, it slows the disease process somewhat. Mutants in genes of other chemokine system components further differentiate the response to infection, and frequencies of these forms vary between and within races. Work relating additional genetic markers to HIV infection or disease is at earlier stages. Dissecting the effects of multiple variants in complex gene systems will clearly require organized comprehensive approaches in considerably larger populations than have typically been assembled. C1 Univ Alabama, Dept Epidemiol, Birmingham, AL 35294 USA. Univ Alabama, Dept Med, Birmingham, AL 35294 USA. Univ Alabama, Dept Microbiol, Birmingham, AL 35294 USA. Emory Univ, Sch Med, Dept Med, Atlanta, GA 30322 USA. Emory Univ, Sch Med, Dept Pathol, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Immunol Branch, Div AIDS STD TB Lab Res, Natl Ctr Infect Dis, Atlanta, GA USA. RP Kaslow, RA (reprint author), Univ Alabama, Dept Epidemiol, 220 A Ryals Bldg,1665 Univ Blvd, Birmingham, AL 35294 USA. FU NIAID NIH HHS [R01-AI41951] NR 62 TC 21 Z9 21 U1 1 U2 1 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 USA SN 1081-650X J9 P ASSOC AM PHYSICIAN JI Proc. Assoc. Am. Phys. PD JUL-AUG PY 1999 VL 111 IS 4 BP 299 EP 307 DI 10.1046/j.1525-1381.1999.99238.x PG 9 WC Medicine, General & Internal; Medicine, Research & Experimental SC General & Internal Medicine; Research & Experimental Medicine GA 216MT UT WOS:000081447000006 PM 10417737 ER PT J AU Potter, LB Sacks, JJ Kresnow, MJ Mercy, J AF Potter, LB Sacks, JJ Kresnow, MJ Mercy, J TI Nonfatal physical violence, United States, 1994 SO PUBLIC HEALTH REPORTS LA English DT Article ID INJURY AB Objectives, Most surveillance and research efforts focus on severe violence, especially on homicides. Because less extreme forms of violence may be precursors to more extreme forms, the authors analyzed data from a national survey to describe the extent of nonfatal physical violence in the US. Methods. The authors generated weighted national estimates from responses to a random-digit-dialed telephone survey. Respondents were asked if they had been "hit, slapped, pushed. or kicked by another person or hit with an object or weapon" in the preceding 12 months. Respondents were also asked how many times such incidents had occurred and, for the last such episode, their relationship with the perpetrator, whether they had been injured, and, if so, whether they had sought medical treatment. Results. The authors estimate that approximately 15 million people, or 8% of the US adult population, experienced nonfatal physical violence. as defined for this study, during a 12-month period. Male gender, the 18-24-year-old age group, never having been married, being out of work or a student, and heavy drinking were associated with a higher likelihood of being assaulted. An estimated 75% of assaults were by a known person and 26% by a stranger. Women were more likely than men to be assaulted by current or former intimate partners; men were more likely than women to be assaulted by strangers, An estimated 18% of incidents resulted in injuries, and an estimated 7% required medical attention. Conclusions, Nonfatal physical violence is fairly common in the US and may lead to more than one million medical encounters each year. C1 CDC, NCIPC, Off Stat & Programming, Atlanta, GA 30341 USA. CDC, NCIPC, Div Unintent Injury Prevent, Atlanta, GA 30341 USA. CDC, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Adult & Community Hlth, Atlanta, GA 30341 USA. RP Potter, LB (reprint author), CDC, NCIPC, Off Stat & Programming, 4770 Buford Hwy NE K-60, Atlanta, GA 30341 USA. NR 26 TC 10 Z9 11 U1 0 U2 1 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JUL-AUG PY 1999 VL 114 IS 4 BP 343 EP 352 DI 10.1093/phr/114.4.343 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 224ZE UT WOS:000081929200018 PM 10501135 ER PT J AU Richards, TB Croner, CM Rushton, G Brown, CK Fowler, L AF Richards, TB Croner, CM Rushton, G Brown, CK Fowler, L TI Geographic information systems and public health: Mapping the future SO PUBLIC HEALTH REPORTS LA English DT Article C1 Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Atlanta, GA 30341 USA. CDC, Natl Ctr Hlth Stat, Off Res & Methodol, Hyattsville, MD USA. Univ Iowa, Iowa City, IA 52242 USA. Natl Assoc Cty & City Hlth Officials, Washington, DC USA. Cleveland Cty Hlth Dept, Norman, OK USA. Assoc State & Terr Local Hlth Liaison Officials, Norman, OK USA. RP Richards, TB (reprint author), Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, 4770 Buford Hwy NE K-55, Atlanta, GA 30341 USA. NR 31 TC 78 Z9 83 U1 2 U2 3 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPERINTENDENT DOCUMENTS,, WASHINGTON, DC 20402-9325 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD JUL-AUG PY 1999 VL 114 IS 4 BP 359 EP + DI 10.1093/phr/114.4.359 PG 14 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 224ZE UT WOS:000081929200020 PM 10501137 ER PT J AU Groseclose, SL Zaidi, AA DeLisle, SJ Levine, WC Louis, MES AF Groseclose, SL Zaidi, AA DeLisle, SJ Levine, WC Louis, MES TI Estimated incidence and prevalence of genital Chlamydia trachomatis infections in the United States, 1996 SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID BEHAVIOR AB Background and Objective: Because genital Chlamydia trachamatis infections and their sequelae have a major impact on individuals and the health care system, it is important to periodically update estimates of chlamydia incidence and prevalence in the United States. Study Design: Chlamydia incidence and prevalence were estimated using: (1) a method based on estimates of population-specific chlamydia prevalence, and (2) a method based on the chlamydia-to-gonorrhea case rate ratio. Results: Using the prevalence-based method, point prevalence among persons 15 to 44 years of age was estimated to be 1.6 million chlamydial infections, and annual incidence, 2.4 million cases per year. Using a method based on the ratio of reported gonorrhea to chlamydia, incidence was estimated to be 2.8 million infections per year, and prevalence, 1.9 million. Adjustment far sensitivity of diagnostic tests yielded annual incidence estimates of 2.5 to 3.3 million infections. Conclusions: Using two methods, we estimated the annual incidence of chlamydial infections in the United States among persons 15 to 44 years of age to be approximately 3.3 million infections. Critical data needed for more precise estimates include: sensitivity of current diagnostics, better data on infections in males, the current extent of underdetection and underreporting, and better data on duration of infection in men and women. C1 Ctr Dis Control & Prevent, CDC, Natl Ctr HIV STD & TB Prevent, Div STD Prevent, Atlanta, GA 30333 USA. RP Groseclose, SL (reprint author), Ctr Dis Control & Prevent, CDC, Natl Ctr HIV STD & TB Prevent, Div STD Prevent, 1600 Clifton Rd NE,MS C-08, Atlanta, GA 30333 USA. NR 22 TC 57 Z9 60 U1 1 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD JUL PY 1999 VL 26 IS 6 BP 339 EP 344 DI 10.1097/00007435-199907000-00006 PG 6 WC Infectious Diseases SC Infectious Diseases GA 211BA UT WOS:000081139000006 PM 10417022 ER PT J AU Beltrami, JF Vermund, SH Fawal, HJ Moon, TD Von Bargen, JC Holmberg, SD AF Beltrami, JF Vermund, SH Fawal, HJ Moon, TD Von Bargen, JC Holmberg, SD TI HIV AIDS in nonurban Alabama: Risk activities and access to services among HIV-infected persons SO SOUTHERN MEDICAL JOURNAL LA English DT Article ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; PATIENT MIGRATION; UNITED-STATES; WOMEN; NETWORKS; PATTERNS; URBAN AB Background. Because AIDS is increasing in rural areas and small cities of the United States, we sought to further describe the epidemiology of HIV/AIDS in nonurban Alabama. Methods. Extensive interviews of HIV-infected residents of Alabama living outside of urban Birmingham were conducted at clinics throughout the state. Results. Of the 417 HIV-infected persons interviewed from January 1995 through January 1997, 310 (74%) were male, 229 (55%) were white, and 179 (43%) were black. Over time, increasing proportions of HIV infections have likely been acquired in nonurban areas. Of the 417 subjects, 43 (10%) had visited an STD clinic in the past pear, and 31 (7%) had smoked crack-cocaine during the past month. Of the 166 persons who had been sexually active in the past month, 59 (36%) had used alcohol before sex and 56 (34%) used condoms inconsistently. Of the 417 subjects, 161 (39%) currently had no health insurance, and 68 (16%) had lost medical insurance since becoming HIV-infected. Conclusions. HIV-infected persons in nonurban Alabama are likely to have practiced high-risk behavior, to have acquired HIV in nonurban settings, and to have inadequate health insurance. C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA USA. Univ Alabama, Sch Publ Hlth, Birmingham, AL 35294 USA. Univ Alabama, Sch Med, Birmingham, AL 35294 USA. RP Beltrami, JF (reprint author), Georgia Dept Human Resources, Epidemiol & Prevent Branch, 2 Peachtree St NW,6th Floor Tower,Room 6-412, Atlanta, GA 30303 USA. OI Vermund, Sten/0000-0001-7289-8698 FU BHP HRSA HHS [OMB 0920-0262] NR 24 TC 18 Z9 19 U1 2 U2 2 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 USA SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD JUL PY 1999 VL 92 IS 7 BP 677 EP 683 DI 10.1097/00007611-199907000-00006 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 215UC UT WOS:000081401000006 PM 10414476 ER PT J AU Cragan, JD AF Cragan, JD TI Teratogen update: Methylene blue SO TERATOLOGY LA English DT Review ID BODY HEMOLYTIC-ANEMIA; NITRIC-OXIDE; GENETIC AMNIOCENTESIS; GUANYLATE-CYCLASE; TWIN PREGNANCIES; SUPEROXIDE ANION; SEPTIC SHOCK; MIDTRIMESTER AMNIOCENTESIS; CHRONIC PERIODONTITIS; SODIUM-NITROPRUSSIDE C1 US Dept HHS, Publ Hlth Serv, Ctr Dis Control & Prevent, Natl Ctr Environm Hlth,Div Birth Defects & Dev Di, Atlanta, GA 30333 USA. RP Cragan, JD (reprint author), Ctr Dis Control & Prevent, Div Birth Defects & Dev Disabil, MSF45,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 87 TC 36 Z9 38 U1 0 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0040-3709 J9 TERATOLOGY JI Teratology PD JUL PY 1999 VL 60 IS 1 BP 42 EP 48 DI 10.1002/(SICI)1096-9926(199907)60:1<42::AID-TERA12>3.0.CO;2-Z PG 7 WC Developmental Biology; Toxicology SC Developmental Biology; Toxicology GA 210UY UT WOS:000081124100012 PM 10413340 ER PT J AU Areola, OO Jadhav, AL Williams-Johnson, M AF Areola, OO Jadhav, AL Williams-Johnson, M TI Relationship between lead accumulation in blood and soft tissues of rats subchronically exposed to low levels of lead SO TOXIC SUBSTANCE MECHANISMS LA English DT Article DE exposure duration; lead exposure; pattern of accumulation; tissue distribution ID TOXICITY; DOPAMINE; CHILDREN; BIRTH AB Studies on the distribution of lead (Pb) at exposure levels that produce blood Pb levels similar to those considered a potential concern (greater than or equal to 10-14 mu g/dl) are seriously lacking in the scientific literature. Because the manifestations of toxic effects of Pb vary depending on concentration and site of action, delineation of patterns of accumulation of Pb in tissues that may serve as sites of action at low levels of exposure may provide critical clues in elucidating the toxic effects of Pb. Also of importance is the contention that blood Pb levels may not adequately represent the potential for tissue-specific toxicity, particularly at low levels of exposure. This study was designed to examine the temporal pattern of Pb accumulation in blood and in various soft tissues during subchronic oral exposure to 5 or 50 ppm Pb. Sixty-three Long-Evans male rats (21 days old) were randomly divided into three groups and were provided 0 (50 ppm sodium acetate) 5, or 50 ppm Pb acetate in drinking water for 90 days. Rats from the three groups were sacrificed at 2-week intervals, and lead concentrations in the blood and seven soft tissues were determined with an atomic absorption spectrophotometer. While there were no significant blood Pb elevations following 5 ppm Pb exposure, the kidney and the brain showed significant Pb accumulation relative to the respective controls. In. the 50-ppm Pb-exposed group, all tissues except testis and liver showed significantly greater Pb accumulation (p < .05) than, the controls. However in the prostate, spleen, liver, and testis, there were no significant differences between the 50-ppm and the 5-ppm exposure groups. Although there were time-dependent variations over the 90-day period, the order of magnitude (ng/g wet tissue) of Pb accumulation in the Pb-treated groups was as follows: kidney > brain > spleen > prostate > heart > testis and liver. These results show that at 5 ppm Pb exposure, brain and kidney accumulate Pb significantly, confirming that at these exposure levels, blood Pb is not a good index of tissue burden. C1 Texas So Univ, Coll Pharm & Hlth Sci, Minor Ctr Toxicol Res, Houston, TX 77004 USA. US Dept HHS, Div Toxicol, Agcy Tox Subst & Dis Registry, Atlanta, GA USA. NR 31 TC 2 Z9 2 U1 2 U2 5 PU TAYLOR & FRANCIS LTD PI LONDON PA ONE GUNPOWDER SQUARE, LONDON EC4A 3DE, ENGLAND SN 1076-9188 J9 TOX SUBST MECH JI Tox. Subst. Mech. PD JUL-SEP PY 1999 VL 18 IS 3 BP 149 EP 161 DI 10.1080/107691899229115 PG 13 WC Biochemistry & Molecular Biology; Toxicology SC Biochemistry & Molecular Biology; Toxicology GA 231LA UT WOS:000082309400004 ER PT J AU Zhu, H Snawder, JE Clark, JC Moorman, WJ Savage, RE AF Zhu, H Snawder, JE Clark, JC Moorman, WJ Savage, RE TI Inhibition of rabbit renal ornithine decarboxylase activity by lead SO TOXICOLOGY METHODS LA English DT Article DE kidney; lead; ODC ID MULTIPLE IONIC FORMS; POLYAMINE METABOLISM; DNA-SYNTHESIS; RAT; TOXICITY; ACETATE; PHOSPHORYLATION; INDUCTION; GROWTH; LIVER AB Ornithine decarboxylase (ODC) is the first and the rate-limiting enzyme in polyamine biosynthesis. Polyamines play key roles in cell proliferation, renal membrane transportation, and plasma membrane calcium fluxes. As part of a multidisciplinary research project to evaluate the application of the rabbit as a relevant model for male reproductive toxicology, the effect of blood lead on rabbit renal ODC activity was investigated. Kidneys from rabbits with experimentally established total blood lead concentrations of 0, 20, 40 and 80 mu g/dL and maintained at these concentrations for 10 weeks were removed at sacrifice and assayed for ODC activity. ODC activity of rabbit kidney decreased as blood lead concentration increased in a dose-dependent manner Direct addition of lead to ODC assay mixture did not alter ODC activity. At the blood lead concentrations examined, body weights of each group increased constantly throughout the study period. Overt lead toxicity was not present among the rabbits during the exposure period. The ratio of rabbit kidney to total body weight did not show a significant difference as the blood lead concentration increased. It is possible that the major pathological lesion of the rabbit kidney with subchronic lead exposure at target blood lead concentrations (20-80 mu g/dL) is characterized by very subtle renal tubular degeneration, though this requires further validation. The results also demonstrated an apparent selective inhibition of lead on form A ODC activity when renal multiform ODC activities derived from control rabbits are compared with those of rabbits maintained at a 40 mu g/dL blood lead concentration. It was recently reported that increasing blood concentrations of lead, even within a range considered Lour, impaired kidney function in adult men. Rabbits and humans share many similarities in the Luminal Lead load of renal tubular cells in lead intoxication. Investigation of the kidney ODC profile in lead-exposed rabbits can be useful to further characterize the mechanism of lead nephrotoxicity in humans. C1 NIOSH, Expt Toxicol Branch, Div Biomed & Behav Sci, Cincinnati, OH 45226 USA. RP Savage, RE (reprint author), NIOSH, Expt Toxicol Branch, Div Biomed & Behav Sci, Cincinnati, OH 45226 USA. NR 45 TC 1 Z9 1 U1 1 U2 2 PU TAYLOR & FRANCIS LTD PI LONDON PA ONE GUNPOWDER SQUARE, LONDON EC4A 3DE, ENGLAND SN 1051-7235 J9 TOXICOL METHOD JI Toxicol. Method. PD JUL-SEP PY 1999 VL 9 IS 3 BP 125 EP 136 PG 12 WC Toxicology SC Toxicology GA 231AG UT WOS:000082283400001 ER PT J AU Jiang, B Gentsch, JR Tsunemitsu, H Saif, LJ Glass, RI AF Jiang, B Gentsch, JR Tsunemitsu, H Saif, LJ Glass, RI TI Sequence analysis of the gene encoding VP4 of a bovine group C rotavirus: Molecular evidence for a new P genotype SO VIRUS GENES LA English DT Article DE rotavirus; Shintoku; Cowden; Bristol; VP4; P genotpye ID GROUP-A ROTAVIRUSES; EQUIVALENT AB Nucleotide sequence of the bovine group C rotavirus Shintoku strain gene 3 was determined. Segment 3 is 2253 nucleotides (nt) in length and contains a long open reading frame (ORF) beginning at nt 22 and terminating at nt 2223. This ORF encodes a polypeptide of 733 amino acids with a predicted molecular mass of 83 kDa. The deduced gene 3 amino acid sequence shares 79% and 73% identities with VP4 of the porcine Cowden and human Bristol strains, respectively. Lack of high amino acid sequence homology in VP4 of bovine, porcine, and human group C rotaviruses indicates that the Shintoku strain represents a new P genotype. C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Div Viral & Rickettsial Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. Natl Inst Anim Hlth, Shichinohe Res Unit, Aomori, Japan. Ohio State Univ, Ohio Agr Res & Dev Ctr, Food Anim Hlth Res Program, Wooster, OH 44691 USA. RP Jiang, B (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Div Viral & Rickettsial Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. NR 17 TC 20 Z9 21 U1 0 U2 0 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA SPUIBOULEVARD 50, PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS SN 0920-8569 J9 VIRUS GENES JI Virus Genes PD JUL PY 1999 VL 19 IS 1 BP 85 EP 88 PG 4 WC Genetics & Heredity; Virology SC Genetics & Heredity; Virology GA 216ZC UT WOS:000081473500010 PM 10499454 ER PT J CA CDC TI Prenatal discussion of HIV testing and maternal HIV testing - 14 states, 1996-1997 (Reprinted from MMWR, vol 48, pg 401-404, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CDC, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Pregnancy Risk Assessment Monitoring Syst Working, Atlanta, GA 30333 USA. CDC, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Surveillance & Epidemiol, Atlanta, GA 30333 USA. RP CDC, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Pregnancy Risk Assessment Monitoring Syst Working, Atlanta, GA 30333 USA. NR 8 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0098-7484 EI 1538-3598 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 30 PY 1999 VL 281 IS 24 BP 2278 EP 2279 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 207FN UT WOS:000080925600010 ER PT J CA CDC TI Determination of nicotine, pH, and moisture content of six US commercial moist snuff products - Florida, January-February 1999 (Reprinted from MMWR, vol 48, pg 398-401, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Univ Miami, Coral Gables, FL 33124 USA. Florida Dept Hlth, Florida Off Tobacco Control, Tallahassee, FL USA. CDC, Natl Ctr Environm Hlth, Div Sci Lab, Air Toxicants Branch, Atlanta, GA 30333 USA. CDC, Natl Ctr Chron Dis Prevent & Hlth Promot, Off Smoking & Hlth, Atlanta, GA 30333 USA. RP CDC (reprint author), Univ Miami, Coral Gables, FL 33124 USA. NR 1 TC 0 Z9 0 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 30 PY 1999 VL 281 IS 24 BP 2279 EP 2280 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 207FN UT WOS:000080925600011 ER PT J AU Lehman, JS AF Lehman, JS TI Anonymous HIV testing and medical care - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Lehman, JS (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 30 PY 1999 VL 281 IS 24 BP 2282 EP 2283 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 207FN UT WOS:000080925600014 ER PT J AU Matte, TD AF Matte, TD TI Reducing blood lead levels - Benefits and strategies SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID NUTRITION EXAMINATION SURVEY; NATIONAL-HEALTH; ASCORBIC-ACID; NHANES; CARIES C1 Ctr Dis Control & Prevent, Div Environm Hazards & Hlth Effects, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. RP Matte, TD (reprint author), Ctr Dis Control & Prevent, Div Environm Hazards & Hlth Effects, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. NR 24 TC 8 Z9 8 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 30 PY 1999 VL 281 IS 24 BP 2340 EP 2342 DI 10.1001/jama.281.24.2340 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 207FN UT WOS:000080925600035 PM 10386560 ER PT J AU Beyers, RH Shenton, LR AF Beyers, RH Shenton, LR TI Sister chromatid exchange data fit with a mixture of Poisson distributions SO MUTATION RESEARCH-FUNDAMENTAL AND MOLECULAR MECHANISMS OF MUTAGENESIS LA English DT Article DE chi-squared; mixture distribution; generalized Poisson distribution; maximum likelihood AB Bowman et al. [K.O. Bowman, Wesley Eddings, Marvin A. Kastenbaum, L.R. Shenton. Sister chromatid exchange data and Gram-Charlier series, Mutat. Res., 403 (1998) 159-169.] have shown that a Gram-Charlier modification of a negative binomial distribution gives a reasonable fit to counts of sister chromatid exchange (SCE) data originally presented by Bender et al. [M.A. Bender, R.J. Preston, R. C. Leonard, B.E. Pyatt, P.C. Gooch, On the distribution of spontaneous SCE in human peripheral blood lymphocytes, Mutat. Res., 281 (1992) 227-232.]. Here we show that a mixture of a generalized Poisson distributions also fits the data, Advantages of the generalized Poisson mixture include a simplified model involving only four parameters which fits the data more closely according to the chi-squared goodness-of-fit criterion. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA 30333 USA. Univ Georgia, Dept Stat, Athens, GA 30602 USA. RP Beyers, RH (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Mail Stop E48, Atlanta, GA 30333 USA. NR 7 TC 2 Z9 2 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0027-5107 J9 MUTAT RES-FUND MOL M JI Mutat. Res.-Fundam. Mol. Mech. Mutagen. PD JUN 30 PY 1999 VL 427 IS 2 BP 157 EP 162 PG 6 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology SC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology GA 214KQ UT WOS:000081327500009 ER PT J AU Carlton, JMR Galinski, MR Barnwell, JW Dame, JB AF Carlton, JMR Galinski, MR Barnwell, JW Dame, JB TI Karyotype and synteny among the chromosomes of all four species of human malaria parasite SO MOLECULAR AND BIOCHEMICAL PARASITOLOGY LA English DT Article DE plasmodium; karyotype; genome map; comparative genomics; synteny ID PLASMODIUM-FALCIPARUM GENOME; LINKAGE GROUPS; IN-VITRO; MOLECULAR KARYOTYPE; SIZE POLYMORPHISMS; PROTEIN GENES; P-FALCIPARUM; MAP; VIVAX; SEQUENCE AB The karyotype and chromosomes of the human malaria parasite Plasmodium falciparum have been well characterized in recent years. Here we present karyotype maps of the three other human malaria species, P. vivax, P. malariae and P. ovale. Chromosomes of these species were found to be of significantly higher molecular weight than those of P. falciparum. Some 14 P. vivax chromosomes were distinguishable, and 12-14 P. malariae and P. ovale chromosomes. The chromosome location of 15 genes, known to be present within five synteny groups between P. falciparum and the rodent malarias, were analyzed, and four of these synteny groups were found to be conserved between all of the human malaria species. In addition, a more detailed genome map of P. vivax was made using ten housekeeping and antigen genes. These data represent the first karyotype maps of all species of malaria which infect man. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Univ Florida, Coll Vet Med, Dept Pathobiol, Gainesville, FL 32610 USA. Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. RP Carlton, JMR (reprint author), Univ Florida, Coll Vet Med, Dept Pathobiol, Gainesville, FL 32610 USA. FU NIAID NIH HHS [AI39211, AI24710, AI35804] NR 49 TC 44 Z9 46 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0166-6851 J9 MOL BIOCHEM PARASIT JI Mol. Biochem. Parasitol. PD JUN 25 PY 1999 VL 101 IS 1-2 BP 23 EP 32 DI 10.1016/S0166-6851(99)00045-6 PG 10 WC Biochemistry & Molecular Biology; Parasitology SC Biochemistry & Molecular Biology; Parasitology GA 210TB UT WOS:000081119800003 PM 10413040 ER PT J AU Daneshvar, MI Peralta, JM Casay, GA Narayanan, N Evans, L Patonay, G Strekowski, L AF Daneshvar, MI Peralta, JM Casay, GA Narayanan, N Evans, L Patonay, G Strekowski, L TI Detection of biomolecules in the near-infrared spectral region via a fiber-optic immunosensor SO JOURNAL OF IMMUNOLOGICAL METHODS LA English DT Article DE immunoassay; fluorescent; near-infrared; fiber-optic; immunosensor; Legionella ID SENSORS AB The design, development, and application of a fluorescent fiber-optic immunosensor (FFOI) procedure for the detection of antibody/antigen binding within the near-infrared (NIR) spectral region is reported. The technique was developed through the combined use of fiber-optics, semiconductor laser excitation, fluorescence detection, NIR dye, and immunochemical techniques. The antibody is immobilized on the FFOI's sensing tip and utilized as a recognition component for trace amounts of specific antigen. The FFOI is constructed to utilize antibody sandwich technique. Three individual immunoassays are reported. The first two assays utilize the FFOI and NN382, a commercial NIR dye, for the detection of human immunoglobulin G (IgG). In these assays, goat anti-human IgG antibody (GAHG) is immobilized on the sensitive terminal of the FFOI followed by the exposure of the antibody-coated terminal to human IgG. The probe is then introduced to GAHG labeled with NN382, generating a signal. The third assay utilizes the FFOI for the detection of trace amounts of Legionella pneumophila serogroup 1 (LPS1). In this assay, rabbit anti-LPS1 antibody is immobilized on the sensitive terminal of the FFOI followed by exposure to LPS1. The antigen-coated probe is then treated with monoclonal anti-LPS1 antibody followed by incubation with GAHG labeled with NN382. The assays are optimized to detect the corresponding antigen via the NIR-FFOI. Typical measurements are performed in 10-15 min. A 780-nm semiconductor laser provides the excitation of the immune complex and the resulting emission is detected by a 820-nm silicon photodiode detector. The intensity of the resulting fluorescence is directly proportional to the concentration of the antigen. Solutions of IgG and LPS 1 with concentrations as low as 10(-11) M and 0.5 ng/ml, respectively, have been detected with a minimum interference. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Georgia State Univ, Dept Chem, Atlanta, GA 30303 USA. Univ Fed Rio de Janeiro, Inst Microbiol, BR-21941 Rio De Janeiro, Brazil. Ansell, Dothan, AL 36302 USA. LI COR, Lincoln, NE 68504 USA. RP Daneshvar, MI (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd,MS G06, Atlanta, GA 30333 USA. NR 17 TC 23 Z9 25 U1 3 U2 9 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0022-1759 J9 J IMMUNOL METHODS JI J. Immunol. Methods PD JUN 24 PY 1999 VL 226 IS 1-2 BP 119 EP 128 DI 10.1016/S0022-1759(99)00050-2 PG 10 WC Biochemical Research Methods; Immunology SC Biochemistry & Molecular Biology; Immunology GA 211LD UT WOS:000081161800012 PM 10410977 ER PT J AU Fries, I Paxton, RJ Tengo, J Slemenda, SB da Silva, AJ Pieniazek, NJ AF Fries, I Paxton, RJ Tengo, J Slemenda, SB da Silva, AJ Pieniazek, NJ TI Morphological and molecular characterization of Antonospora scoticae n. gen., n. sp (Protozoa, Microsporidia) a parasite of the communal bee, Andrena scotica Perkins, 1916 (Hymenoptera, Andrenidae) SO EUROPEAN JOURNAL OF PROTISTOLOGY LA English DT Article DE Antonospora scoticae n. gen and n. sp.; Andrena scotica; ultrastructure; molecular phylogeny; taxonomy ID RIBOSOMAL-RNA SEQUENCES; NOSEMA-APIS Z; ENTEROCYTOZOON-BIENEUSI; SP DIPTERA; ALIGNMENT; PHYLOGENY; POLYMERASE; INFECTION; TAXONOMY; REGION AB The new microsporidium Antonospora scoticae n. gen., n. sp., a parasite of the communal bee Andrena scotica, is described based on light microscopy, ultrastructural characteristics and the nucleotide sequence of the small subunit ribosomal RNA coding region. The parasite is apansporoblastic and develops in close contact with the host cytoplasm. All developmental stages are diplokaryotic. Cytoplasmic fission was not observed, but the sporogony is believed to be disporoblastic. Live spores are ovocylindrical, straight to slightly curved, and measure 6.8 x 2.7 mu m whereas spores fixed and stained for TEM measure 5.0 x 1.8 mu m. The exospore is four-layered, with an internal single layer followed by a thicker, more electron dense layer, then another single layer followed by a thin external double layer. The polar filament is isofilar and arranged in 15-22 coils in the posterior and mid-part of the spore. The polaroplast has tightly packed lamellae that become less densely packed in the posterior region. The coding region of the small subunit ribosomal RNA is 1371 base pairs long. Its GC content (62%) is significantly higher than previously reported for this group of organisms. The systematic position of the described microsporidium was found to be ambiguous and is discussed in the context of inconsistencies between the molecular and morphological taxonomy of microsporidia. A new genus is proposed for A. scoticae without defining superior taxa because the current developmental and morphological evidence is limited and partly contradictory to the molecular data. Current taxonomies of microsporidia are based on characters that are most likely polyphyletic in nature. Traditional systems of microsporidian taxonomy may need to be extensively revised, as molecular data become available. C1 Swedish Univ Agr Sci, Dept Entomol, S-75007 Uppsala, Sweden. Univ Tubingen, Inst Zool, D-72076 Tubingen, Germany. Uppsala Univ, Ecol Res Stn, S-38693 Farjestaden, Sweden. Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA USA. RP Fries, I (reprint author), Swedish Univ Agr Sci, Dept Entomol, Box 7044, S-75007 Uppsala, Sweden. RI Paxton, Robert/D-7082-2015 OI Paxton, Robert/0000-0003-2517-1351 NR 39 TC 19 Z9 19 U1 0 U2 4 PU GUSTAV FISCHER VERLAG PI JENA PA VILLENGANG 2, D-07745 JENA, GERMANY SN 0932-4739 J9 EUR J PROTISTOL JI Eur. J. Protistol. PD JUN 21 PY 1999 VL 35 IS 2 BP 183 EP 193 PG 11 WC Microbiology SC Microbiology GA 220HN UT WOS:000081659300008 ER PT J AU Jaffe, HW Pellett, PE AF Jaffe, HW Pellett, PE TI Human herpesvirus 8 and Kaposi's sarcoma - Some answers, more questions SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID HUMAN-HERPESVIRUS-8; TRANSMISSION; INFECTION C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Jaffe, HW (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 11 TC 14 Z9 16 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUN 17 PY 1999 VL 340 IS 24 BP 1912 EP 1913 DI 10.1056/NEJM199906173402410 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 206EC UT WOS:000080863500010 PM 10369856 ER PT J CA CDC TI Impact of arthritis and other rheumatic conditions on the health-care system - United States, 1997 (Reprinted from MMWR, vol 48, pg 349, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID COST RP CDC (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Div Hlth Care Stat, Hyattsville, MD USA. NR 10 TC 0 Z9 0 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 16 PY 1999 VL 281 IS 23 BP 2177 EP 2178 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 204RB UT WOS:000080777000012 ER PT J AU Hay, A Gust, I Hampson, A Nerome, K Lim, W Chan, M Saw, TA Mak, KH Canas, L Guo, Y AF Hay, A Gust, I Hampson, A Nerome, K Lim, W Chan, M Saw, TA Mak, KH Canas, L Guo, Y TI Update: Influenza activity - United States and worldwide, 1998-99 season, and composition of the 1999-2000 influenza vaccine (Reprinted from MMWR, vol 48, pg 374, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 WHO Collaborating Ctr Reference & Res Influenza, Parkville, Vic, Australia. Natl Inst Infect Dis, WHO Collaborating Ctr Reference & Res Influenza, Tokyo, Japan. Dept Hlth Hong Kong, Special Adm Reg, Hong Kong, Peoples R China. Natl Ctr Prevent Med, Inst Virol, Beijing, Peoples R China. Armstrong Lab, Brooks AFB, TX 78235 USA. WHO, Natl Influenza Ctr, Div Emerging & Other Communicable Dis Surveilianc, CH-1211 Geneva, Switzerland. US FDA, Ctr Biol Evaluat & Res, Div Virol, Rockville, MD 20857 USA. CDC, Natl Resp Enter Virus Surveillance Syst Collabora, Atlanta, GA 30333 USA. CDC, WHO Collaborating Labs, Atlanta, GA 30333 USA. CDC, WHO Collaborating Ctr Reference & Res Influenza, Influenza Branch,Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. CDC, Sentinel Phys Influenza Surveillance Syst, Atlanta, GA 30333 USA. CDC, Sentinel Phys Influenza Surveillance Syst, Atlanta, GA 30333 USA. RP Hay, A (reprint author), Natl Inst Med Res, WHO Collaborating Ctr Reference & Res Influenza, Mill Hill, London NW7 1AA, England. NR 5 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 16 PY 1999 VL 281 IS 23 BP 2178 EP 2180 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 204RB UT WOS:000080777000013 ER PT J AU Franks, AL Steinberg, KK AF Franks, AL Steinberg, KK TI Encouraging news from the SERM frontier SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID HORMONE REPLACEMENT THERAPY; POSTMENOPAUSAL WOMEN; BREAST-CANCER; RALOXIFENE; PREVENTION; DISEASE; SYSTEM C1 Prudential Ctr Hlth Care Res, Atlanta, GA USA. Ctr Dis Control & Prevent, Mol Biol Branch, Atlanta, GA USA. RP Franks, AL (reprint author), Prudential Ctr Hlth Care Res, 2859 Paces Ferry Rd,Suite 820, Atlanta, GA USA. NR 20 TC 12 Z9 12 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 16 PY 1999 VL 281 IS 23 BP 2243 EP 2244 DI 10.1001/jama.281.23.2243 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 204RB UT WOS:000080777000042 PM 10376579 ER PT J AU Coates, RJ Bowen, DJ Kristal, AR Feng, ZD Oberman, A Hall, WD George, V Lewis, CE Kestin, M Davis, M Evans, M Grizzle, JE Clifford, CK AF Coates, RJ Bowen, DJ Kristal, AR Feng, ZD Oberman, A Hall, WD George, V Lewis, CE Kestin, M Davis, M Evans, M Grizzle, JE Clifford, CK TI The Women's Health Trial Feasibility Study in Minority Populations: Changes in dietary intakes SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE blacks; clinical trials; diet; dietary fats; health education; Hispanic Americans; nutrition ID LOW-FAT DIET; FACTOR-INTERVENTION-TRIAL; BREAST-CANCER; RANDOMIZED TRIAL; PREVENTION; RISK; NUTRIENT; PROGRAM; THERAPY; DESIGN AB This randomized clinical trial examined the feasibility of low-fat dietary interventions among postmenopausal women of diverse backgrounds. During 1992-1994, 2,208 women aged 50-79 years, 28% of whom were black and 16% Hispanic, enrolled at clinics in Atlanta, Georgia, Birmingham, Alabama, and Miami, Florida. Intervention/support groups met periodically with a nutritionist to reduce fat intake to 20% of energy and to make other diet modifications. At 6 months postrandomization, the intervention group reduced fat intake from 39.7% of energy at baseline to 26.4%, a reduction of 13.3% of energy, compared with 2.3% among controls. Saturated fatty acid and cholesterol intakes were reduced, but intakes of fruits and vegetables, but not grain products, increased. Similar effects were observed at 12 and 18 months. Black and non-Hispanic white women had similar levels of reduction in fat, but the decrease in Hispanic women was less. Changes did not vary significantly by education. While bias in self-reported intakes may have resulted in somewhat overestimated changes in fat intake, the reported reduction was similar to the approximately 10% of energy decrease found in most trials and suggests that large changes in fat consumption can be attained in diverse study populations and in many subgroups. C1 Emory Univ, Dept Epidemiol, Atlanta, GA 30322 USA. Fred Hutchinson Canc Res Ctr, Dept Publ Hlth Sci, Seattle, WA 98104 USA. Univ Alabama, Med Sch Birmingham, Div Prevent Med, Birmingham, AL USA. Emory Univ, Dept Med, Atlanta, GA 30322 USA. Univ Miami, Dept Epidemiol & Publ Hlth, Miami, FL 33152 USA. Emory Univ, Dept Behav Sci & Hlth Educ, Atlanta, GA 30322 USA. NHLBI, Bethesda, MD 20892 USA. NCI, Rockville, MD USA. RP Coates, RJ (reprint author), Ctr Dis Control & Prevent, Div Canc Prevent & Control, MS K-55,4770 Buford Highway,NE, Atlanta, GA 30341 USA. RI Kristal, Alan/A-8779-2008; OI Kristal, Alan/0000-0002-7329-1617 FU NCI NIH HHS [N01-CN-25425, N01-CN-25426, N01-CN-25427] NR 36 TC 52 Z9 52 U1 0 U2 1 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 15 PY 1999 VL 149 IS 12 BP 1104 EP 1112 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 205HA UT WOS:000080814200004 PM 10369504 ER PT J AU Gorjanc, ML Flanders, WD VanDerslice, J Hersh, J Malilay, J AF Gorjanc, ML Flanders, WD VanDerslice, J Hersh, J Malilay, J TI Effects of temperature and snowfall on mortality in Pennsylvania SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE cerebrovascular disorders; cold climate; heart diseases; mortality; respiration disorders; weather ID HIGH CORONARY MORTALITY; UNITED-STATES; DEATH; FLUCTUATIONS; CLIMATE; SWEDEN; WINTER AB The relation between exposure to severe cold weather and mortality is examined in a retrospective study of deaths occurring during the month of January from 1991 to 1996 in Pennsylvania. Using division-days as units of observation (n = 1,560) aggregated from death certificates and geographic divisions, the authors estimated mortality rates for total deaths and deaths due to ischemic heart disease, cerebrovascular diseases, and respiratory diseases by analyses based on generalized estimating equations. Total mortality increased on days of "extreme" climatic conditions, that is, when snowfall was greater than 3 cm and when temperatures were below -7 degrees C (rate ratio (RR) = 1.27, 95 percent confidence interval (CI) 1.12-1.44). On days of extreme conditions, mortality due to ischemic heart diseases tripled among males aged 35-49 years (RR = 3.54, 95 percent CI 2.35-5.35), increased for men aged 50-64 years (RR = 1.77, 95 percent CI 1.32-2.38), and rose for males aged 65 years and older (RR = 1.58, 95 percent CI 1.37-1.82), when compared with milder conditions. Among females, mortality for those aged 65 years and older increased for respiratory causes (RR = 1.68, 95 percent CI 1.28-2.21) and cerebrovascular causes (RR = 1.47, 95 percent CI 1.13-1.91). Cold and snow exposure may be hazardous among men as young as 35 years. C1 Ctr Dis Control & Prevent, Environm Hazards Epidemiol Sect, Div Environm Hazards & Hlth Effects, Hlth Studies Branch,Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA. Univ Texas, Houston Sch Publ Hlth, El Paso, TX 79968 USA. Penn Dept Hlth, Bur Epidemiol, Harrisburg, PA 17108 USA. RP Malilay, J (reprint author), Ctr Dis Control & Prevent, Environm Hazards Epidemiol Sect, Div Environm Hazards & Hlth Effects, Hlth Studies Branch,Natl Ctr Environm Hlth, 4770 Buford Highway,NE,Mailstop F-46, Atlanta, GA 30341 USA. NR 25 TC 27 Z9 27 U1 1 U2 2 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 15 PY 1999 VL 149 IS 12 BP 1152 EP 1160 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 205HA UT WOS:000080814200010 PM 10369510 ER PT J AU Draper, WM Ashley, K Glowacki, CR Michael, PR AF Draper, WM Ashley, K Glowacki, CR Michael, PR TI Industrial hygiene chemistry: Keeping pace with rapid change in the workplace SO ANALYTICAL CHEMISTRY LA English DT Review ID VOLATILE ORGANIC-COMPOUNDS; X-RAY-FLUORESCENCE; CAPILLARY GAS-CHROMATOGRAPHY; SOLID-PHASE MICROEXTRACTION; LINKED-IMMUNOSORBENT-ASSAY; NEUTRON-ACTIVATION ANALYSIS; PERFORMANCE LIQUID-CHROMATOGRAPHY; POLYCYCLIC AROMATIC-HYDROCARBONS; ANALYTICAL INTERLABORATORY TEST; CERTIFIED REFERENCE MATERIALS C1 Calif Dept Hlth Serv, Sanitat & Radiat Lab, Berkeley, CA 94704 USA. NIOSH, US Dept Hlth & Human Serv, Ctr Dis Control & Prevent, Cincinnati, OH 45226 USA. Ashland Chem Inc, Dublin, OH 43017 USA. Monsanto Co, St Louis, MO 63167 USA. RP Draper, WM (reprint author), Calif Dept Hlth Serv, Sanitat & Radiat Lab, 2151 Berkeley Way, Berkeley, CA 94704 USA. RI Ashley, Kevin/C-9005-2011 NR 640 TC 3 Z9 3 U1 3 U2 9 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0003-2700 J9 ANAL CHEM JI Anal. Chem. PD JUN 15 PY 1999 VL 71 IS 12 BP 33R EP 60R PG 28 WC Chemistry, Analytical SC Chemistry GA 206XW UT WOS:000080906600003 PM 10384781 ER PT J AU Slagle, BL Kaufman, RH Reeves, WC Icenogle, JP AF Slagle, BL Kaufman, RH Reeves, WC Icenogle, JP TI Expression of ras, c-myc, and p53 proteins in cervical intraepithelial neoplasia - Author reply SO CANCER LA English DT Letter C1 Baylor Coll Med, Div Mol Virol, Houston, TX 77030 USA. Baylor Coll Med, Dept Obstet & Gynecol, Houston, TX 77030 USA. Ctr Dis Control & Prevent, Viral Exanthems & Herpesvirus Branch, Div Viral & Rickettsial Dis, Atlanta, GA USA. RP Slagle, BL (reprint author), Baylor Coll Med, Div Mol Virol, 1 Baylor Plaza, Houston, TX 77030 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0008-543X J9 CANCER JI Cancer PD JUN 15 PY 1999 VL 85 IS 12 BP 2669 EP 2669 DI 10.1002/(SICI)1097-0142(19990615)85:12<2669::AID-CNCR26>3.0.CO;2-A PG 1 WC Oncology SC Oncology GA 204RL UT WOS:000080777900026 ER PT J AU Stiger, TR Barnhart, HX Williamson, JM AF Stiger, TR Barnhart, HX Williamson, JM TI Testing proportionality in the proportional odds model fitted with GEE SO STATISTICS IN MEDICINE LA English DT Article ID GENERALIZED ESTIMATING EQUATIONS; CATEGORICAL-DATA; LINEAR-MODELS; LOGISTIC-REGRESSION; ORDINAL DATA; WALDS TEST; RISK AB Generalized estimating equations (GEE) methodology as proposed by Liang and Zeger has received widespread use in the analysis of correlated binary data. Miller et al, and Lipsitz er al. extended GEE to correlated nominal and ordinal categorical data; in particular, they used GEE for fitting McCullagh's proportional odds model. In this paper, we consider robust (that is, empirically corrected) and model-based versions of both a score test and a Wald test for assessing the assumption of proportional odds in the proportional odds model fitted with GEE. The Wald test is based on fitting separate multiple logistic regression models for each dichotomization of the response variable, whereas the score test requires fitting just the proportional odds model. We evaluate the proposed tests in small to moderate samples by simulating data from a series of simple models. We illustrate the use of the tests on three data sets from medical studies. (C) 1999 John Wiley & Sons, Ltd. C1 Pfizer Inc, Div Cent Res, Dept Biometr, Groton, CT 06340 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol E48, Atlanta, GA 30333 USA. RP Stiger, TR (reprint author), Pfizer Inc, Div Cent Res, Dept Biometr, E Point Rd, Groton, CT 06340 USA. FU NHLBI NIH HHS [R29 HL58014-01] NR 24 TC 20 Z9 20 U1 0 U2 6 PU JOHN WILEY & SONS LTD PI W SUSSEX PA BAFFINS LANE CHICHESTER, W SUSSEX PO19 1UD, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD JUN 15 PY 1999 VL 18 IS 11 BP 1419 EP 1433 DI 10.1002/(SICI)1097-0258(19990615)18:11<1419::AID-SIM127>3.0.CO;2-Q PG 15 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 204LA UT WOS:000080764700009 PM 10399205 ER PT J AU DeStefano, F Chen, RT AF DeStefano, F Chen, RT TI Negative association between MMR and autism SO LANCET LA English DT Editorial Material ID UK C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Vaccine Safety & Dev Branch, Atlanta, GA 30333 USA. RP DeStefano, F (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Vaccine Safety & Dev Branch, Atlanta, GA 30333 USA. NR 9 TC 13 Z9 13 U1 2 U2 12 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUN 12 PY 1999 VL 353 IS 9169 BP 1987 EP 1988 DI 10.1016/S0140-6736(99)00160-9 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 205GD UT WOS:000080812200003 PM 10376608 ER PT J AU Weidle, PJ Mbidde, E Djomand, G Lackritz, EM AF Weidle, PJ Mbidde, E Djomand, G Lackritz, EM TI Relevance of AIDS treatment with two nucleoside analogues alone SO LANCET LA English DT Editorial Material ID INFECTION; MORTALITY C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Projet RETRO CI, Abidjan, Cote Ivoire. Uganda Canc Inst, Kampala, Uganda. RP Weidle, PJ (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. NR 11 TC 4 Z9 4 U1 0 U2 0 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUN 12 PY 1999 VL 353 IS 9169 BP 1989 EP 1990 DI 10.1016/S0140-6736(99)00161-0 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 205GD UT WOS:000080812200005 PM 10376610 ER PT J CA Ctr Dis Control Prevention TI Motor-vehicle safety: A 20th century public health achievement (Reprinted from MMWR, vol 48, pg 369, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CDC, Div Unintent Injury Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. RP CDC, Div Unintent Injury Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 9 PY 1999 VL 281 IS 22 BP 2080 EP 2082 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 202TJ UT WOS:000080668000012 ER PT J AU Henderson, DA Inglesby, TV Bartlett, JG Ascher, MS Eitzen, E Jahrling, PB Hauer, J Layton, M McDade, J Osterholm, MT O'Toole, T Parker, G Perl, T Russell, PK Tonat, K AF Henderson, DA Inglesby, TV Bartlett, JG Ascher, MS Eitzen, E Jahrling, PB Hauer, J Layton, M McDade, J Osterholm, MT O'Toole, T Parker, G Perl, T Russell, PK Tonat, K CA Working Grp Civilian Biodefense TI Smallpox as a biological weapon - Medical and public health management SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ORTHOPOXVIRUS; DISEASE AB Objective. To develop consensus-based recommendations for measures to be taken by medical and public health professionals following the use of smallpox as a biological weapon against a civilian population. Participants. The working group included 21 representatives from staff of major medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence. The first author (D.A.H..) conducted a literature search in conjunction with the preparation of another publication on smallpox as well as this article. The literature identified was reviewed and opinions were sought from experts in the diagnosis and management of smallpox, including members of the working group. Consensus Process. The first draft of the consensus statement was a synthesis of information obtained in the evidence-gathering process. Members of the working group provided formal written comments that were incorporated into the second draft of the statement. The working group reviewed the second draft on October 30, 1998. No significant disagreements existed and comments were incorporated into a third draft. The fourth and final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions. Specific recommendations are made regarding smallpox vaccination, therapy, postexposure isolation and infection control, hospital epidemiology and infection control, home care, decontamination of the environment, and additional research needs. In the event of an actual release of smallpox and subsequent epidemic, early detection, isolation of infected individuals, surveillance of contacts, and a focused selective vaccination program will be the essential items of an effective control program. C1 Johns Hopkins Univ, Ctr Civilian Biodef Studies, Baltimore, MD 21202 USA. Johns Hopkins Univ, Sch Publ Hlth, Baltimore, MD 21202 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD 21202 USA. Calif Dept Hlth, Berkeley, CA USA. USA, Med Res Inst Infect Dis, Frederick, MD USA. New York City Dept Hlth, Off Emergency Management, New York, NY 10013 USA. New York City Dept Hlth, Off Communicable Dis, New York, NY 10013 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Minnesota Dept Hlth, Minneapolis, MN USA. US Dept HHS, Off Emergency Preparedness, Rockville, MD USA. RP Henderson, DA (reprint author), Johns Hopkins Univ, Ctr Civilian Biodef Studies, Candler Bldg,Suite 850,111 Market Pl, Baltimore, MD 21202 USA. NR 50 TC 512 Z9 523 U1 4 U2 37 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 9 PY 1999 VL 281 IS 22 BP 2127 EP 2137 DI 10.1001/jama.281.22.2127 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 202TJ UT WOS:000080668000036 PM 10367824 ER PT J AU White, NJ Nosten, F Looareesuwan, S Watkins, WM Marsh, K Snow, RW Kokwaro, G Ouma, J Hien, TT Molyneux, ME Taylor, TE Newbold, CI Ruebush, TK Danis, M Greenwood, BM Anderson, RM Olliaro, P AF White, NJ Nosten, F Looareesuwan, S Watkins, WM Marsh, K Snow, RW Kokwaro, G Ouma, J Hien, TT Molyneux, ME Taylor, TE Newbold, CI Ruebush, TK Danis, M Greenwood, BM Anderson, RM Olliaro, P TI Averting a malaria disaster SO LANCET LA English DT Editorial Material ID RESISTANT FALCIPARUM-MALARIA; PLASMODIUM-FALCIPARUM; DRUG-RESISTANCE; PYRIMETHAMINE; CHLOROQUINE; SULFADOXINE; ARTEMETHER; AFRICA C1 Mahidol Univ, Fac Trop Med, Bangkok 10400, Thailand. Wellcome Mahidol Univ Oxford, Trop Med Res Programme, Bangkok, Thailand. KEMRI Wellcome Trust Collaborat Res Programme, Nairobi, Kenya. Minist Hlth, Natl Malaria Control Programme, Nairobi, Kenya. Cho Quan Hosp, Ctr Trop Dis, Ho Chi Minh City, Vietnam. Univ Malawi, Coll Med, Zomba, Malawi. Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England. Univ Oxford, Inst Mol Med, Oxford, England. Ctr Dis Control & Prevent, Atlanta, GA USA. Grp Hosp Pitie Salpetriere, F-75634 Paris, France. London Sch Hyg & Trop Med, London WC1, England. Univ Oxford, Dept Zool, Oxford OX1 3PS, England. WHO, CH-1211 Geneva, Switzerland. RP White, NJ (reprint author), Mahidol Univ, Fac Trop Med, 420-6 Rajvithi Rd, Bangkok 10400, Thailand. RI White, Nicholas/I-4629-2012; OI Newbold, Chris/0000-0002-9274-3789; Nosten, Francois/0000-0002-7951-0745 NR 13 TC 413 Z9 419 U1 1 U2 20 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUN 5 PY 1999 VL 353 IS 9168 BP 1965 EP 1967 DI 10.1016/S0140-6736(98)07367-X PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 202TP UT WOS:000080668500047 PM 10371589 ER PT J AU Farley, TA McFarland, L McClelland, J AF Farley, TA McFarland, L McClelland, J TI Aldicarb as a cause of food poisoning - Louisiana, 1998 (Reprinted from MMWR, vol 48, pg 269, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID TOXICITY C1 Louisiana Dept Hlth & Hosp, Infect Dis Epidemiol Sect, Baton Rouge, LA 70821 USA. Natl Ctr Environm Hlth, Div Environm Hazards & Hlth Effects, Hlth Studies Branch, Louisiana Dept Agr, Baton Rouge, LA USA. CDC, Atlanta, GA 30333 USA. RP Farley, TA (reprint author), Louisiana Dept Hlth & Hosp, Infect Dis Epidemiol Sect, Baton Rouge, LA 70821 USA. NR 11 TC 0 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 1999 VL 281 IS 21 BP 1979 EP 1980 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 200NN UT WOS:000080546700007 ER PT J AU Cohen, BB Friedman, DJ Zhang, Z Trudeau, EB Walker, DK Anderka, M Fogerty, S Franklin, S McKenna, PA AF Cohen, BB Friedman, DJ Zhang, Z Trudeau, EB Walker, DK Anderka, M Fogerty, S Franklin, S McKenna, PA TI Impact of multiple births on low birthweight - Massachusetts, 1989-1996 (Reprinted from vol 48, pg 289, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID UNITED-STATES C1 Massachusetts Dept Publ Hlth, Bur Family & Community Hlth, Boston, MA 02111 USA. March Dimes, Boston, MA USA. CDC, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Atlanta, GA 30333 USA. NR 9 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 1999 VL 281 IS 21 BP 1980 EP 1981 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 200NN UT WOS:000080546700008 ER PT J AU Sfetcu, O Cremenasiu, D Circiumaru, S Barhala, M Florescu, R Duca, E Cojan, A Marialaky, E Yanku, MM Irimia, M Dobrescu, A Popa, M Ion-Nedelcu, N Craciun, D AF Sfetcu, O Cremenasiu, D Circiumaru, S Barhala, M Florescu, R Duca, E Cojan, A Marialaky, E Yanku, MM Irimia, M Dobrescu, A Popa, M Ion-Nedelcu, N Craciun, D TI Frequency of vaccine-related and therapeutic injections - Romania, 1998 (Reprinted from MMWR, vol 48, pg 271, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Hunedoara Hlth Dist, Hunedoara, Romania. Iasi Hlth Dist, Iasi, Romania. Minist Hlth, Dept Prevent Med, Bucharest, Romania. Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Atlanta, GA USA. CDC, Atlanta, GA 30333 USA. RP Sfetcu, O (reprint author), Hunedoara Hlth Dist, Hunedoara, Romania. RI Popa, Mircea /A-4830-2011 NR 1 TC 0 Z9 0 U1 2 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 1999 VL 281 IS 21 BP 1981 EP 1982 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 200NN UT WOS:000080546700009 ER PT J AU Engelgau, MM Narayan, KMV Williamson, DF Thomson, TJ Dong, F AF Engelgau, MM Narayan, KMV Williamson, DF Thomson, TJ Dong, F TI Screening for type 2 diabetes - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID RISK C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Battelle Ctr Publ Hlth Res, Seattle, WA USA. RP Engelgau, MM (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RI Narayan, K.M. Venkat /J-9819-2012 OI Narayan, K.M. Venkat /0000-0001-8621-5405 NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JUN 2 PY 1999 VL 281 IS 21 BP 1987 EP 1988 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 200NN UT WOS:000080546700020 ER PT J AU Baillargeon, J Borucki, M Williamson, J Dunn, K AF Baillargeon, J Borucki, M Williamson, J Dunn, K TI Determinants of HIV-related survival among Texas prison inmates SO AIDS PATIENT CARE AND STDS LA English DT Article ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; NEW-YORK-CITY; INFECTED INDIVIDUALS; SYNDROME AIDS; EXPERIENCE; PATTERNS; DISEASE; TRENDS; COHORT; VIRUS AB Research indicates that being incarcerated adversely affects disease progression and overall health status. Because HIV infection is a growing problem among prison populations in the United States, understanding how incarceration affects HIV-related survival patterns is critical. The present study examined determinants of HIV-related survival in a cohort of 2380 Texas Department of Criminal Justice (TDCJ) inmates who were treated for HIV/AIDS, dating from January 1, 1992 and June 31, 1997. Assessment of the study factors indicated that there were no substantial violations of the assumptions of the Cox's proportional hazards (PH) model in the present study population. Furthermore, to address the potential problem of censoring-related bias, mortality information was collected on all inmates who were paroled on the basis of disease status. The present study's findings indicate that the following factors were associated with significant decreases in HIV-related survival in the TDCJ prison population: male gender, older age, self-report of no known HIV transmission risk factors, and presence of cytomegalovirus (CMV), Mycobacterium avium complex (MAC), and Pneumocystis carinii pneumonia. Moreover, survival decreased in a monotonic fashion with decrease in baseline CD4 count. While the majority of the present study's findings were consistent with those reported for nonincarcerated populations, it will be important for investigators to assess whether these findings persist among future cohorts of prison inmates. C1 Univ Texas, Med Branch, Dept Internal Med, Galveston, TX 77550 USA. Ctr Dis Control, Div HIV AIDS Prevent, Atlanta, GA 30333 USA. RP Baillargeon, J (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pediat, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. NR 29 TC 4 Z9 4 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1087-2914 J9 AIDS PATIENT CARE ST JI Aids Patient Care STDS PD JUN PY 1999 VL 13 IS 6 BP 355 EP 361 DI 10.1089/apc.1999.13.355 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 206WW UT WOS:000080904200006 PM 10842856 ER PT J AU Flegal, KM AF Flegal, KM TI Evaluating epidemiologic evidence of the effects of food and nutrient exposures SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT Workshop on the Role of Epidemiology in Determining When Evidence is Sufficient to Support Nutrition Recommendations CY OCT 07-08, 1997 CL WASHINGTON, D.C. SP ILSI N Amer DE bias; diet; epidemiologic methods; measurement error; nutrition assessment ID FREQUENCY QUESTIONNAIRE; ENERGY-INTAKE; NUTRITIONAL EPIDEMIOLOGY; FUNDAMENTAL PRINCIPLES; DIETARY ASSESSMENT; MEASUREMENT ERROR; VALIDITY; REPRODUCIBILITY; VALIDATION; RECALL AB The objective of this paper is to discuss some of the issues to be considered when evaluating and interpreting epidemiologic evidence from observational studies that collect data on dietary intake. The assessment of such evidence should include consideration of the study design, sample selection, and the measurements of exposure and disease. The degree and type of error in nutrient data can lead to analytic problems and potentially be a source of bias either toward or away from the null value. Because methods of statistical correction and adjustment for error, such its energy adjustment, cannot necessarily completely compensate for sources of bias in dietary data, additional research should be conducted on sources of error in dietary data. Published research using reported dietary data should include a discussion of potential sources of error and their effect on the results. The most useful studies are likely to be those designed to address a clearly defined prior hypothesis about a specific diet-disease relation. Because of the potential for bias and confounding, observational epidemiologic studies of diet and outcome cannot generally provide decisive evidence by themselves either far or against specific hypotheses. Although randomized clinical trials of the effects of specific nutrients or dietary modifications are not always feasible, they provide more definitive results and should generally be considered more valid than observational studies using self-reported dietary intake. Well-designed observational epidemiologic studies using self-reported dietary intake can provide valuable data to support or challenge hypotheses derived from clinical or laboratory data and to suggest further directions for investigation. C1 Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Flegal, KM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, 6525 Belcrest Rd,Room 900, Hyattsville, MD 20782 USA. RI Flegal, Katherine/A-4608-2013 NR 51 TC 32 Z9 35 U1 1 U2 3 PU AMER SOC CLINICAL NUTRITION PI BETHESDA PA 9650 ROCKVILLE PIKE, SUBSCRIPTIONS, RM L-3300, BETHESDA, MD 20814-3998 USA SN 0002-9165 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JUN PY 1999 VL 69 IS 6 BP 1339S EP 1344S PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 199UT UT WOS:000080503000051 PM 10359234 ER PT J AU Saraiya, M Berg, CJ Shulman, H Green, CA Atrash, HK AF Saraiya, M Berg, CJ Shulman, H Green, CA Atrash, HK TI Estimates of the annual number of clinically recognized pregnancies in the United States, 1981-1991 SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE abortion; epidemiologic methods; ethnic groups; fetal death; pregnancy ID SPONTANEOUS-ABORTION AB The authors estimated the number of clinically recognized pregnancies that occurred annually from 1981 to 1991 in the United States by type of outcome and by race. Estimates of the numbers of livebirths, induced abortions, ectopic pregnancies, and fetal deaths were obtained by using data from the Centers for Disease Control and Prevention in Atlanta, Georgia. The number of spontaneous abortions was estimated by using previously published, age-specific rates. More than 67 million pregnancies occurred during the study period. Overall, 62.5% of these pregnancies resulted in livebirths, 21.9% in legal induced abortions, 13.8% in spontaneous abortions, 1.3% in ectopic pregnancies, and 0.5% in fetal deaths. These data can be used to provide denominators for the calculation of a variety of pregnancy outcome-specific rates. C1 Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Reprod Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Saraiya, M (reprint author), Ctr Dis Control & Prevent, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway NE,Mailstop K-55, Atlanta, GA 30341 USA. NR 21 TC 66 Z9 70 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 BP 1025 EP 1029 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200DJ UT WOS:000080524100007 PM 10355378 ER PT J AU Fagot-Campagna, A Saaddine, J Narayan, KMV Goldschmid, M AF Fagot-Campagna, A Saaddine, J Narayan, KMV Goldschmid, M TI "Sex differences in risk factors for clinical diabetes mellitus in a general population. A 12-year follow-up of the Finnmark Study" SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Letter ID PLASMA-LIPOPROTEINS; INDIANS C1 Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Med Res Fdn, Washington, DC 20010 USA. RP Fagot-Campagna, A (reprint author), Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RI Narayan, K.M. Venkat /J-9819-2012 OI Narayan, K.M. Venkat /0000-0001-8621-5405 NR 3 TC 1 Z9 1 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 BP 1073 EP 1074 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200DJ UT WOS:000080524100015 PM 10355385 ER PT J AU Adams, MM AF Adams, MM TI How accurate is birth certificate information for the outcome of the previous pregnancy? SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Div Reprod Hlth, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 153 BP S39 EP S39 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500153 ER PT J AU Ayala-Lopez, A Rigau-Perez, JG Clark, GG AF Ayala-Lopez, A Rigau-Perez, JG Clark, GG TI Re-introduction and transmission of dengue-3 in Puerto Rico, 1998-1999. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Puerto Rico Dept Hlth, San Juan, PR 00921 USA. Ctr Dis Control & Prevent, Deague Branch, San Juan, PR 00921 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA L3 BP S78 EP S78 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500307 ER PT J AU Bowers, JG Kreindel, S Orloski, K Happ, C Hayes, E AF Bowers, JG Kreindel, S Orloski, K Happ, C Hayes, E TI Risk factors for Lyme disease in Nantucket County, Massachusetts. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Massachusetts Dept Publ Hlth, Boston, MA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA L4 BP S78 EP S78 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500309 ER PT J AU Boyle, JP Thompson, TJ Narayan, KMV Williamson, DF AF Boyle, JP Thompson, TJ Narayan, KMV Williamson, DF TI A Markov chain model for predicting chronic disease prevalence and costs. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control, Atlanta, GA 30341 USA. RI Narayan, K.M. Venkat /J-9819-2012 OI Narayan, K.M. Venkat /0000-0001-8621-5405 NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 94 BP S24 EP S24 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500095 ER PT J AU Correa, A Stone , AE Wong, LY Lin, B Lynberg, M AF Correa, A Stone , AE Wong, LY Lin, B Lynberg, M TI Assessing exposure to trihalomethanes in tap water in studies of pregnancy outcome. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 230 BP S58 EP S58 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500231 ER PT J AU Curtis, KM Marchbanks, PA Wilson, HG Shelton, JD Oberle, MW Rosero-Bixby, L AF Curtis, KM Marchbanks, PA Wilson, HG Shelton, JD Oberle, MW Rosero-Bixby, L TI Parity, age at first birth, and risk of invasive cervical cancer. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 108 BP S27 EP S27 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500108 ER PT J AU Daley, WR Smith, A Paz, E Malilay, J McGeehin, M AF Daley, WR Smith, A Paz, E Malilay, J McGeehin, M TI An outbreak of carbon monoxide poisoning after a major ice storm. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 16 BP S4 EP S4 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500017 ER PT J AU Ford, E AF Ford, E TI Serum copper concentration and coronary heart disease among US adults. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA 30345 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 194 BP S49 EP S49 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500195 ER PT J AU Galuska, DA Will, JC Serdula, MK Ford, ES AF Galuska, DA Will, JC Serdula, MK Ford, ES TI Do health care providers advise obese patients to lose weight? SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 32 BP S8 EP S8 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500033 ER PT J AU Hillis, S Anda, R Felitti, V Nordenberg, D Marchbanks, P AF Hillis, S Anda, R Felitti, V Nordenberg, D Marchbanks, P TI Adverse childhood experiences and sexually transmitted diseases. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 75 BP S19 EP S19 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500074 ER PT J AU Honein, M Paulozzi, L AF Honein, M Paulozzi, L TI Family history, maternal smoking, and clubfoot: An indication of a gene-environment interaction. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 265 BP S67 EP S67 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500264 ER PT J AU Li, R Serdula, MK Bland, S Mokdad, A Bowman, BA Nelson, DE AF Li, R Serdula, MK Bland, S Mokdad, A Bowman, BA Nelson, DE TI Trends in fruits and vegetables consumption among US adults: Behavioral risk factor surveillance surveys in 16 states, 1990-1996. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 121 BP S31 EP S31 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500121 ER PT J AU Loria, C Klag, M Caulfield, L Szklo, M Whelton, P AF Loria, C Klag, M Caulfield, L Szklo, M Whelton, P TI Serum ascorbate and mortality from all causes and cancer among us men and women. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, NCHS, Hyattsville, MD 20782 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 86 BP S22 EP S22 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500087 ER PT J AU Mosure, DJ Aral, SO AF Mosure, DJ Aral, SO TI Vaginal douching among women of reproductive age in the US SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 174 BP S44 EP S44 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500175 ER PT J AU Nsubuga, P McCarthy, B Brann, A McNabb, SJN AF Nsubuga, P McCarthy, B Brann, A McNabb, SJN TI Using birthweight and age-at-death data to assess maternal and perinatal health and care, Uganda, 1998. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control, Atlanta, GA 30333 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA L5 BP S78 EP S78 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500308 ER PT J AU Prince, MM Ward, EM Ruder, A Salvan, A Dennis, RR AF Prince, MM Ward, EM Ruder, A Salvan, A Dennis, RR TI Ischemic heart disease mortality among rubber manufacturing workers. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 NIOSH, Cincinnati, OH 45226 USA. RI Ruder, Avima/I-4155-2012 OI Ruder, Avima/0000-0003-0419-6664 NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 134 BP S34 EP S34 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500135 ER PT J AU Shults, RA Sehgal, M Sleet, D AF Shults, RA Sehgal, M Sleet, D TI Are residents from states with weaker drunk driving counter-measures more likely to drink and drive? SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 49 BP S13 EP S13 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500049 ER PT J AU Wang, S FitzSimmons, S Khoury, M AF Wang, S FitzSimmons, S Khoury, M TI Does newborn screening for cystic fibrosis reduce the risk of Pseudomonas aeruginosa colonization among cystic fibrosts patients in the United States? SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 CDC, Off Genet & Dis Prevent, Atlanta, GA 30341 USA. Cyst Fibrosis Fdn, Bethesda, MD 20814 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 303 BP S76 EP S76 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500300 ER PT J AU Whitehead, NS Hill, HA Devine, OJ Brogan, D Blackmore-Prince, C AF Whitehead, NS Hill, HA Devine, OJ Brogan, D Blackmore-Prince, C CA PRAMS Working Grp TI A threshold effect in the relation of life events to preterm delivery. SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD JUN 1 PY 1999 VL 149 IS 11 SU S MA 163 BP S41 EP S41 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200EK UT WOS:000080526500162 ER PT J AU Cardo, DM Soule, BM AF Cardo, DM Soule, BM TI Hospital infection prevention and control: A global perspective SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Editorial Material C1 Ctr Dis Control & Prevent, HIV Infect Branch, Hosp Infect Program, Atlanta, GA USA. RP Cardo, DM (reprint author), 1600 Clifton Rd,Mail Stop E68, Atlanta, GA 30333 USA. NR 19 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD JUN PY 1999 VL 27 IS 3 BP 233 EP 235 DI 10.1053/ic.1999.v27.a98298 PG 3 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 205FC UT WOS:000080809800001 PM 10358224 ER PT J AU Manangan, LP Archibald, LK Pearson, ML Duffy, RE Garrett, DO Alonso-Echanove, JA Richet, HM Parvez, FM Jarvis, WR AF Manangan, LP Archibald, LK Pearson, ML Duffy, RE Garrett, DO Alonso-Echanove, JA Richet, HM Parvez, FM Jarvis, WR TI Selected global health care activities of the Hospital Infections Program, Centers for Disease Control and Prevention SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article AB In the past decade, rapid advances in medical technology and increasing populations of immunodeficient patients worldwide have resulted in increased interest in health care-associated infections in developed and developing countries. Many health care facilities in the developing world now have the capability to provide specialized services, such as dialysis, cardiac catheterization, and transplantation. The increased availability of these specialized procedures and the use of invasive devices have predictably been accompanied by an increased number of health care-associated infections globally: Implementation of infection control programs in the developing world has not been very successful because of lack of personnel and financial resources, laboratory capacity, or limited access to formal training in hospital epidemiology and infection control. Throughout the years, the Hospital Infections Program (HIP), Centers for Disease Control and Prevention (CDC), has expanded its global activities in response to an increasing demand for epidemiologic assistance and training in issues related to nosocomial infections. This article summarizes selected recent international outbreak investigations (1993 through 1998) conducted by HIP and provides an overview of some of HIP's ongoing global activities. C1 Ctr Dis Control & Prevent, Invest & Prevent Branch, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Manangan, LP (reprint author), Ctr Dis Control, Hosp Infect Program, Mailstop E-69,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 8 TC 6 Z9 6 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD JUN PY 1999 VL 27 IS 3 BP 270 EP 274 DI 10.1053/ic.1999.v27.a98398 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 205FC UT WOS:000080809800008 PM 10358231 ER PT J AU Lawton, RM Fridkin, SK Steward, CD Edwards, JR Pryor, ER McGowan, JE Archibald, LK Gaynes, RP Tenover, FC Pichette, SC Mohammed, J Felicione, E Hubert, S AF Lawton, RM Fridkin, SK Steward, CD Edwards, JR Pryor, ER McGowan, JE Archibald, LK Gaynes, RP Tenover, FC Pichette, SC Mohammed, J Felicione, E Hubert, S CA NNIS System Project ICARE Hosp TI Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Surveillance Report, Data Summary from January 1996 through December 1997 SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article AB The Intensive Care Antimicrobial Resistance Epidemiology project has established laboratory-based surveillance for antimicrobial resistance and antimicrobial use at a subset of hospitals participating in the National Nosocomial Infections Surveillance system. These data illustrate that, for most antimicrobial resistant organisms studied, rates of resistance were highest in the intensive care unit areas and lowest in the outpatient areas. For most of the antimicrobial agents, the rate of use was highest in the intensive care unit areas in parallel to the pattern seen for resistance. These comparative data on antimicrobial use and resistance among similar areas tie, intensive care unit or other inpatient areas) can be used as a benchmark by participating hospitals to focus their efforts at addressing antimicrobial resistance. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept HHS, Atlanta, GA USA. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA USA. RP Fridkin, SK (reprint author), CDC, Hosp Infect Program, MS E-55,1600 Clifton Rd, Atlanta, GA 30333 USA. RI mcgowan jr, john/G-5404-2011 NR 4 TC 58 Z9 58 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD JUN PY 1999 VL 27 IS 3 BP 279 EP 284 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 205FC UT WOS:000080809800010 ER PT J AU McDonnell, SM Preston, BL Jewell, SA Barton, JC Edwards, CQ Adams, PC Yip, R AF McDonnell, SM Preston, BL Jewell, SA Barton, JC Edwards, CQ Adams, PC Yip, R TI A survey of 2,851 patients with hemochromatosis: Symptoms and response to treatment SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID HEREDITARY HEMOCHROMATOSIS; GENETIC HEMOCHROMATOSIS; IRON OVERLOAD; UNITED-STATES; POPULATION; PREVALENCE; HEALTH; HAND AB PURPOSE: Hemochromatosis is a genetic disorder of iron absorption that affects 5 per 1,000 persons and is associated with reduced health and quality of life. We sought to determine the type and frequency of symptoms that patients experienced before the diagnosis and the treatments that they received. METHODS: We mailed a questionnaire to 3,562 patients with hemochromatosis who were located using patient advocacy groups, physicians, blood centers, newsletters, and the Internet. RESULTS: Of the 2,851 respondents, 99% were white and 62% were men. Circumstances that led to diagnosis of hemochromatosis included symptoms (35%), an abnormal laboratory test (45%), and diagnosis of a family member with hemochromatosis (20%). The mean (+/- SD) age of symptom onset was 41 +/- 14 years. Symptoms had been present for an average of 10 +/- 10 years before the diagnosis was made. Among the 58% of patients with symptoms, 65% had physician-diagnosed arthritis and 52% had liver disease. The most common and troublesome symptoms were extreme fatigue (46%), arthralgia (44%), and loss of libido (26%). Physician instructions to patients included treatment with phlebotomy (90%), testing family members (75%), and avoiding iron supplements (65%). CONCLUSIONS: The diagnosis of hemochromatosis in most patients was delayed. Physician education is needed to increase the detection of patients with the disease and to improve its management. Am J Med. 1999;106:619-624. (C) 1999 by Excerpta Medica, Inc. C1 Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, Atlanta, GA 30341 USA. Georgia Inst Technol, Sch Biol, Atlanta, GA 30332 USA. So Iron Overload Disorders, Birmingham, AL USA. Latter Day St Hosp, Dept Med, Salt Lake City, UT 84143 USA. Univ Western Ontario, London Hlth Sci Ctr, Dept Gastroenterol, London, ON, Canada. RP McDonnell, SM (reprint author), Ctr Dis Control & Prevent, Div Int Hlth, MS C-08,4770 Buford Highway, Atlanta, GA 30341 USA. RI Preston, Benjamin/B-9001-2012 OI Preston, Benjamin/0000-0002-7966-2386 FU PHS HHS [1632] NR 24 TC 141 Z9 147 U1 0 U2 1 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JUN PY 1999 VL 106 IS 6 BP 619 EP 624 DI 10.1016/S0002-9343(99)00120-5 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 204VE UT WOS:000080784600004 PM 10378618 ER PT J AU Aral, SO Hughes, JP Stoner, B Whittington, W Handsfield, HH Anderson, RM Holmes, KK AF Aral, SO Hughes, JP Stoner, B Whittington, W Handsfield, HH Anderson, RM Holmes, KK TI Sexual mixing patterns in the spread of gonococcal and chlamydial infections SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID SOCIAL NETWORKS; PARTNER CHANGE; GONORRHEA; TRANSMISSION; HIV; DISEASE; EPIDEMIOLOGY; BEHAVIOR; CHOICE AB Objectives. This study sought to define, among sexually transmitted disease (STD) clinic attendees, (1) patterns of sex partner selection, (2) relative risks for gonococcal or chlamydial infection associated with each mixing pattern, and (3) selected links and potential and actual bridge populations. Methods. Mixing matrices were computed based on characteristics of the study participants and their partners. Risk of infection was determined in study participants with various types of partners, and odds ratios were used to estimate relative risk of infection for discordant vs concordant partnerships. Results. Partnerships discordant in terms of race/ethnicity, age, education, and number of partners were associated with significant risk for gonorrhea and chlamydial infection. In low-prevalence subpopulations, within-subpopulation mixing was associated with chlamydial infection, and direct links with high-prevalence subpopulations were associated with gonorrhea. Conclusions. Mixing patterns influence the risk of specific infections, and they should be included in risk assessments for individuals and in the design of screening, health education, and partner notification strategies for populations. C1 Ctr Dis Control & Prevent, Div STD Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Ctr AIDS & STD, Seattle, WA 98195 USA. Seattle King Cty Dept Publ Hlth, Seattle, WA USA. Washington Univ, Dept Med, St Louis, MO 63130 USA. Washington Univ, Dept Anthropol, St Louis, MO 63130 USA. Univ Oxford, Dept Zool, Oxford OX1 3PS, England. RP Aral, SO (reprint author), Ctr Dis Control & Prevent, Div STD Prevent, Natl Ctr HIV STD & TB Prevent, 1600 Clifton Rd NE,MS-E02, Atlanta, GA 30333 USA. FU NIAID NIH HHS [AI31448] NR 33 TC 177 Z9 179 U1 0 U2 12 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUN PY 1999 VL 89 IS 6 BP 825 EP 833 DI 10.2105/AJPH.89.6.825 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200PC UT WOS:000080548000005 PM 10358670 ER PT J AU Powell-Griner, E Bolen, J Bland, S AF Powell-Griner, E Bolen, J Bland, S TI Health care coverage and use of preventive services among the near elderly in the United States SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID INSURANCE; RISK; ACCESS AB Objectives. It has been proposed that individuals aged 55 to 64 years be allowed to buy into Medicare. This group is more likely than younger adults to have marginal health status, to be separating from the workforce, to face high premiums, and to risk financial hardship from major medical illness. The present study examined prevalence of health insurance coverage by demographic characteristics and examined bow lack of insurance may affect use of preventive health services. Methods. Data were obtained from the Behavioral Risk Factor Surveillance System, an ongoing telephone survey of adults conducted by the 50 states and the District of Columbia. Results. Many near-elderly adults least likely to have health care coverage were Black or Hispanic, had less than a high school education and incomes less than $15 000 per year, and were unemployed or self-employed. Health insurance coverage was associated with increased use of clinical preventive services even when sex, face/ethnicity, marital status, and educational level were controlled. Conclusions. Many near-elderly individuals without insurance will probably not be able to participate in a Medicare buy-in unless it is subsidized in some way. C1 Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Bolen, J (reprint author), Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Hwy,NE K-47, Atlanta, GA 30341 USA. NR 30 TC 48 Z9 48 U1 0 U2 2 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUN PY 1999 VL 89 IS 6 BP 882 EP 886 DI 10.2105/AJPH.89.6.882 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200PC UT WOS:000080548000014 PM 10358679 ER PT J AU Hutin, YJF Bell, BP Marshall, KLE Schaben, CP Dart, M Quinlisk, MP Shapiro, CN AF Hutin, YJF Bell, BP Marshall, KLE Schaben, CP Dart, M Quinlisk, MP Shapiro, CN TI Identifying target groups for a potential vaccination program during a hepatitis A communitywide outbreak SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID SWEDISH COMMUNITY; DRUG-ADDICTS AB Objectives. This study sought to identify groups for targeted vaccination during a communitywide hepatitis A outbreak in 1996. Methods. Residents of the Sioux City, Iowa, metropolitan area reported with hepatitis A between September 1995 and August 1996 were sampled and compared with population-based controls. Results. In comparison with SI controls, the 40 case patients were more likely to inject methamphetamine, to attend emergency rooms more often than other health care facilities, and to have a family member who used the Special Supplemental Nutrition Program for Women, Infants, and Children. Conclusions. Groups at increased risk of hepatitis A can be identified and accessed for vaccination during communitywide outbreaks. C1 Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. Iowa Dept Publ Hlth, Des Moines, IA 50319 USA. Sioux & Dist Hlth Dept, Sioux City, IA USA. RP Bell, BP (reprint author), Ctr Dis Control & Prevent, Hepatitis Branch, Div Viral & Rickettsial Dis, MS G37,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 19 TC 17 Z9 18 U1 1 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JUN PY 1999 VL 89 IS 6 BP 918 EP 921 DI 10.2105/AJPH.89.6.918 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 200PC UT WOS:000080548000022 PM 10358687 ER PT J AU Comer, JA Tzianabos, T Flynn, C Vlahov, D Childs, JE AF Comer, JA Tzianabos, T Flynn, C Vlahov, D Childs, JE TI Serologic evidence of rickettsialpox (Rickettsia akari) infection among intravenous drug users in inner-city Baltimore, Maryland SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID MOUNTAIN-SPOTTED-FEVER; LYMPHOCYTIC CHORIOMENINGITIS; HIV-1 INFECTION; ANTIBODIES; ASSOCIATION AB We tested single serum samples from 631 intravenous (IV) drug users from inner-city Baltimore, Maryland for serologic evidence of exposure to spotted fever group rickettsiae. A total of 102 (16%) individuals had titers greater than or equal to 64 to Rickettsia rickettsii by an indirect immunofluorescence assay. Confirmation that infection was caused by R. akari was obtained by cross-adsorption studies on a subset of serum samples that consistently resulted in higher titers to R. akari than to R. rickettsii. Current IV drug use, increased frequency of injection, and shooting gallery use were significant risk factors for presence of group-specific antibodies reactive with R. rickettsii. There was a significant inverse association with the presence of antibodies reactive to R. rickettsii and antibodies reactive to the human immunodeficiency virus. This study suggests that IV drug users are at an increased risk for R, akari infections. Clinicians should be aware of rickettsialpox, as well as other zoonotic diseases of the urban environment, when treating IV drug users for any acute febrile illness of undetermined etiology. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Ctr Epidemiol & Hlth Serv Res, Dept Hlth & Mental Hyg, AIDS Adm, Baltimore, MD 21202 USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Program Infect Dis, Baltimore, MD 21205 USA. RP Comer, JA (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Mailstop G-13,1600 Clifton Rd, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 31 TC 29 Z9 29 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 894 EP 898 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300003 PM 10403316 ER PT J AU Ashford, DA Hajjeh, RA Kelley, MF Kaufman, L Hutwagner, L McNeil, MM AF Ashford, DA Hajjeh, RA Kelley, MF Kaufman, L Hutwagner, L McNeil, MM TI Outbreak of histoplasmosis among cavers attending the National Speleological Society Annual Convention, Texas, 1994 SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID LARGE URBAN OUTBREAK AB In June 1994, Is people developed serologically confirmed histoplasmosis following cave exploration associated with the annual National Speleological Society Convention in Bracketville, Texas. Six others had an undiagnosed illness suspected to be histoplasmosis. Two persons were hospitalized. We conducted a survey of convention attendees and a nested case-control study of those entering caves. We also conducted a histoplasmin skin test survey of a subgroup of the society, the Texas Cavers Association, who were attending a reunion in October 1994. Among the national convention attendees, exposure to two caves was identified as responsible for 22 (92%) of the 24 cases; 12 (75%) of 16 people exploring one cave (Cave A) and 10 (77%) of 13 exploring a separate cave (Cave B) developed acute histoplasmosis. Additional risk-factors included fewer years of caving experience, longer time spent in the caves, and entering a confined crawl space in Cave A. Of 113 participants in the separate skin test survey, 68 (60%) were found to be skin test positive, indicating previous exposure to Histoplasma capsulatum. A positive skin test was significantly associated with male sex and more years of caving experience. Those less experienced in caving associations should be taught about histoplasmosis, and health care providers should pursue histories of cave exposure for patients with bronchitis or pneumonia that does not respond to initial antibiotic therapy. C1 Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Atlanta, GA 30333 USA. Texas Dept Hlth, Austin, TX 78756 USA. RP Ashford, DA (reprint author), Ctr Dis Control & Prevent, Meningitis & Special Pathogens Branch, Mailstop C-23,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 21 TC 23 Z9 25 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 899 EP 903 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300004 PM 10403317 ER PT J AU Barat, LM Barnett, BJ Smolinski, MS Espey, DK Levy, CE Zucker, JR AF Barat, LM Barnett, BJ Smolinski, MS Espey, DK Levy, CE Zucker, JR TI Evaluation of malaria surveillance using retrospective, laboratory-based active case detection in four southwestern states, 1995 SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID UNITED-STATES AB The global resurgence of malaria has raised concerns of the possible reintroduction of indigenous transmission in the United States. The Centers for Disease Control and Prevention's National Malaria Surveillance System, using data supplied by state and local health departments (SLHDs), is maintained to detect local malaria transmission and monitor trends in imported cases. To determine the completeness of reporting of malaria cases to SLHDs, cases identified by local surveillance systems were compared with these identified through active case detection conducted at all laboratories that receive clinical specimens from 11 metropolitan areas in Arizona, California, New Mexico, and Texas. Of the 61 malaria cases identified through either local surveillance or active case detection, 43 (70%) were identified by SLHDs (range by metropolitan area = 50-100%) and 56 (92%) through active case detection. High percentages of cases were identified by SLHDs in New Mexico (80%) and San Diego County (88%), where laboratories are required to send positive blood smears to the SLHD laboratory for confirmation. Completeness of reporting, calculated using the Lincoln-Peterson Capture-Recapture technique, was 69% for SLHD surveillance systems and 89% for laboratory-based active case detection. The high percentage of cases identified by the 11 SLHDs suggests that the National Malaria Surveillance System provides trends that accurately reflect the epidemiology of malaria in the United States. Case identification may be improved by promoting confirmatory testing in SLHD laboratories and incorporating laboratory-based reporting into local surveillance systems. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Malaria Epidemiol Sect, Atlanta, GA 30341 USA. Crawford Long Hosp, Emory Clin, Div Infect Dis, Atlanta, GA 30308 USA. US Dept HHS, Off Dis Prevent & Hlth Promot, Washington, DC 20201 USA. New Mexico Dept Hlth, Breast & Cerv Canc Detect & Control Program, Albuquerque, NM 87110 USA. Arizona Dept Hlth Serv, Off Infect Dis Serv, Phoenix, AZ 85015 USA. UNICEF, Hlth Sect, New York, NY 10017 USA. RP Barat, LM (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Malaria Epidemiol Sect, Mailstop F-22,4770 Buford Highway NE, Atlanta, GA 30341 USA. RI Alkhalawi, Mohammed/C-6111-2012 NR 16 TC 7 Z9 7 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 910 EP 914 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300006 PM 10403319 ER PT J AU Al-Sherbiny, MM Osman, AM Hancock, K Deelder, AM Tsang, VCW AF Al-Sherbiny, MM Osman, AM Hancock, K Deelder, AM Tsang, VCW TI Application of immunodiagnostic assays: Detection of antibodies and circulating antigens in human schistosomiasis and correlation with clinical findings SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; ADULT MICROSOMAL ANTIGENS; ANODIC ANTIGEN; MONOCLONAL-ANTIBODIES; CATHODIC ANTIGENS; S-HAEMATOBIUM; FAST-ELISA; MANSONI; JAPONICUM; URINE AB In an initial cross-sectional survey, serum, urine, and stool samples were collected from 370 participants representing about 10% of the population (n = 4,438) in Behbeet village, 50 km south of Cairo, Egypt, an area well known to be endemic solely for Schistosoma haematobium. Diagnosis was approached in two parallel ways. The first approach, which simulated actual conditions in many endemic areas in Egypt, was based on physical examination and urine and stool microscopic analysis. The second approach was based on two advanced immunodiagnostic assay systems. One system detected antibodies to species-specific microsomal antigens, the other detected circulating schistosomal antigens. Microsomal antigens from S. haematobium and S. mansoni were used to detect antibodies in the Falcon assay screening test (FAST(R))-ELISA and the enzyme-linked immunoelectrotransfer blot (EITB). Circulating anodic antigen (CAA) and circulating cathodic antigen (CCA) were quantified in serum and urine samples in a sandwich ELISA using monoclonal antibodies. Parasitologically, the prevalence of S, haemntobium was 7.01% in females and 25.82% in males, giving an overall prevalence of 15.8%. The combination of urine CCA and serum CAA for detecting circulating antigens and the combination of the S. haematobium adult worm microsomal antigens (HAMA) FAST-ELISA and the HAMA EITB for detecting antibodies significantly improved the sensitivity of detecting S. haematobium circulating antigens and antibodies. Also, including a medical examination as an integral part of field studies and correlating immunodiagnostic results with other clinical and investigational data allowed us to calculate an accurate estimation of S. haematobium prevalence in this area of low endemicity. C1 Egyptian Org Biol & Vaccine Prod, Biomed Res Ctr Infect Dis, Egyptian Reference & Diagnost Ctr, Cairo, Egypt. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Leiden Univ, Med Ctr, Dept Parasitol, NL-2300 RC Leiden, Netherlands. Cairo Univ, Fac Sci, Dept Zool, Cairo, Egypt. RP Al-Sherbiny, MM (reprint author), Egyptian Org Biol & Vaccine Prod, Biomed Res Ctr Infect Dis, Egyptian Reference & Diagnost Ctr, 51 Wezaret El Zerra St, Cairo, Egypt. NR 30 TC 48 Z9 53 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 960 EP 966 PG 7 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300015 PM 10403328 ER PT J AU Simard, F Fontenille, D Lehmann, T Girod, R Brutus, L Gopaul, R Dournon, C Collins, FH AF Simard, F Fontenille, D Lehmann, T Girod, R Brutus, L Gopaul, R Dournon, C Collins, FH TI High amounts of genetic differentiation between populations of the malaria vector Anopheles arabiensis from west Africa and eastern outer islands SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID GAMBIAE COMPLEX; INDIAN-OCEAN; MICROSATELLITE; KENYA; MUTATION; MOSQUITO; TRANSMISSION; MADAGASCAR; STRATEGY; ALLELES AB Polymorphism at nine microsatellite loci was examined to assess the level of genetic differentiation between four Anopheles arabiensis populations from Senegal, the high plateau of Madagascar, and Reunion and Mauritius islands. Eight of nine loci showed great polymorphism (2-16 alleles/locus) and significant genetic differentiation was revealed between all four populations by F- and R-statistics, with Fst estimates ranging from 0.080 to 0.215 and equivalent Rst values ranging between 0.022 and 0.300. These high amounts of genetic differentiation are discussed in relation to geographic distance including large bodies of water, and history of mosquito settlement, and insecticide use on the islands. The results suggest that historical events of drift rather than mutation are probably the forces generating genetic divergence between these populations, with homogenization of the gene pool by migration being drastically restricted across the ocean. C1 Inst Pasteur, Lab IRD Zool Med, Dakar, Senegal. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Direct Dept Affaires Sanitaires & Sociales, Serv Lutte Antipalud, F-97400 St Denis La Reunion, France. IRD, Programme Rech Appl Madagascar Sante & Environm, Antananarivo 101, Madagascar. Med Entomol Div, Candos, Mauritius. Univ Nancy 1, Lab Biol Expt Immunol, Equipe Accueil Genet & Interact Cellulaires Repro, F-54506 Vandoeuvre Les Nancy, France. Univ Notre Dame, Galvin Life Sci, Dept Biol Sci, Notre Dame, IN 46556 USA. RP Simard, F (reprint author), Inst Pasteur, Lab IRD Zool Med, BP 220, Dakar, Senegal. RI Brutus, Laurent/A-7430-2011; FONTENILLE, didier/G-4091-2013; SIMARD, Frederic/J-9489-2016 OI Brutus, Laurent/0000-0002-9967-0666; SIMARD, Frederic/0000-0002-2871-5329 NR 61 TC 41 Z9 41 U1 0 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DR, STE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 1000 EP 1009 PG 10 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300021 PM 10403334 ER PT J AU Barat, L Chipipa, J Kolczak, M Sukwa, T AF Barat, L Chipipa, J Kolczak, M Sukwa, T TI Does the availability of blood slide microscopy for malaria at health centers improve the management of persons with fever in Zambia? SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID THERAPY EFFICACY; TREATMENT POLICY; CHLOROQUINE; DIAGNOSIS; AFRICA AB Some Ministries of Health in Africa plan to make blood slide microscopy available in peripheral health centers to improve malaria diagnosis over the current practice, which relies solely on clinical findings. To assess whether microscopy improves the management of febrile persons in health centers, we prospectively reviewed medical records of all outpatients visiting six health centers with laboratories in Zambia during a 2-3-day period. Staff interviews and a blinded review of a series of blood slides from each facility by two expert microscopists were also conducted. Of 1,442 outpatients, 655 (45%) reported fevers or had a temperature greater than or equal to 37.5 degrees C. Blood slide microscopy was ordered in 28-93% of patients with fever (mean = 46%). Eighty-eight (35%) patients without parasitemia were prescribed an antimalarial drug. Antimalarial drugs were prescribed with equal frequency to those who were referred for a blood slide (56%) and those not referred (58%). The sensitivity of microscopy was 88% and the specificity was 91%. Use of malaria microscopy varied widely, indicating that clinicians an not using standard criteria for ordering this test. Although diagnosis by microscopy was generally accurate, it appeared to have had little impact on the treatment of persons with fever. Guidelines for using blood slide microscopy are needed and prescription of antimalarial drugs should be discouraged when slide results are negative. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Malaria Epidemiol Sect, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Div Parasit Dis, Data Management Activ, Atlanta, GA 30341 USA. Trop Dis Res Ctr, Ndola, Zambia. RP Barat, L (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Malaria Epidemiol Sect, Mailstop F-22,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 14 TC 94 Z9 96 U1 0 U2 2 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 1024 EP 1030 PG 7 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300024 PM 10403337 ER PT J AU Daniels, NA Simons, SL Rodrigues, A Gunnlaugsson, G Forster, TS Wells, JG Hutwagner, L Tauxe, RV Mintz, ED AF Daniels, NA Simons, SL Rodrigues, A Gunnlaugsson, G Forster, TS Wells, JG Hutwagner, L Tauxe, RV Mintz, ED TI First do no harm: Making oral rehydration solution safer in a cholera epidemic SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID DRINKING-WATER; STORAGE; CONTAMINATION; COMMUNITY; HOME AB Oral rehydration solution (ORS) is lifesaving therapy for cholera and pediatric diarrhea. During a cholera epidemic in Guinea-Bissau, we evaluated the microbiologic quality of ORS prepared at a hospital and tested a simple intervention using special vessels for disinfecting tap water with bleach and for preparing, storing, and dispensing ORS. Few coliform bacteria and Escherichia coli were recovered from tap water; however, pre-intervention ORS contained numerous bacteria including E. coli and toxigenic Vibrio cholerae O1. In contrast, ORS samples from intervention vessels had few or no coliform bacteria, no E. coli, and no V. cholerae. Mean pre-intervention counts of coliform bacteria (3.4 x 10(7) colony-forming units [cfu]/100 mi) and E. coli (6.2 x 10(3) cfu) decreased significantly during the intervention period to 3.6 x 10(2) cfu and 0 cfu, respectively (P < 0.001). This simple system using bleach disinfectant and special storage vessels prevents bacterial contamination of ORS and reduces the risk of nosocomial transmission of cholera and other enteric pathogens. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis,Biostat & Informat Management, Div Bacterial & Mycot Dis, Foodborne & Diarrheal Dis Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv Program, Epidemiol Program Off, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Hosp Environm Lab Branch, Hosp Infect Program, Atlanta, GA 30333 USA. Minist Publ Hlth, Bissau, Guinea Bissau. Univ Uppsala Hosp, Dept Womens & Childrens Hlth, Sect Int Maternal & Child Hlth, Uppsala, Sweden. RP Daniels, NA (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis,Biostat & Informat Management, Div Bacterial & Mycot Dis, Foodborne & Diarrheal Dis Branch, Mailstop A-38,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 24 TC 15 Z9 15 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 1051 EP 1055 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300029 PM 10403342 ER PT J AU Secor, WE Freeman, GL Wirtz, RA AF Secor, WE Freeman, GL Wirtz, RA TI Short report: Prevention of Schistosoma mansoni infections in mice by the insect repellents AI3-37220 and N,N-diethyl-3-methylbenzamide SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID FIELD-EVALUATION; 4 REPELLENTS; DIPTERA; PENETRATION; CERCARIAE; CULICIDAE; DEET AB N,N-diethyl-3-methylbenzamide (DEET) has recently been reported to kill cercariae of Schistosoma mansoni in vitro. In addition, it blocked cercarial entry into mouse tail skin. We confirmed these results and compared the efficacy of DEET to a second insect repellent, 1-(3-Cyclohexen-1-yl-carbonyl)-2-methylpiperidine (AI3-37220), in preventing S. mansoni infections in mice. Both AI3-37220 and DEFT conferred 100% protection against S. mansoni infection via percutaneous exposure to cercariae. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. RP Secor, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Mailstop F-13,4770 Buford Highway, Atlanta, GA 30341 USA. NR 10 TC 6 Z9 7 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JUN PY 1999 VL 60 IS 6 BP 1061 EP 1062 PG 2 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 214FE UT WOS:000081317300031 PM 10403344 ER PT J AU Li, RK Rinaldi, MG AF Li, RK Rinaldi, MG TI In vitro antifungal activity of nikkomycin Z in combination with fluconazole or itraconazole SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID CANDIDA-ALBICANS; POLYOXIN-D; SACCHAROMYCES-CEREVISIAE; SYNERGISTIC ACTION; PAPULACANDIN-B; CELL-WALL; IN-VITRO; INHIBITION; AZOLE; PROTOPLASTS AB Nikkomycins are nucleoside-peptide antibiotics produced by Streptomyces species with antifungal activities through the inhibition of chitin synthesis. We investigated the antifungal activities of nikkomycin Z alone and in combination with fluconazole and itraconazole. Checkerboard synergy studies were carried out by a macrobroth dilution procedure with RPMI 1640 medium at pH 6.0. At least 10 strains of the following fungi were tested: Candida albicans, other Candida spp,, Cryptococcus neoformans, Coccidioides immitis, Aspergillus spp,, and dematiacious fungi (including Exophiala jeanselmei, Exophiala spinifera, Bipolaris spicifera, Wangiella dermatitidis, Ochroconis humicola, Phaeoannellomyces werneckii, and Cladophialophora bantiana), and 2 strains each of Fusarium, Scedosporium, Paecilomyces, Penicillium, and Trichoderma spp. A total of 110 isolates were examined. Inocula of fungal elements were standardized by hemacytometer counting or spectrophotametrically. MICs and minimum lethal concentrations (MLCs) were determined visually by comparison of growth in drug-treated tubes with growth in drug-free control tubes. Additive and synergistic interactions between nikkomycin and either fluconazole or itraconazole were observed against C. albicans. Candida parapsilosis, Cryptococcus neoformans, and Coccidioides immitis. Marked synergism was also observed between nikkomycin and itraconazole against Aspergillus fumigatus and Aspergillus flavus. No antagonistic interaction between the drugs was observed with any of the strains tested. C1 Univ Texas, Ctr Hlth Sci, Dept Pathol, San Antonio, TX 78284 USA. RP Li, RK (reprint author), Ctr Dis Control & Prevent, Mycot Dis Branch, 1600 Clifton Rd NE,MS G-11, Atlanta, GA 30333 USA. NR 31 TC 71 Z9 72 U1 0 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JUN PY 1999 VL 43 IS 6 BP 1401 EP 1405 PG 5 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 201NK UT WOS:000080601500016 PM 10348760 ER PT J AU Guarner, J Greer, PW Bartlett, J Chu, MC Shieh, WJ Zaki, SR AF Guarner, J Greer, PW Bartlett, J Chu, MC Shieh, WJ Zaki, SR TI Immunohistochemical detection of Francisella tularensis in formalin-fixed paraffin-embedded tissue SO APPLIED IMMUNOHISTOCHEMISTRY & MOLECULAR MORPHOLOGY LA English DT Article DE Francisella tularensis; tularemia; diagnosis; pathogenesis; immunohistochemistry ID TULAREMIA AB Tularemia is a zoonotic disease caused by Francisella tularensis. Histopathologic lesions of lymph nodes in cases of ulceroglandular tularemia include stellate microabscesses similar to those seen in cat-scratch disease or lymphogranuloma venereum. When the lung is involved, the pathology is that of an acute necrotizing pneumonia. Traditionally, diagnosis is based on serology, culture, and fluorescent antigen detection, but each of these methods presents problems. We studied formalin-fixed tissues from four tularemia cases as well as control tissues by using immunohistochemistry (IHC) for F, tularensis. Positive immunostaining was seen in all the tularemia cases examined. Three cases were fatal, and positive IHC staining could be seen in the lungs (bacteria in cellular debris, and intracellularly in alveolar macrophages, endothelia, and polymorphonuclear leukocytes), spleen tin necrotic areas), lymph nodes tin stellate abscesses), and liver tin Kupffer cells). The fourth patient had ulceroglandular tularemia, and the lymph node biopsy demonstrated the typical stellate microabscesses. By IHC, there was positive staining of bacteria in the abscesses and occasional macrophages and endothelial cells in nonnecrotic areas. In conclusion, F. tularensis can be detected by IHC in formalin-fixed tissue, which, if available as biopsy material, can be useful for diagnosis. MC can be helpful in our understanding of tularemia pathogenesis because bacteria are visualized in the context of the surrounding tissue morphology. C1 Ctr Dis Control & Prevent, Infect Dis Pathol Act, US Dept HHS, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div Vector Borne Dis, US Dept HHS, Atlanta, GA 30333 USA. RP Guarner, J (reprint author), Ctr Dis Control & Prevent, Infect Dis Pathol Act, US Dept HHS, Mailstop G 32,1600 Clifton Rd NE, Atlanta, GA 30333 USA. RI Guarner, Jeannette/B-8273-2013 NR 11 TC 16 Z9 16 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1062-3345 J9 APPL IMMUNOHISTO M M JI Appl. Immunohistochem. PD JUN PY 1999 VL 7 IS 2 BP 122 EP 126 DI 10.1097/00022744-199906000-00004 PG 5 WC Anatomy & Morphology; Medical Laboratory Technology; Pathology SC Anatomy & Morphology; Medical Laboratory Technology; Pathology GA 224MP UT WOS:000081903100004 ER PT J AU Stennies, G Ikeda, R Leadbetter, S Houston, B Sacks, J AF Stennies, G Ikeda, R Leadbetter, S Houston, B Sacks, J TI Firearm storage practices and children in the home, United States, 1994 SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Public-Health-Association 122nd CY OCT 21-25, 1996 CL NEW YORK, NEW YORK SP Amer Public Hlth Assoc ID HOUSEHOLD EXPOSURE; INJURIES; ATTITUDES; HANDGUNS; GUNS AB Objectives: To estimate the national prevalence of firearm ownership and storage practices in the home, to compare storage practices in homes With and without children, and to analyze demographic characteristics related to firearm storage practices in homes with children. Design: A 1994 random-digit dialing telephone survey. We weighted the data to provide national estimates. Participants: English- and Spanish-speaking adults in households in 50 states and Washington, DC. Main Outcome Measures: Ownership of working powder firearm(s) in home and/or vehicle and firearm storage practices in the home. Results: Of 5238 households surveyed, one third kept at least 1 firearm in the home and/or vehicle. Of 1598 households with firearm(s) in the home and known firearm storage practices, 21.5% kept at least 1 gun loaded and unlocked in the home, 30.0% stored all firearms unloaded and locked, and 48.5% stored firearms in a manners classified between these 2 practices. Households with children were more likely than households without children to store all firearms unloaded and locked (41.5% vs 20.9%); households without children were more likely than households with children to store at least 1 firearm loaded and unlocked (29.8% vs 11.1%). Among households with children and firearms, there were regional differences with respect to storage practices. Conclusions: These prevalence data show that children are potentially exposed to firearms in many households. This health threat illustrates the need for education about the issue of pediatric firearm injuries and for interventions to minimize associated risks. Health care providers should take advantage of opportunities to counsel patients regarding firearm safety in the home. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA USA. RP Stennies, G (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, 4770 Buford Hwy NE,MS F22, Atlanta, GA 30341 USA. NR 26 TC 49 Z9 49 U1 2 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD JUN PY 1999 VL 153 IS 6 BP 586 EP 590 PG 5 WC Pediatrics SC Pediatrics GA 200RN UT WOS:000080554000005 PM 10357298 ER PT J AU Gabriel, SE Espy, M Erdman, DD Bjornsson, J Smith, TF Hunder, GG AF Gabriel, SE Espy, M Erdman, DD Bjornsson, J Smith, TF Hunder, GG TI The role of parvovirus B19 in the pathogenesis of giant cell arteritis - A preliminary evaluation SO ARTHRITIS AND RHEUMATISM LA English DT Article ID POLYMERASE CHAIN-REACTION; DNA; AMPLIFICATION; INFECTION; PCR AB Objective. To determine whether parvovirus B19 DNA is more likely to be present in the temporal arteries of patients with giant cell arteritis (GCA) than in the temporal arteries of control subjects. Methods. We prospectively examined temporal artery biopsy (TAB) tissue from 50 consecutive patients presenting for TAB for the presence of B19 DNA using the polymerase chain reaction (PCR). Clinical and demographic information was obtained from the patients' medical records. A separate PCR analysis of 30 original tissue specimens was conducted at the Centers for Disease Control and Prevention (CDC) using primers directed toward another target sequence in the nonstructural coding area of B19. Results. The 50 patients had an average age of 70.8 years; 27 (54%) were female. Amplicons for human beta-globulin, but not for cytomegalovirus, were produced for all tissue samples. The PCR results for B19 agreed in 29 of 30 samples tested by our institution and by the CDC (97% agreement; kappa = 0.9). A comparison of the B19 DNA analysis and the results of TAB indicated a statistically significant association between histologic evidence of GCA and the presence of B19 DNA in TAB tissue (chi(2) = 10.38, P = 0.0013). Conclusion. These findings suggest that B19 may play a role in the pathogenesis of GCA. C1 Mayo Clin & Mayo Fdn, Dept Hlth Sci Res, Rochester, MN 55905 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Gabriel, SE (reprint author), Mayo Clin & Mayo Fdn, Dept Hlth Sci Res, 200 1st St SW, Rochester, MN 55905 USA. RI sebastianovitsch, stepan/G-8507-2013 NR 16 TC 94 Z9 100 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0004-3591 J9 ARTHRITIS RHEUM JI Arthritis Rheum. PD JUN PY 1999 VL 42 IS 6 BP 1255 EP 1258 DI 10.1002/1529-0131(199906)42:6<1255::AID-ANR23>3.0.CO;2-P PG 4 WC Rheumatology SC Rheumatology GA 204VU UT WOS:000080786000023 PM 10366119 ER PT J AU Satten, GA Sternberg, MR AF Satten, GA Sternberg, MR TI Fitting semi-Markov models to interval-censored data with unknown initiation times SO BIOMETRICS LA English DT Article DE chain-of-events data; doubly censored data; EM algorithm; HIV AIDS; initiation time; interval censoring; left censoring; multistage model; semi-Markov model; truncation AB In a semi-Markov model, the hazard of making a transition between stages depends on the time spent in the current stage but is independent of time spent in other stages. If the initiation time (time of entry into the network) is not known for some persons and if transition time data are interval censored (i.e., if transition times are not known exactly but are known only to have occurred in some interval), then the length of time these persons spent in any stage is not known. We show how a semi-Markov model can still be fit to interval-censored data with missing initiation times. For the special case of models in which all persons enter the network at the same initial stage and proceed through the same succession of stages to a unique absorbing stage, we present discrete-time nonparametric maximum likelihood estimators of the waiting-time distributions for this type of data. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA USA. Emory Univ, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30322 USA. RP Satten, GA (reprint author), Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA USA. OI Satten, Glen/0000-0001-7275-5371 FU NIAID NIH HHS [T32-AI07442] NR 7 TC 24 Z9 24 U1 0 U2 1 PU INTERNATIONAL BIOMETRIC SOC PI WASHINGTON PA 1441 I ST, NW, SUITE 700, WASHINGTON, DC 20005-2210 USA SN 0006-341X J9 BIOMETRICS JI Biometrics PD JUN PY 1999 VL 55 IS 2 BP 507 EP 513 DI 10.1111/j.0006-341X.1999.00507.x PG 7 WC Biology; Mathematical & Computational Biology; Statistics & Probability SC Life Sciences & Biomedicine - Other Topics; Mathematical & Computational Biology; Mathematics GA 214GT UT WOS:000081320800024 PM 11318207 ER PT J AU Sternberg, MR Satten, GA AF Sternberg, MR Satten, GA TI Discrete-time nonparametric estimation for semi-Markov models of chain-of-events data subject to interval censoring and truncation SO BIOMETRICS LA English DT Article DE chain-of-events data; EM algorithm; HIV AIDS; interval censoring; multistage model; self-consistent estimator; semi-Markov assumption; truncation ID SURVIVAL; DISEASE; AIDS AB Chain-of-events data are longitudinal observations on a succession of events that can only occur in a prescribed order. One goal in an analysis of this type of data is to determine the distribution of times between the successive events. This is difficult when individuals are observed periodically rather than continuously because the event times are then interval censored. Chain-of-events data may also be subject to truncation when individuals can only be observed if a certain event in the chain (e.g., the final event) has occurred. We provide a nonparametric approach to estimate the distributions of times between successive events in discrete time for data such as these under the semi-Markov assumption that the times between events are independent. This method uses a self-consistency algorithm that extends Turnbull's algorithm (1976, Journal of the Royal Statistical Society, Series B 38, 290-295). The quantities required to carry out the algorithm can be calculated recursively for improved computational efficiency. Two examples using data from studies involving HIV disease are used to illustrate our methods. C1 Emory Univ, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA USA. RP Sternberg, MR (reprint author), Emory Univ, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30322 USA. FU NIAID NIH HHS [T32-AI07442] NR 13 TC 23 Z9 23 U1 0 U2 0 PU INTERNATIONAL BIOMETRIC SOC PI WASHINGTON PA 1441 I ST, NW, SUITE 700, WASHINGTON, DC 20005-2210 USA SN 0006-341X J9 BIOMETRICS JI Biometrics PD JUN PY 1999 VL 55 IS 2 BP 514 EP 522 DI 10.1111/j.0006-341X.1999.00514.x PG 9 WC Biology; Mathematical & Computational Biology; Statistics & Probability SC Life Sciences & Biomedicine - Other Topics; Mathematical & Computational Biology; Mathematics GA 214GT UT WOS:000081320800025 PM 11318208 ER PT J AU Helzlsouer, KJ Alberg, AJ Huang, HY Hoffman, SC Strickland, PT Brock, JW Burse, VW Needham, LL Bell, DA Lavigne, JA Yager, JD Comstock, GW AF Helzlsouer, KJ Alberg, AJ Huang, HY Hoffman, SC Strickland, PT Brock, JW Burse, VW Needham, LL Bell, DA Lavigne, JA Yager, JD Comstock, GW TI Serum concentrations of organochlorine compounds and the subsequent development of breast cancer SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID POLYCHLORINATED-BIPHENYLS PCBS; ADIPOSE-TISSUE; BLOOD-LEVELS; RISK; PESTICIDES; GLUTATHIONE; EXPOSURE; WOMEN; DDT; POLYMORPHISMS AB A nested case-control study was conducted to examine the association between serum concentrations of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE), the primary metabolite of 1,1,1-trichloro-2,2-bis(p-chlorophenyl)ethane (DDT), and polychlorinated biphenyls (PCBs) and the development of breast cancer up to 20 years later. Cases (n = 346) and controls (n = 346) were selected from cohorts of women who donated blood in 1974, 1989, or both, and were matched on age, race, menopausal status, and month and year of blood donation. Analyses were stratified by cohort participation because median DDE and PCB concentrations among the controls were 59 and 147% higher in 1974 than 1989, respectively. Median concentrations of DDE were lower among cases than controls in both time periods [11.7% lower in 1974 (P = 0.06) and 8.6% lower in 1989 (P = 0.41)]. Median concentrations of PCBs were similar among cases and controls [P = 0.21 for 1974 and P = 0.37 for 1989 (Wilcoxon signed rank test)]. The risk of developing breast cancer among women with the highest concentrations of DDE was roughly half that among women with the lowest concentrations, whether based on concentrations in 1974 [odds ratio (OR), 0.50; 95% confidence interval (CI), 0.27-0.89; P-trend = 0.02] or in 1989 (OR, 0.53; 95% CI, 0.24-1.17; P-trend = 0.08). The associations between circulating concentrations of PCBs and breast cancer were less pronounced but still in the same direction (1974: OR, 0.68; 95% CI, 0.36-12.9; P-trend = 0.2; and 1989: OR, 0.73; 95% CI, 0.37-1.46; P-trend = 0.6). Adjustment for family history of breast cancer, body mass index, age at menarche or first birth, and months of lactation did not materially alter these associations. These associations remained consistent regardless of lactation history and length of the follow-up interval, with the strongest inverse association observed among women diagnosed 16-20 years after blood drawing. Results from this prospective, community-based nested case-control study are reassuring. Even after 20 years of follow-up, exposure to relatively high concentrations of DDE or PCBs showed no evidence of contributing to an increased risk of breast cancer. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Environm Hlth Sci, Baltimore, MD 21205 USA. Ctr Dis Control, Div Environm Hlth Lab Sci, Atlanta, GA 30341 USA. NIEHS, Res Triangle Pk, NC 27709 USA. RP Helzlsouer, KJ (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Room E-6132,615 N Wolfe St, Baltimore, MD 21205 USA. RI Needham, Larry/E-4930-2011 FU NCI NIH HHS [CA62988]; NHLBI NIH HHS [HL21670]; NIEHS NIH HHS [ES03819] NR 41 TC 128 Z9 129 U1 0 U2 5 PU AMER ASSOC CANCER RESEARCH PI BIRMINGHAM PA PO BOX 11806, BIRMINGHAM, AL 35202 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD JUN PY 1999 VL 8 IS 6 BP 525 EP 532 PG 8 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 204TJ UT WOS:000080780100007 PM 10385143 ER PT J AU Pfeiffer, CM Gunter, EW AF Pfeiffer, CM Gunter, EW TI Automated assay for methylmalonic acid (MMA) in plasma. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 8 Z9 8 U1 0 U2 1 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 1999 VL 45 IS 6 SU S BP A166 EP A167 PN 2 PG 2 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 202XB UT WOS:000080676500709 ER PT J AU Shahangian, S Cohn, RD AF Shahangian, S Cohn, RD TI Systems to assess variability of laboratory test results: Use of an audit-sample/split-specimen design. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Div Lab Syst, Publ Hlth Practice Program Off, Atlanta, GA USA. Analyt Sci Inc, Stat & Publ Hlth Res Div, Durham, NC USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 1999 VL 45 IS 6 SU S BP A27 EP A27 PN 2 PG 1 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 202XB UT WOS:000080676500201 ER PT J AU Waymack, PP Ko, SC Ethridge, SF Myers, GL AF Waymack, PP Ko, SC Ethridge, SF Myers, GL TI Comparison of three homogeneous high density lipoprotein cholesterol methods and a conventional dextran sulfate method to the reference method using frozen serum. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 1999 VL 45 IS 6 SU S BP A18 EP A19 PN 2 PG 2 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 202XB UT WOS:000080676500177 ER PT J AU Waymack, PP Ethridge, SF Myers, GL AF Waymack, PP Ethridge, SF Myers, GL TI The effect of temperature on the betaquantification procedure for low-density lipoprotein cholesterol in serum. SO CLINICAL CHEMISTRY LA English DT Meeting Abstract C1 Ctr Dis Control & Prevent, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC CLINICAL CHEMISTRY PI WASHINGTON PA 2101 L STREET NW, SUITE 202, WASHINGTON, DC 20037-1526 USA SN 0009-9147 J9 CLIN CHEM JI Clin. Chem. PD JUN PY 1999 VL 45 IS 6 SU S BP A18 EP A18 PN 2 PG 1 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 202XB UT WOS:000080676500176 ER PT J AU Guris, D Strebel, PM Bardenheier, B Brennan, M Tachdjian, R Finch, E Wharton, M Livengood, JR AF Guris, D Strebel, PM Bardenheier, B Brennan, M Tachdjian, R Finch, E Wharton, M Livengood, JR TI Changing epidemiology of pertussis in the United States: Increasing reported incidence among adolescents and adults, 1990-1996 SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT International Conference on Emerging Infectious Diseases CY MAR 08-11, 1998 CL ATLANTA, GEORGIA SP Ctr Dis Control & Prevent, Council State & Terr Epidemiologists, Amer Soc Microbiol, Natl Fdn CDC, Alliance Prudent Use Antibiot, Amer Acad Pediat, Amer Assoc Blood Banks, Amer Assoc Hlth Plans, Amer Canc Soc, Amer Coll Prevent Med, Amer Hosp Assoc, Amer Med Assoc, Amer Mosquito Control Assoc, Amer Publ Hlth Assoc, Amer Sexually Transmitted Dis Assoc, Amer Soc Clin Pathologists, Amer Soc Trop Med & Hyg, Amer Vet Med Assoc, Assoc Amer Vet Med Coll, Assoc Sch Publ Hlth, Assoc State & Terr Directors Hlth Promot & Publ Hlth Educ, Assoc State & Terr Hlth Officials, Assoc State & Terr Publ Hlth Lab Directors, Assoc Teachers Prevent Med, Burroughs Wellcome Fund, Emory Univ, Sch Med, Fogarty Int Ctr, US FDA, Indian Hlth Serv, Infect Dis Soc Amer, Int Life Sci Inst, Int Soc Infect Dis, Int Soc Travel Med, Int Union Hlth Promot & Educ, Int Union Microbiol Soc, Minor Hlth Profess Fdn, Morehouse Sch Med, NASA, Natl Assoc City & County Hlth Officials, Natl Assoc State Publ Hlth Vetinarians, Natl Council Int Hlth, Natl Fdn Infect Dis, Natl Hispan Med Assoc, NIAID, Natl Med Assoc, NOAA, Off Sci & Technol Policy, Pan Amer Hlth Org, Emory Univ, Rollins Sch Publ Hlth, Soc Healthcare Epidemiol Amer, Soc Occupat & Environm Hlth, Soc Publ Hlth Educ, Carter Ctr, Henry J Kaiser Family Fdn, HMO Grp, Robert Wood Johnson Fdn, Rockefeller Fdn, World Bank, Us Agcy Int Dev, USDA, US Dept Def, US Dept State, US Dept Justice, US Dept Vet Affairs, US EPA, WHO ID WHOLE-CELL VACCINE; BORDETELLA-PERTUSSIS; LABORATORY DIAGNOSIS; CONTROLLED TRIAL; IMMUNIZATION; POPULATION; VOLUNTEERS; OUTBREAK; ART AB Since 1990, the reported incidence of pertussis has increased in the United States with peaks occurring every 3-4 years. On the basis of analysis of pertussis cases reported to the Centers for Disease Control and Prevention, the incidence remained stable among children aged younger than 5 years, most of whom were protected by vaccination. In contrast to 1990-1993, during 1994-1996, the average incidence among persons aged 5-9 years, 10-19 years, and 20 years or older increased 40%, 106%, and 93%, respectively. Since 1990, 14 states reported pertussis incidences of greater than or equal to 2 cases per 100,000 population during at least 4 years between 1990 and 1996; seven of these states also reported that a high proportion of cases occurred in persons aged 10 years or older. Analysis of national data on pertussis did not provide sufficient information to fully elucidate the relative importance of multiple possible explanations for the increase in the incidence of pertussis in adolescents and adults. Improvement in diagnosis and reporting of pertussis in this age group, particularly in some states, is an important factor contributing to the overall increase. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA 30333 USA. RP Guris, D (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, 1600 Clifton Rd,Mailstop E-61, Atlanta, GA 30333 USA. NR 32 TC 297 Z9 312 U1 0 U2 5 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUN PY 1999 VL 28 IS 6 BP 1230 EP 1237 DI 10.1086/514776 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 207CD UT WOS:000080917000008 PM 10451158 ER PT J AU Orenstein, WA AF Orenstein, WA TI Pertussis in adults: Epidemiology, signs, symptoms, and implications for vaccination SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Conference on Pertussis in Adults - Epidemiology, Signs, Symptoms, and Implications for Vaccination CY OCT 28-29, 1997 CL BETHESDA, MARYLAND SP NICHHD, NIAID, Natl Heart Lung & Blood Inst, Ctr Dis Control & Prevent, Ctr Biolog Evaluat & Res, US FDA ID INFECTION; POPULATION; FREQUENCY; OUTBREAK; COUGH AB Transmission of pertussis among adults is being increasingly recognized. About 1 or 2 in 1,000 adolescents and adults develop pertussis each year, greater than or equal to 12% of persons with acute cough illnesses of at least 1-2 weeks' duration have evidence of pertussis infection, and adults have been the source of pertussis for younger children. The advent of acellular pertussis vaccines, if safe and effective in adults, offers the opportunity to prevent transmission of pertussis in older populations. Several issues should be clarified before routine immunization is recommended, including the health burden of pertussis in adults and adolescents to be prevented by vaccination and how much morbidity resulting from pertussis in infants and children would be indirectly prevented. Preliminary studies suggest that pertussis vaccines are safe and immunogenic in adults. Potential recommendations for future vaccination might include all adolescents and adults at 10-year intervals along with the adult tetanus-diphtheria toxoids booster. Cost-benefit or cost-effectiveness analyses would be useful in developing vaccination policies for adults. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA 30333 USA. RP Orenstein, WA (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, 1600 Clifton Rd NE,E05, Atlanta, GA 30333 USA. NR 25 TC 28 Z9 29 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUN PY 1999 VL 28 SU 2 BP S147 EP S150 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 208MK UT WOS:000080995000011 PM 10447034 ER PT J AU Fridkin, SK Gaynes, RP AF Fridkin, SK Gaynes, RP TI Antimicrobial resistance in intensive care units SO CLINICS IN CHEST MEDICINE LA English DT Article ID UNIVERSITY MEDICAL-CENTER; BLOOD-STREAM INFECTIONS; SPECTRUM BETA-LACTAMASE; KLEBSIELLA-PNEUMONIAE; ANTIFUNGAL SUSCEPTIBILITY; NOSOCOMIAL INFECTIONS; ESCHERICHIA-COLI; HAND ANTISEPSIS; DRUG-RESISTANCE; VANCOMYCIN AB The unique nature of the intensive care unit (ICU) environment makes this part of the hospital a focus for the emergence and spread of many antimicrobial-resistant pathogens. There are ample opportunities for the cross-transmission of resistant bacteria from patient to patient, and patients are commonly exposed to broad-spectrum antimicrobial agents. Rates of resistance have increased for most pathogens associated with nosocomial infections among ICU patients, and rates are almost universally higher among ICU patients compared with non-ICU patients. There are many opportunities, however, to prevent the emergence and spread of these resistant pathogens through improved use of established infection control measures (i.e., patient isolation, hand washing, glove use, and appropriate gown use), and implementation of a systematic review of antimicrobial use. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Hosp Infect Program, Nosocomial Infect Surveillance Act, Atlanta, GA 30333 USA. RP Fridkin, SK (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Hosp Infect Program, Nosocomial Infect Surveillance Act, MS E-55, Atlanta, GA 30333 USA. NR 62 TC 195 Z9 201 U1 1 U2 5 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA SN 0272-5231 J9 CLIN CHEST MED JI Clin. Chest Med. PD JUN PY 1999 VL 20 IS 2 BP 303 EP + DI 10.1016/S0272-5231(05)70143-X PG 15 WC Respiratory System SC Respiratory System GA 211LN UT WOS:000081162700006 PM 10386258 ER PT J AU Tenover, FC Giovannoni, SJ AF Tenover, FC Giovannoni, SJ TI Microbial diversity, organism identification, and strain typing: "The needs of the many versus the needs of the one" SO CURRENT OPINION IN MICROBIOLOGY LA English DT Editorial Material ID SOIL BACTERIA; DNA C1 Ctr Dis Control, Atlanta, GA 30333 USA. Oregon State Univ, Dept Microbiol, Corvallis, OR 97331 USA. RP Tenover, FC (reprint author), Ctr Dis Control, 1600 Clifton Rd,Re NE G08, Atlanta, GA 30333 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU CURRENT BIOLOGY LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1369-5274 J9 CURR OPIN MICROBIOL JI Curr. Opin. Microbiol. PD JUN PY 1999 VL 2 IS 3 BP 297 EP 298 DI 10.1016/S1369-5274(99)80051-4 PG 2 WC Microbiology SC Microbiology GA 206AH UT WOS:000080853500012 ER PT J AU Dearry, AD Collman, GW Saint, C Fields, N Redd, S AF Dearry, AD Collman, GW Saint, C Fields, N Redd, S TI Building a network of research in children's environmental health - Introduction SO ENVIRONMENTAL HEALTH PERSPECTIVES LA English DT Editorial Material C1 NIEHS, Div Extramural Res & Training, Res Triangle Pk, NC 27709 USA. US EPA, Natl Ctr Environm Res & Qual Assurance, Atlanta, GA USA. Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Washington, DC USA. RP Dearry, AD (reprint author), NIEHS, Div Extramural Res & Training, POB 12233, Res Triangle Pk, NC 27709 USA. NR 0 TC 11 Z9 11 U1 0 U2 0 PU US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE PI RES TRIANGLE PK PA NATL INST HEALTH, NATL INST ENVIRONMENTAL HEALTH SCIENCES, PO BOX 12233, RES TRIANGLE PK, NC 27709-2233 USA SN 0091-6765 J9 ENVIRON HEALTH PERSP JI Environ. Health Perspect. PD JUN PY 1999 VL 107 SU 3 BP 391 EP 392 PG 2 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 206JJ UT WOS:000080874400001 PM 10346987 ER PT J AU Dearborn, DG Yike, I Sorenson, WG Miller, MJ Etzel, RA AF Dearborn, DG Yike, I Sorenson, WG Miller, MJ Etzel, RA TI Overview of investigations into pulmonary hemorrhage among infants in Cleveland, Ohio SO ENVIRONMENTAL HEALTH PERSPECTIVES LA English DT Article; Proceedings Paper CT International Conference on Indoor Mold and Children CY APR 21-24, 1998 CL ALEXANDRIA, VIRGINIA DE environmental tobacco smoke; idiopathic pulmonary hemosiderosis; indoor mold; pulmonary hemorrhage; satratoxins; Stachybotrys chartarum; sudden infant death syndrome; toxigenic fungi; trichothecenes ID STACHYBOTRYS-CHARTARUM; EXPOSURE; ATRA; HEMOSIDEROSIS; FUNGI; LUNG; FERMENTATION; MYCOTOXINS; TAXONOMY; DISEASE AB between 1993 and 1998. This rare disorder has been related to 12 deaths, including 7 originally thought to be sudden infant death syndrome. Thirty of the infants were African American, ail of whom lived in a limited geographic area of eastern metropolitan Cleveland, an area of older housing stock. An investigation led by the Centers for Disease Control and Prevention has found an association with household exposure to a toxigenic mold, Stachybotrys chartarum, and other fungi. The rapidly growing lungs of young infants appear to be especially vulnerable to the toxins made by toxigenic molds. Environmental tobacco smoke was frequently present in the infants' homes and may be a trigger precipitating the acute bleeding. Stachybotrys, although not thought to be a common mold, is known to have a wide geographic distribution. An additional 101 cases of acute, idiopathic pulmonary hemorrhage have been reported in infants in the United States over the past 5 years. In this overview, the investigations are summarized, the clinical profile is described, the toxicity of S. chartarum is discussed, and pathophysiologic concepts are presented. Key words: environmental tobacco smoke, idiopathic pulmonary hemosiderosis, indoor mold, pulmonary hemorrhage, satratoxins, Stachybotrys chartarum, sudden infant death syndrome, toxigenic fungi, trichothecenes. C1 Case Western Reserve Univ, Dept Pediat, Cleveland, OH 44106 USA. NIOSH, Div Resp Dis Studies, Morgantown, WV 26505 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Dearborn, DG (reprint author), Case Western Reserve Univ, Dept Pediat, 11100 Euclid Ave, Cleveland, OH 44106 USA. FU NCRR NIH HHS [M01 RR 00080]; NIEHS NIH HHS [ES08549] NR 51 TC 110 Z9 111 U1 0 U2 4 PU US DEPT HEALTH HUMAN SCIENCES PUBLIC HEALTH SCIENCE PI RES TRIANGLE PK PA NATL INST HEALTH, NATL INST ENVIRONMENTAL HEALTH SCIENCES, PO BOX 12233, RES TRIANGLE PK, NC 27709-2233 USA SN 0091-6765 J9 ENVIRON HEALTH PERSP JI Environ. Health Perspect. PD JUN PY 1999 VL 107 SU 3 BP 495 EP 499 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health; Toxicology SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Toxicology GA 206JJ UT WOS:000080874400016 PM 10346998 ER PT J AU Hedberg, CW Angulo, FJ White, KE Langkop, CW Schell, WL Stobierski, MG Schuchat, A Besser, JM Dietrich, S Helsel, L Griffin, PM McFarland, JW Osterholm, MT AF Hedberg, CW Angulo, FJ White, KE Langkop, CW Schell, WL Stobierski, MG Schuchat, A Besser, JM Dietrich, S Helsel, L Griffin, PM McFarland, JW Osterholm, MT CA Invest Team TI Outbreaks of salmonellosis associated with eating uncooked tomatoes: implications for public health SO EPIDEMIOLOGY AND INFECTION LA English DT Article ID GROWTH; MONTEVIDEO; SURVIVAL AB Laboratory-based surveillance of salmonella isolates serotyped at four state health departments (Illinois, Michigan, Minnesota and Wisconsin) led to the identification of multistate outbreaks of salmonella infections during 1990 (176 cases of S. javiana) and 1993 (100 cases of S. montevideo). Community-based case-control studies and product traceback implicated consumption of tomatoes from a single South Carolina tomato packer (Packer A) MOR 16.0; 95 % CI 2.1, 120.6; P < 0.0001 in 1990 and again in 1993 (MOR 5.7; 95 % CI 1.5, 21.9; P = 0.01) as the likely vehicle. Contamination likely occurred at the packing shed, where field grown tomatoes were dumped into a common water bath. These outbreaks represent part of a growing trend of large geographically dispersed outbreaks caused by sporadic or low-level contamination of widely distributed food items. Controlling contamination of agricultural commodities that are also ready-to-eat foods, particularly fruits and vegetables, presents a major challenge to industry, regulators and public health officials. C1 Minnesota Dept Hlth, Acute Dis Epidemiol Sect, Minneapolis, MN 55414 USA. Minnesota Dept Hlth, Publ Hlth Lab, Minneapolis, MN USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Foodborne & Diarrheal Dis Branch, Atlanta, GA USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Div Field Epidemiol, Atlanta, GA USA. Ctr Dis Control & Prevent, Epidemiol Program Off, Epidem Intelligence Serv, Atlanta, GA USA. Illinois Dept Hlth, Communicable Dis Control Sect, Springfield, IL USA. Wisconsin Dept Hlth & Family Serv, Madison, WI USA. Michigan Dept Publ Hlth, Lansing, MI 48909 USA. RP Hedberg, CW (reprint author), Minnesota Dept Hlth, Acute Dis Epidemiol Sect, 717 Se Delaware St, Minneapolis, MN 55414 USA. NR 19 TC 122 Z9 124 U1 1 U2 11 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD JUN PY 1999 VL 122 IS 3 BP 385 EP 393 DI 10.1017/S0950268899002393 PG 9 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 226LW UT WOS:000082022300005 PM 10459640 ER PT J AU Mahon, BE Sobel, J Townes, JM Mendoza, C Lemus, MG Cano, F Tauxe, RV AF Mahon, BE Sobel, J Townes, JM Mendoza, C Lemus, MG Cano, F Tauxe, RV TI Surveying vendors of street-vended food: a new methodology applied in two Guatemalan cities SO EPIDEMIOLOGY AND INFECTION LA English DT Article ID EPIDEMIC CHOLERA; TRANSMISSION; STORAGE; WATER AB Lack of reliable data about street vendors, who are difficult to survey, has hampered efforts to improve the safety of street-vended food. A two-phase method for sampling vendors, surveying first in areas of concentrated vending activity identified by local authorities and second in randomly selected areas, was developed and implemented in two Guatemalan cities where street-vended food had been implicated in cholera transmission. In a 4-day survey in Escuintla, 59 vendors (42 from phase 1, 17 from phase 2) were interviewed. They demonstrated good knowledge of food safety and cholera but unsafe practices, implying that more effective, practical training was needed. In a B-day survey in Guatemala City, 78 vendors (77 from phase 1, 1 from phase 2) were interviewed. Sixty-eight (87%) vendors stored water, usually in wide-mouthed vessels prone to contamination; this led to a field test of a new system for safe water storage. Useful information for public health planning and intervention can be gathered rapidly with this new method for surveying street vendors. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Foodborne & Diarrheal Dis Branch, Atlanta, GA 30333 USA. Med Entomol Res & Training Unit, Guatemala City, Guatemala. Minist Salud Publ & Asistencia Social, Div Gen Serv Salud, Guatemala City, Guatemala. Inst Nutr Cent Amer & Panama, Guatemala City, Guatemala. RP Tauxe, RV (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Foodborne & Diarrheal Dis Branch, Mailstop A-38,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 16 TC 5 Z9 5 U1 3 U2 5 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 USA SN 0950-2688 J9 EPIDEMIOL INFECT JI Epidemiol. Infect. PD JUN PY 1999 VL 122 IS 3 BP 409 EP 416 DI 10.1017/S095026889900240X PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 226LW UT WOS:000082022300008 PM 10459643 ER PT J AU Trevathan, E Murphy, CC Yeargin-Allsopp, M AF Trevathan, E Murphy, CC Yeargin-Allsopp, M TI The descriptive epidemiology of infantile spasms among Atlanta children SO EPILEPSIA LA English DT Article DE infantile spasms; epilepsy; seizures; mental retardation; Lennox-Gastaut syndrome; epidemiology; prevalence ID METROPOLITAN ATLANTA; 10-YEAR-OLD CHILDREN; DEVELOPMENTAL-DISABILITIES; WEST SYNDROME; PREVALENCE; ETIOLOGY; EPILEPSY; HISTORY AB Purpose: To determine the population-based epidemiology of infantile spasms (IS) among Atlanta children. Methods: By using data from a cross-sectional, population-based surveillance system that included 21 EEG laboratories, we identified children born in 1975-1977 in metropolitan Atlanta with IS. Cumulative incidence up to age 2 years was estimated from the number of children with IS born in the study area in 1975-1977, and age-specific prevalence was calculated from the number of children previously diagnosed with IS who lived in the study area at age 10 years. Data regarding coexisting disabilities were available from the surveillance system for developmental disabilities. Results: The cumulative incidence of IS was 2.9/10,000 live births; half of the children with IS had cryptogenic IS. The age-specific prevalence of IS was 2.0/10,000 among 10-year-old children. Eighty-three percent of 10-year-old children with a history of IS had mental retardation (MR, IQ less than or equal to 70); 56% of children with a history of IS had profound MR (IQ <20). Developmental outcome did not differ between the children with cryptogenic IS and those with symptomatic IS. Among the 10-year-old children with profound MR who were living in Atlanta at age 10 years, 12% had a history of IS. Fifty percent of children with IS developed Lennox-Gastaut syndrome (LGS) before age 11 years. Conclusions: The syndrome of IS is rare in the general population, yet a significant percentage of all children with profound MR and severe childhood epilepsy syndromes in the general population have a history of IS. C1 Washington Univ, St Louis Childrens Hosp, Sch Med,Dept Neurol, Pediat Epilepsy Ctr,Comprehens Epilepsy Program, St Louis, MO 63110 USA. Washington Univ, St Louis Childrens Hosp, Dept Pediat, St Louis, MO 63110 USA. US PHS, Div Birth Defects & Dev Disabil, Natl Ctr Environm Hlth,Ctr Dis Control & Prevent, US Dept Hlth & Human Serv, Atlanta, GA USA. RP Trevathan, E (reprint author), Washington Univ, St Louis Childrens Hosp, Sch Med,Dept Neurol, Pediat Epilepsy Ctr,Comprehens Epilepsy Program, 12E47,1 Childrens Pl, St Louis, MO 63110 USA. NR 31 TC 76 Z9 80 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD JUN PY 1999 VL 40 IS 6 BP 748 EP 751 DI 10.1111/j.1528-1157.1999.tb00773.x PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA 203DK UT WOS:000080692200011 PM 10368073 ER PT J AU Graffunder, CM Wyatt, SW Bewerse, B Hall, I Reilley, B Lee-Pethel, R AF Graffunder, CM Wyatt, SW Bewerse, B Hall, I Reilley, B Lee-Pethel, R TI Skin cancer prevention: The problem, responses, and lessons learned SO HEALTH EDUCATION & BEHAVIOR LA English DT Article ID BASAL-CELL CARCINOMA; UNITED-STATES; MALIGNANT-MELANOMA; CUTANEOUS MELANOMA; RISK; TRENDS; EXPOSURE; SITE; AGE AB Skin cancer is one of the most common forms of cancer and has rapidly increased during the past three-decades in the United States; More than 1 million new cases of skin cancer are estimated to be diagnosed in the United States each year. The National Skin Cancer Prevention Education Program (NSCPEP) was launched by the Centers for Disease Control and Prevention (CDC) in 1994 as a national effort to address the Healthy People : 2000 objectives for skin cancer prevention. The NSCPEP is a comprehensive, multidimensional public health approach that includes (1) primary prevention interventions; (2) coalition and partnership development; (3) health communications and education; and (4) surveillance, research, and evaluation. In 1994, through support from the CDC, state health departments in Arizona, California Georgia, Hawaii, and Massachusetts initiated primary prevention intervention projects to conduct and evaluate skin cancer prevention education. This article discusses the comprehensive, multidimensional public health approach highlighting examples from the state demonstration projects. C1 Ctr Dis Control & Prevent, Program Serv Branch, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. Univ Kentucky, Markey Canc Ctr, Lexington, KY 40506 USA. Univ N Carolina, Chapel Hill, NC 27514 USA. Ctr Dis Control & Prevent, Canc Surveillance Branch, Div Canc Prevent & Control, Atlanta, GA 30333 USA. Baylor Coll Med, Chron Dis Prevent & Control Res Ctr, Houston, TX 77030 USA. RP Graffunder, CM (reprint author), 4770 Buford Hwy NE,Mailstop K-57, Chamblee, GA 30341 USA. NR 22 TC 9 Z9 10 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1090-1981 J9 HEALTH EDUC BEHAV JI Health Educ. Behav. PD JUN PY 1999 VL 26 IS 3 BP 308 EP 316 DI 10.1177/109019819902600303 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 197CC UT WOS:000080346200002 PM 10349570 ER PT J AU Glassman, A Reich, MR Laserson, K Rojas, F AF Glassman, A Reich, MR Laserson, K Rojas, F TI Political analysis of health reform in the Dominican Republic SO HEALTH POLICY AND PLANNING LA English DT Article AB This article examines the major political challenges associated with the adoption of health reform proposals, through the experience of one country, the Dominican Republic. The article briefly presents the problems of the health sector in the Dominican Republic, and the health reform efforts that were initiated in 1995. The PolicyMaker method of applied political analysis is described, and the results of its application in the Dominican Republic are presented, including analysis of the policy content of the health reform, and assessment of five key groups of players (public sector, private sector, unions, political parties, and other non-governmental organizations). The PolicyMaker exercise was conducted in collaboration with the national Office of Technical Coordination (OCT) for health reform, and produced a set of 11 political strategies to promote the health reform effort in the Dominican Republic. These strategies were partially implemented by the OCT, but were insufficient to overcome political obstacles to the reform by late 1997. The conclusion presents six factors that affect the pace and political feasibility of health reform proposals, with examples from the case of the Dominican Republic. C1 Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Inter Amer Dev Bank, Washington, DC USA. Ctr Dis Control & Prevent, US Publ Hlth Serv, Atlanta, GA USA. RP Reich, MR (reprint author), Harvard Univ, Sch Publ Hlth, 665 Huntington Ave, Boston, MA 02115 USA. NR 20 TC 39 Z9 39 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0268-1080 J9 HEALTH POLICY PLANN JI Health Policy Plan. PD JUN PY 1999 VL 14 IS 2 BP 115 EP 126 DI 10.1093/heapol/14.2.115 PG 12 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 211XF UT WOS:000081186600003 PM 10538715 ER PT J AU Karem, KL Dubois, KA McGill, SL Regnery, RL AF Karem, KL Dubois, KA McGill, SL Regnery, RL TI Characterization of Bartonella henselae-specific immunity in BALB/c mice SO IMMUNOLOGY LA English DT Article ID CAT-SCRATCH DISEASE; BACILLARY ANGIOMATOSIS; INFECTION; ANTIGEN; PATIENT AB BALB/c mice were inoculated with Bartonella henselae by both systemic and mucosal routes. Culture analysis of tissues from mice infected intraperitoneally with a high dose of B. henselae yielded positive results 24 hr after infection. However, culture analysis of blood taken between 6 hr and 7 days after infection from groups receiving live B. henselae were negative. Following intraperitoneal infection, B. henselae was detected by polymerase chain reaction in liver and mesenteric lymph nodes by 6 hr and up to 7 days after infection in liver, kidney and spleen tissue. Enzyme-linked immunosorbent assay (ELISA) of serum samples collected as early as 13 days after infection indicated humoral immune responses to B. henselae. Specific humoral responses remained through week 6. Analysis of faecal samples revealed induction of B. henselae-specific immunoglobulin A by day 28 after infection. In addition, B, henselac-specific cellular responses were indicated by a positive delayed-type hypersensitivity and a T helper 1 (Th1) (CD4(+) T cell)-type cytokine response following in vitro stimulation of splenocytes. The significance and implications of these data in relation to B. henselae infections are discussed. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Heska Corp, Ft Collins, CO USA. RP Karem, KL (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Viral & Rickettsial Zoonoses Branch, Mail Stop G-13, Atlanta, GA 30333 USA. NR 21 TC 28 Z9 29 U1 0 U2 1 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0019-2805 J9 IMMUNOLOGY JI Immunology PD JUN PY 1999 VL 97 IS 2 BP 352 EP 358 PG 7 WC Immunology SC Immunology GA 209BM UT WOS:000081027500024 PM 10447753 ER PT J AU Fiore, AE Butler, JC Emori, TG Gaynes, RP AF Fiore, AE Butler, JC Emori, TG Gaynes, RP TI A survey of methods used to detect nosocomial legionellosis among participants in the National Nosocomial, Infections Surveillance System SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID COPPER-SILVER IONIZATION; COMMUNITY-ACQUIRED PNEUMONIA; WATER DISTRIBUTION-SYSTEMS; LEGIONNAIRES-DISEASE; PNEUMOPHILA; EFFICACY; OUTBREAK; RISK AB OBJECTIVE: To help define the scope of nosocomial legionnaire's disease (LD) and to assess use of recommended diagnostic methods and transmission control practices. METHODS: We surveyed 253 hospitals participating in the National Nosocomial Infections Surveillance (NNIS) System. The anonymous survey included questions about episodes of nosocomial LD, environmental sampling practices, maintenance of hospital water systems, and diagnostic techniques. RESULTS: Of 192 hospitals that responded, 29% reported at least one episode of nosocomial LD from 1990 through 1996, and 61% of these reported at least two episodes. Of 79 hospitals with transplant programs, 42% reported nosocomial LD, compared with 20% of hospitals without transplant programs. Environmental sampling had been conducted by 55% of hospitals, including 79% of those reporting nosocomial LD. Legionella were isolated in 34% that sampled potable water and 19% that sampled cooling system reservoirs. Supplemental potable-water decontamination systems were installed in 20% of hospitals. Only 19% routinely performed testing for legionellosis among patients at high risk for nosocomial LD. CONCLUSIONS: Nosocomial LD is relatively common among NNIS hospitals, especially those performing organ transplants. Environmental sampling for Legionella is a common practice among NNIS hospitals, and Legionella often are isolated from sampled hospital cooling towers and hospital potable-water systems. Hospitals have responded to suspected nosocomial LD infection with a variety of water sampling and control strategies; some have not attempted to sample or decontaminate water systems despite identified transmission (Infect Control Hosp Epidemiol 1999;20:412-416). C1 Ctr Dis Control & Prevent, Resp Dis Branch, Div Bacterial & Mycot Dis, US Dept HHS,Publ Hlth Serv, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept HHS, Atlanta, GA 30333 USA. RP Fiore, AE (reprint author), Ctr Dis Control & Prevent, Resp Dis Branch, Div Bacterial & Mycot Dis, US Dept HHS,Publ Hlth Serv, MS D-18,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 23 TC 33 Z9 35 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JUN PY 1999 VL 20 IS 6 BP 412 EP 416 DI 10.1086/501642 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 208LL UT WOS:000080992500008 PM 10395143 ER PT J AU Stayner, L Smith, RJ Gilbert, S Bailer, AJ AF Stayner, L Smith, RJ Gilbert, S Bailer, AJ TI Epidemiologic approaches to risk assessment SO INHALATION TOXICOLOGY LA English DT Article ID MAGNETIC-FIELD EXPOSURE; METHYLENE-CHLORIDE; METAANALYSIS; CANCER C1 NIOSH, Risk Evaluat Branch, Educ & Informat Div, Cincinnati, OH 45226 USA. Miami Univ, Dept Math & Stat, Oxford, OH 45056 USA. RP Stayner, L (reprint author), NIOSH, Educ & Informat Div, Risk Evaluat Branch Mail Stop C15, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 22 TC 4 Z9 4 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0895-8378 J9 INHAL TOXICOL JI Inhal. Toxicol. PD JUN-JUL PY 1999 VL 11 IS 6-7 BP 593 EP 601 PG 9 WC Toxicology SC Toxicology GA 212UX UT WOS:000081236900015 PM 11203001 ER PT J AU Bailey, RC Kamenga, MC Nsuami, MJ Nieburg, P St Louis, ME AF Bailey, RC Kamenga, MC Nsuami, MJ Nieburg, P St Louis, ME TI Growth of children according to maternal and child HIV, immunological and disease characteristics: a prospective cohort study in Kinshasa, Democratic Republic of Congo SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE HIV-1; maternal risk factors; anthropometry; AIDS; Congo; Zaire ID HUMAN-IMMUNODEFICIENCY-VIRUS; INFANTS BORN; PERINATAL TRANSMISSION; SEROPOSITIVE WOMEN; TRANSGENIC MICE; INFECTION; MORTALITY; MOTHERS; TYPE-1; IMPACT AB Background Most HIV-infection in children occurs in sub-Saharan Africa where antiretroviral therapy is seldom available. This study compares the growth progression and retardation of HIV-infected and uninfected children in the Democratic Republic of Congo (formerly Zaire). It estimates the risk for child growth retardation according to child and maternal immunological factors, severity of maternal and child illness, and maternal socioeconomic and marital status. Methods In a prospective cohort study of 258 children born to HIV seropositive mothers and 256 children of seronegative mothers in Kinshasa, Congo, the growth in length, weight, and weight-for-length of infected children (n = 68), uninfected children born to seropositive mothers (n = 190), and uninfected children born to uninfected mothers (n = 256) was compared. Serological, anthropometric and other clinical measures were collected monthly from 3-12 months and bi-monthly during the second year of life. Polymerase chain reaction for HIV was performed on bloods drawn at 2 days and 3 months post partum. Length-for-age, weight-for-age, and weight-for-length mean z-scores against National Center for Health Statistics (NCHS) reference data were calculated, and Cox proportional hazards models were used to estimate the risk of falling below -2.00 z-scores as a function of child and maternal immunological. clinical and sociodemographic variables. Results There was no difference in mean length-for-age at birth between HIV-infected (Group I) children, uninfected children of infected mothers (Group 2) or Control children, but by 3 months old, HIV-infected children were shorter than both Group 2 and Controls. In weight-for-age and weight-for-length, Group 1 infants were lighter and more wasted at birth and onwards. Group 2 newborns were lighter than Controls at birth, but by three months they had caught up to Controls in both length and weight and remained the same as Controls thereafter. The odds of falling below -2.00 z-scores by 20 months for length, weight, and weight-for-length for HIV-infected children compared to uninfected children were 2.10, 2.84, and 2.56 respectively. Both HIV-infection and associated illnesses were factors associated with child stunting, underweight and wasting. The mother's age, socioeconomic status, presence of father, stage of illness and immune status had no detectable effect on the child's growth in the first two years of life. Conclusion The HIV-infected children in Congo with no access to antiretroviral therapy were stunted, underweight, and wasted compared to same age uninfected children. Both HIV infection and HIV-associated signs and symptoms, not maternal immunological or socioeconomic circumstances, placed children at risk for growth retardation. C1 Univ Illinois, Sch Publ Hlth, Div Epidemiol, Chicago, IL 60612 USA. Family Hlth Int, AIDSCAP, Behav Res Unit, Arlington, VA 22201 USA. Louisiana State Univ, Med Ctr, Dept Publ Hlth & Prevent Med, New Orleans, LA 70112 USA. Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. RP Bailey, RC (reprint author), Univ Illinois, Sch Publ Hlth, Div Epidemiol, 2121 W Taylor, Chicago, IL 60612 USA. NR 42 TC 56 Z9 58 U1 0 U2 5 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD JUN PY 1999 VL 28 IS 3 BP 532 EP 540 DI 10.1093/ije/28.3.532 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 213XP UT WOS:000081298800027 PM 10405861 ER PT J AU Conde-Glez, CJ Juarez-Figueroa, L Uribe-Salas, F Hernandez-Nevarez, P Schmid, DS Calderon, E Hernandez-Avila, M AF Conde-Glez, CJ Juarez-Figueroa, L Uribe-Salas, F Hernandez-Nevarez, P Schmid, DS Calderon, E Hernandez-Avila, M TI Analysis of Herpes simplex virus 1 and 2 infection in women with high risk sexual behaviour in Mexico SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE herpes virus infection; female prostitutes; Mexico City ID GENITAL HERPES; TYPE-2 INFECTION; GLYCOPROTEIN-G; HIV-INFECTION; AIDS; CITY; EPIDEMIOLOGY; ACQUISITION; ANTIBODIES; PREVALENCE AB Background This paper describes the seroprevalence and risk factors of Herpes simplex virus (HSV) infection in a group of female prostitutes from Mexico City. Methods Women who consented to participate in the study voluntarily attended a sexually transmitted disease (STD) clinic during 1992. A standardized questionnaire was administered and a blood sample was obtained from each participant. Type-specific Western blot serology was performed to determine the serostatus of HSV-1 and HSV-2 for participants. Bivariate and multivariate analyses were applied to identify variables associated with an increased risk for HSV infection. Results Prevalences of infection among the 997 prostitutes studied were 93.9% for HSV-1 and 60.8% far HSV-2. Only 1.8% of the women were seronegative for both viruses. The only variable associated with HSV-I seropositivity was crowding index. The following variables were associated with an increased risk for infection with HSV-2: age, level of education, working site, born outside Mexico City and increasing time as a prostitute. Conclusions This is the first assessment of HSV infection in Mexico and may be useful for the development and application of control and preventive measures among the prostitute population at risk of acquiring and transmitting human immunodeficiency virus (HIV) and other STD. C1 Natl Inst Publ Hlth, Cuernavaca 62508, Morelos, Mexico. Ctr Dis Control & Prevent, Cid, Div Viral & Rickettsial Dis, Atlanta, GA USA. RP Conde-Glez, CJ (reprint author), Natl Inst Publ Hlth, Av Univ 655,Col Sta Maria Ahuacatitlan, Cuernavaca 62508, Morelos, Mexico. NR 33 TC 37 Z9 38 U1 2 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD JUN PY 1999 VL 28 IS 3 BP 571 EP 576 DI 10.1093/ije/28.3.571 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 213XP UT WOS:000081298800032 PM 10405866 ER PT J AU Gillum, RF AF Gillum, RF TI Distribution of waist-to-hip ratio, other indices of body fat distribution and obesity and associations with HDL cholesterol in children and young adults aged 4-19 years: The Third National Health and Nutrition Examination Survey SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article DE lipoprotein; high density; adolescence; child; sex factors; blacks; Hispanics ID CARDIOVASCULAR RISK-FACTORS; SERUM TOTAL CHOLESTEROL; BLOOD-PRESSURE; ADOLESCENTS; MEN; LIPIDS; WOMEN; HYPERTENSION; OVERWEIGHT; ADIPOSITY AB BACKGROUND: Little data has been published on the association of indices of body fat distribution and HDL cholesterol (HDL), a risk factor for cardiovascular morbidity, in representative samples of total populations of children and adolescents including blacks and Hispanics. OBJECTIVE: To describe the distribution of waist-to-hip ratio (WHR) in US children and adolescents and to assess the association with HDL. DESIGN: Cross-sectional survey of a large national sample, the Third National Health and Nutrition Examination Survey. PARTICIPANTS: People aged 4-19y. MEASUREMENTS: Body circumferences, skinfold thickness, body mass index (BMI), and serum total and HDL cholesterol concentrations. RESULTS: Mean WHR varied consistently with age, gender, and ethnic group. Levels were highest in Mexican Americans. WHR showed significant negative associations with HDL cholesterol concentration and positive associations with the ratio of total serum cholesterol to HDL in pre- and postpubertal girls independent of age and BMI. However, associations were often not as strong as those with BMI. Other indices of body fat distribution were not superior to WHR. CONCLUSION: Further research is needed on the association of WHR, other indices of body fat distribution and HDL measured in childhood with subsequent risk of atherosclerosis. C1 Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Gillum, RF (reprint author), Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, 6525 Belcrest Rd,Room 730, Hyattsville, MD 20782 USA. NR 42 TC 58 Z9 60 U1 1 U2 3 PU STOCKTON PRESS PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD JUN PY 1999 VL 23 IS 6 BP 556 EP 563 DI 10.1038/sj.ijo.0800866 PG 8 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 203KP UT WOS:000080707100002 PM 10411227 ER PT J AU Koumans, EH Barker, K Massanga, M Hawkins, RV Somse, P Parker, KA Moran, J AF Koumans, EH Barker, K Massanga, M Hawkins, RV Somse, P Parker, KA Moran, J TI Patient-led partner referral enhances sexually transmitted disease service delivery in two towns in the Central African Republic SO INTERNATIONAL JOURNAL OF STD & AIDS LA English DT Article DE partner notification; STD; Central African Republic ID CHLAMYDIA-TRACHOMATIS INFECTION; FIELD FOLLOW-UP; ASYMPTOMATIC GONORRHEA; NOTIFICATION; STD; PREVALENCE; SYPHILIS; NIGERIA; IBADAN; MEN AB In Bambari and Bria, 2 towns in the Central African Republic (CAR), we analysed a patient-led partner referral programme within enhanced sexually transmitted disease (STD) services. New (index) patients received syndromic management, counselling about notifying and treating contacts, and vouchers for distribution. From October 1993 to February 1996, 5232 and 4320 patient visits, of which 1814 (35%) and 4320 (30%) were contact referral visits, were logged in Bambari and Bria, respectively. Vouchers were distributed for at least 90% of contacts. Index and contact patients had similar age and sex distributions. In both towns, having a spouse (Bambari: odds ratio [OR] 1.5, 95% confidence interval [CI] 1.4-1.7; Bria: OR 1.9, 95% CI 1.5-2.3) was a factor associated with successful referral of a partner. Successful referral was accomplished by both male and female patients. Appropriate counselling techniques and vouchers facilitated partner referral. Further research on how to reach casual partners would enhance STD control efforts using patient-led partner referral. C1 Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA 30333 USA. RP Koumans, EH (reprint author), Ctr Dis Control & Prevent, Div STD Prevent, 1600 Clifton Rd NE,MS E-02, Atlanta, GA 30333 USA. NR 26 TC 4 Z9 4 U1 0 U2 0 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON W1M 8AE, ENGLAND SN 0956-4624 J9 INT J STD AIDS JI Int. J. STD AIDS PD JUN PY 1999 VL 10 IS 6 BP 376 EP 382 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 207XC UT WOS:000080960200005 PM 10414880 ER PT J AU De Cock, KM Chaisson, RE AF De Cock, KM Chaisson, RE TI Will DOTS do it? A reappraisal of tuberculosis control in countries with high rates of HIV infection SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; SUB-SAHARAN AFRICA; DIRECTLY OBSERVED THERAPY; NEW-YORK-CITY; COTE-DIVOIRE; ACTIVE TUBERCULOSIS; PREVENTIVE THERAPY; TESTING CENTER; PROGRAM; ABIDJAN AB In 1993 the WHO declared tuberculosis a global emergency, and subsequently introduced the DOTS strategy, a technical and management package based on earlier work of the IUATLD and international experience with directly observed therapy. Despite successful implementation of most of the elements of this strategy in several African countries and settings, tuberculosis case rates continue to escalate where the prevalence of HN infection is high. We explore possible reasons for the failure to control tuberculosis even in the context of tuberculosis programmes that have been considered models for others to emulate. In many African countries half or more of tuberculosis patients are now HIV-infected; in such settings, the overall epidemiology of tuberculosis is disproportionately affected by what happens in the HIV-infected subpopulation of the community. Persons with HIV infection are at increased risk of rapid progression following primary infection or re-infection, and also from reactivation of latent infection with Mycobacterium tuberculosis. More intensive strategies need to be targeted to the HIV-infected to interrupt on-going transmission (active and passive case detection; prevention of nosocomial transmission) and reactivation (preventive therapy). The high burden of other HIV-related disease in patients with tuberculosis, such as other bacterial infections, toxoplasmosis and other manifestations of AIDS, require that tuberculosis programmes integrate their activities better with those of HIV/AIDS programmes, including those for provision of HIV/AIDS care. Enhanced epidemiological surveillance is required to follow tuberculosis trends in the HIV-positive and negative sub-populations of communities, which may respond differently to control efforts. Strategies for tuberculosis control programmes in countries of high and low HIV prevalence cannot be the same, but must take into account the epidemiology of HIV infection. HIV/AIDS in Africa poses severe challenges of purpose and identity to tuberculosis control programmes, which have not adapted to the altered realities of the HIV/AIDS era. DOTS alone is unlikely to control tuberculosis in sub-Saharan Africa; one major achievement of DOTS when implemented, however, has been its apparent ability to limit the development and spread of drug resistance. C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA 30333 USA. London Sch Hyg & Trop Med, London WC1, England. Johns Hopkins Univ, Baltimore, MD USA. RP De Cock, KM (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, MS D21, Atlanta, GA 30333 USA. NR 54 TC 182 Z9 184 U1 0 U2 5 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD JUN PY 1999 VL 3 IS 6 BP 457 EP 465 PG 9 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 202NH UT WOS:000080658600001 PM 10383056 ER PT J AU Nguyen, TNL Wells, CD Binkin, NJ Pham, DL Nguyen, VC AF Nguyen, TNL Wells, CD Binkin, NJ Pham, DL Nguyen, VC TI The importance of quality control of sputum smear microscopy: the effect of reading errors on treatment decisions and outcomes SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE tuberculosis; acid-fast bacilli; microscopy; quality control; treatment delay; Vietnam AB SETTING: Ho Chi Minh City, Vietnam. OBJECTIVE: To evaluate the impact of slide reading errors at peripheral level on case-finding and treatment decisions. DESIGN: Over a 6-month period in 1997, information on date, type of slide, results of other slides from the patient, and treatment status was collected for all slides from district TB centers detected as having reading errors during smear microscopy quality control re-readings. RESULTS: Reading errors were detected in 117 slides: 115 (98.3%) were incorrectly read as negative, and 75 (65.2%) of these errors occurred in case-finding slides. In the 75 falsely negative case-finding slides, re-reading resulted in initiation of treatment in 38 patients (50.7%). The remaining 37 (43.3%) had only one positive slide and were told to return for follow-up after 6 months; the two (5.4%) who did return were both diagnosed with active TB. Detection of errors in the 40 false-negative follow-up slides resulted in treatment changes in four patients (10%). CONCLUSIONS: Quality control plays a critical role in helping to ensure the timely diagnosis and treatment of new TB cases and appropriate management of patients currently on treatment. The usefulness of quality control could be enhanced by focusing greater efforts on case-finding slides initially read as negative. C1 Ctr Dis Control & Prevent, Div TB Eliminat, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30030 USA. Pham Ngoc Thach TB & Lung Dis Ctr, Ho Chi Minh, Vietnam. Natl Inst TB & Resp Dis, Hanoi, Vietnam. RP Binkin, NJ (reprint author), Ctr Dis Control & Prevent, Div TB Eliminat, Natl Ctr HIV STD & TB Prevent, 1600 Clifton Rd, Atlanta, GA 30030 USA. NR 5 TC 11 Z9 11 U1 0 U2 0 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD JUN PY 1999 VL 3 IS 6 BP 483 EP 487 PG 5 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 202NH UT WOS:000080658600005 PM 10383060 ER PT J AU Corbett, EL Hay, M Churchyard, GJ Herselman, P Clayton, T Williams, BG Hayes, R Mulder, D De Cock, KM AF Corbett, EL Hay, M Churchyard, GJ Herselman, P Clayton, T Williams, BG Hayes, R Mulder, D De Cock, KM TI Mycobacterium kansasii and M-scrofulaceum isolates from HIV-negative South African gold miners: incidence, clinical significance and radiology SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE non-tuberculous; mycobacteria; HIV-negative; pneumoconiosis ID PULMONARY TUBERCULOSIS; NONTUBERCULOUS MYCOBACTERIA; INFECTION; DISEASE; EPIDEMIOLOGY; COMPLEX AB SETTING: A South African gold mining hospital. OBJECTIVE: To investigate the clinical significance of non-tuberculous mycobacteria (NTM) isolates, and estimate NTM disease incidence in human immunodeficiency virus (HIV) negative miners. DESIGN: Retrospective case series describing clinical and radiological features associated with NTM sputum isolates from HIV-negative miners between January 1993 and July 1996, and a comparison group with Mycobacterium tuberculosis infection. RESULTS: Of miners with NTM isolates, 90% had been HIV-tested and 81% were HIV-negative. M. kansasii and M. scrofulaceum accounted for 202 (68%) and 41 (14%) isolates respectively. More than 80% of miners with M. kansasii or M. scrofulaceum were smear positive, and new cavitation was present in 78% and 74% respectively. Treatment failure occurred in 3% of M. kansasii and 12% of M. scrofulaceum patients. A normal pre-morbid radiograph was significantly less common in NTM than M. tuberculosis patients (odds ratio 0.26 and 0.10 for M. kansasii and M. scrofulaceum, respectively). NTM disease incidence, defined as NTM isolate plus new cavitation, was estimated at 66 and 12 per 100 000 person-years for M. kansasii and M. scrofulaceum, respectively. CONCLUSIONS: M. kansasii and M. scrofulaceum disease are common in HIV-negative South African gold miners. Most isolates are associated with new cavitation against a background of silicosis or old TB scarring. C1 Univ London London Sch Hyg & Trop Med, Dept Infect & Trop Dis, London WC1E 7HT, England. Ernest Oppenheimer Hosp, Dept Radiol, Welkom, South Africa. Ernest Oppenheimer Hosp, Dept Med, Welkom, South Africa. Ernest Oppenheimer Hosp, Dept Occupat Hlth, Welkom, South Africa. Epidemiol Res Unit, Johannesburg, South Africa. Univ Amsterdam, Inst Social Med, Trop Epidemiol & Publ Hlth, Amsterdam, Netherlands. Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Surveillance & Epidemiol, Atlanta, GA USA. RP Corbett, EL (reprint author), Univ London London Sch Hyg & Trop Med, Dept Infect & Trop Dis, Keppel St, London WC1E 7HT, England. OI Corbett, Elizabeth/0000-0002-3552-3181; Hayes, Richard/0000-0002-1729-9892 NR 16 TC 38 Z9 40 U1 0 U2 0 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD JUN PY 1999 VL 3 IS 6 BP 501 EP 507 PG 7 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 202NH UT WOS:000080658600008 PM 10383063 ER PT J AU Anderson, JE Wilson, RW Barker, P Doll, L Jones, TS Holtgrave, D AF Anderson, JE Wilson, RW Barker, P Doll, L Jones, TS Holtgrave, D TI Prevalence of sexual and drug-related HIV risk behaviors in the US adult population: Results of the 1996 National Household Survey on Drug Abuse SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES LA English DT Article DE HIV risk behaviors; drug abuse; sexual transmission ID UNITED-STATES; CONDOM USE; CRACK COCAINE; TRANSMISSION; INJECTION; DESIGN; AIDS; MEN AB Context: Data on the prevalence of HIV risk behavior that art: representative of the general population are needed to help evaluate the effectiveness of prevention programs. Objective: To use data from a large national interview survey to make estimates of the prevalence of sexual and drug-related HN risk behaviors in the adult population of the United States. Design: Nationally representative cross-sectional survey with in-person interviews collecting information on drug use and sexual behavior. Setting and Participants: 12,381 U.S. adults aged between 18 and 59 who were respondents to the 1996 National Household Survey on Drag Abuse, as part of sample of the noninstitutionalized population. Interviews took place in respondents homes using face-to-face interviewer-administered and self-administered questionnaires. Results: In total, 2.8% of respondents were classified as having increased risk for HIV through sexual behavior; this represents 3.9 million persons. 1.7% reported some degree of risk through drug-related behaviors,representing 1.2 million persons. 3.5% of adults (5 million persons) were found to have some degree of HIV risk from sexual or drug-related behavior. Persons who were at risk through drug behavior were much more likely than others to be at risk through sexual behavior. Condom use was not related to HIV risk, although having a recent HIV test was found to be. Among those who reported some behaviors that placed them at increased risk for HIV infection, only 22% used a condom the last time they had sex with a regular partner. Conclusions: The high rate of sexual risk behavior on the part of drug users suggests increasing condom use for this group should be a priority goal for programs, especially condom use with main partners. Survey work needs to be continued and improved to make it possible to assess the impact of successful local prevention efforts on national rates of HIV risk behavior. C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent Intervent Res & Support, Natl Ctr HIV Sexually Transmitted Dis & TB Preven, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. Substance Abuse & Mental Hlth Serv Adm, Off Appl Studies, Rockville, MD USA. RP Anderson, JE (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent Intervent Res & Support, Natl Ctr HIV Sexually Transmitted Dis & TB Preven, E-37, Atlanta, GA 30333 USA. NR 43 TC 44 Z9 45 U1 6 U2 6 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. PD JUN 1 PY 1999 VL 21 IS 2 BP 148 EP 156 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 202JA UT WOS:000080647500011 PM 10360807 ER PT J AU Manor, Y Handsher, R Halmut, T Neuman, M Bobrov, A Rudich, H Vonsover, A Shulman, L Kew, O Mendelson, E AF Manor, Y Handsher, R Halmut, T Neuman, M Bobrov, A Rudich, H Vonsover, A Shulman, L Kew, O Mendelson, E TI Detection of poliovirus circulation by environmental surveillance in the absence of clinical cases in Israel and the Palestinian Authority SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID LENGTH-POLYMORPHISM ASSAY; MOLECULAR EPIDEMIOLOGY; POLIOMYELITIS OUTBREAK; WILD; SEWAGE; TYPE-1; CELL; VIRUSES; WATER AB The global eradication of poliomyelitis, believed to be achievable around the year 2000, relies on strategies which include high routine immunization coverage and mass vaccination campaigns, along with continuous monitoring of wild-type virus circulation by using the laboratory-based acute flaccid paralysis (AFP) surveillance. Israel and the Palestinian Authority are located in a geographical region in which poliovirus is still endemic but have been free of poliomyelitis since 1988 as a result of intensive immunization programs and mass vaccination campaigns. To monitor the wild-type virus circulation, environmental surveillance of sewage samples collected monthly from 25 to 30 sites across the country was implemented in 1989 and AFP surveillance began in 1994. The sewage samples were processed in tie laboratory with a double-selective tissue culture system, which enabled economical processing of large number of samples. Between 1989 and 1997, 2,294 samples were processed, and wild-type poliovirus was isolated from 17 of them in four clusters, termed "silent outbreaks," in September 1990 (type 3), between May and September 1991 (type 1), between October 1994 and June 1995 (type 1), and in December 1996 (type 1). Fifteen of the 17 positive samples were collected in the Gaza Strip, 1 was collected in the West Bank, and 1 was collected in the Israeli city of Ashdod, located close to the Gaza Strip. The AFP surveillance system failed to detect the circulating wild-type viruses. These findings further emphasize the important role that environmental surveillance ran play in monitoring the eradication of polioviruses. C1 Chaim Sheba Med Ctr, Cent Virol Lab, Publ Hlth Labs, Minist Hlth, IL-52621 Tel Hashomer, Israel. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Respiratory & Enter Viruses Branch, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. RP Mendelson, E (reprint author), Chaim Sheba Med Ctr, Cent Virol Lab, Publ Hlth Labs, Minist Hlth, IL-52621 Tel Hashomer, Israel. NR 39 TC 68 Z9 73 U1 1 U2 6 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUN PY 1999 VL 37 IS 6 BP 1670 EP 1675 PG 6 WC Microbiology SC Microbiology GA 197BN UT WOS:000080344900002 PM 10325305 ER PT J AU Unicomb, LE Podder, G Gentsch, JR Woods, PA Hasan, KZ Faruque, ASG Albert, MJ Glass, RI AF Unicomb, LE Podder, G Gentsch, JR Woods, PA Hasan, KZ Faruque, ASG Albert, MJ Glass, RI TI Evidence of high-frequency genomic reassortment of group a rotavirus strains in Bangladesh: Emergence of type G9 in 1995 SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID GROUP-A ROTAVIRUSES; LINKED IMMUNOSORBENT-ASSAY; POLYMERASE CHAIN-REACTION; MONOCLONAL-ANTIBODIES; P-TYPE; ENZYME-IMMUNOASSAY; NEW-DELHI; INTERSPECIES TRANSMISSION; PROBE-HYBRIDIZATION; ANIMAL ROTAVIRUSES AB We characterized 1,534 rotavirus (RV) strains collected in Bangladesh from 1992 to 1997 to assess temporal changes in G type and to study the most common G and P types using reverse transcription-PCR, oligonucleotide probe hybridization, and monoclonal antibody-based enzyme immunoassay. Results from this study combined with our previous findings from 1987 to 1991 (F. Bingnan et al., J. Clin. Microbiol. 29:862-868, 1991, and L. E. Unicomb et al., Arch. Virol. 132:201-208, 1993) (n = 2,515 fecal specimens) demonstrated that the distribution of the four major G types varied from year to year, types G1 to G4 constituted 51% of all strains tested (n = 1,364), and type G4 was the most prevalent type (22%), followed by type G2 (17%). Of 351 strains tested for both G and P types, three globally common types, type P[8], G1, type P[4], G2, and type P[8], G4, comprised 45% (n = 159) of the strains, although eight other strains were circulating during the study period. Mixed G and/or P types were found in 23% (n = 79) of the samples tested. Type G9 RVs that were genotype P[6] and P[8] with both long and short electrophoretic patterns emerged in 1995. The finding of five different genotypes among G9 strains, of which three were frequently detected, suggests that they may have an unusual propensity for reassortment that exceeds that found among the common G types. We also detected antigenic changes in serotypes G2 and G4 over time, as indicated by the loss of reactivity with standard typing monoclonal antibodies. Our data suggest that a vaccine must provide protection against type G9 RVs as well as against the four major G types because G9 strains constituted 16% (n = 56) of the typeable RV strains and have predominated since 1996. C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Atlanta, GA 30329 USA. Int Ctr Diarrhoeal Dis Res, Dhaka 1000, Bangladesh. RP Gentsch, JR (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, 1600 Clifton Rd,NW,MS G-04, Atlanta, GA 30329 USA. NR 72 TC 174 Z9 177 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUN PY 1999 VL 37 IS 6 BP 1885 EP 1891 PG 7 WC Microbiology SC Microbiology GA 197BN UT WOS:000080344900039 PM 10325342 ER PT J AU Engelthaler, DM Gage, KL Montenieri, JA Chu, M Carter, LG AF Engelthaler, DM Gage, KL Montenieri, JA Chu, M Carter, LG TI PCR detection of Yersinia pestis in fleas: Comparison with mouse inoculation SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; NUCLEOTIDE-SEQUENCE; GENE AB The "gold standard" for identifying Yersinia pestis-infected fleas has been inoculation of mice with pooled flea material. Inoculated mice are monitored for 21 days, and those that die are further analyzed for Y, pestis infection by fluorescent-antibody assay and/or culture. PCR may provide a more rapid and sensitive alternative for identifying Y. pestis in fleas, To compare these assays, samples were prepared from 381 held-collected fleas, Each flea was analyzed individually by both PCR and mouse inoculation. Sixty of the 381 flea samples were positive for Y. pestis by PCR; 48 of these PCR-positive samples caused death in mice (80.0% agreement). None of the 321 PCR-negative samples caused death. Among the 12 mice that survived inoculation with PCR-positive samples, 10 were later demonstrated by serology or culture to have been infected with Y. pestis, This suggests that death of inoculated mice is less reliable than PCR as an indicator of the presence of Y. pestis in flea samples, Mouse inoculation assays produce results that are comparable to PCR only when surviving as well as dead mice are analyzed for infection. The sapidity and sensitivity (10 to 100 CFU of Y. pestis) of PCR suggest that it could serve as a useful alternative to mouse inoculation for routine plague surveillance and outbreak investigations. C1 Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Publ Hlth Serv, US Dept Hlth & Human Serv, Ft Collins, CO 80522 USA. RP Gage, KL (reprint author), Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Publ Hlth Serv, US Dept Hlth & Human Serv, POB 208, Ft Collins, CO 80522 USA. NR 18 TC 33 Z9 35 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD JUN PY 1999 VL 37 IS 6 BP 1980 EP 1984 PG 5 WC Microbiology SC Microbiology GA 197BN UT WOS:000080344900056 PM 10325359 ER PT J AU Blindauer, KM Jackson, RJ McGeehin, M Pertowski, C Rubin, C AF Blindauer, KM Jackson, RJ McGeehin, M Pertowski, C Rubin, C TI Environmental pesticide illness and injury - The need for a national surveillance system SO JOURNAL OF ENVIRONMENTAL HEALTH LA English DT Article ID UNITED-STATES; PUBLIC-HEALTH; EXPOSURE; DIOXINS; CENTERS; CANCER; RISKS; HOME AB The potential impact of pesticides on public health is substantial. The U.S. Environmental Protection Agency (U.S. EPA) reports that more than one billion pounds of conventional active pesticide ingredients are used annually in the United States and that 69 million American households, or 85 percent of all families, store and use pesticides in and around the home. Poison control center reports and hospital-based data suggest that the impact of acute pesticide poisoning may be significant. In the absence of a national system for reporting nonoccupational pesticide-related illnesses, however, it is not possible to accurately estimate the public health impact of pesticide-related morbidity and mortality in the United States. In addition, surveillance is needed to provide information essential for the prevention and control of pesticide-related illness and injury. The National Center for Environmental Health (NCEH) proposes to establish a national surveillance system to monitor pesticide-related health conditions resulting from nonoccupational pesticide exposures. As an initial step, NCEH and U.S. EPA are funding a pilot surveillance project to be tested in 1999. The test will be conducted in a state that already has an occupational pesticide-illness surveillance program; with the knowledge-base and infrastructure already in place, costs and start-up time will be reduced. NCEH and its state and federal partners recognize the need for a national program for surveillance of nonoccupational pesticide-related health effects; however, funding will remain a challenge to establishing an effective and ongoing national surveillance system. C1 CDC, Hlth Studies Branch, Div Environm Hazards & Hlth Effects, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Blindauer, KM (reprint author), CDC, Hlth Studies Branch, Div Environm Hazards & Hlth Effects, Natl Ctr Environm Hlth, 4770 Buford Hwy NE, Atlanta, GA 30341 USA. NR 31 TC 4 Z9 4 U1 0 U2 0 PU NATL ENVIRON HEALTH ASSN PI DENVER PA 720 S COLORADO BLVD SUITE 970, SOUTH TOWER, DENVER, CO 80222 USA SN 0022-0892 J9 J ENVIRON HEALTH JI J. Environ. Health PD JUN PY 1999 VL 61 IS 10 BP 9 EP + PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 200PF UT WOS:000080548300001 ER PT J AU Wisner, CL Gilmer, TP Saltzman, LE Zink, TM AF Wisner, CL Gilmer, TP Saltzman, LE Zink, TM TI Intimate partner violence against women - Do victims cost wealth plans more? SO JOURNAL OF FAMILY PRACTICE LA English DT Article DE domestic violence; health care costs; medical records systems; computerized; regression analysis ID BATTERED WOMEN; DOMESTIC VIOLENCE; PHYSICAL ABUSE; HEALTH; PREVALENCE; IMPACT; INJURY AB BACKGROUND. Previous studies of intimate partner violence have not compared the health care costs of female victims with those of a general female population. METHODS. Our study is an analysis of the computerized cost data for 126 identified victims of intimate partner violence in a large health plan in Minneapolis and St. Paul, Minnesota, in 1994. Data were compared with a random sample of 1007 general female enrollees (aged 18 to 64 years) who used health care services in the same year. RESULTS. We found that an annual difference of $1775 more was spent for victims of intimate partner violence than on a random sample of general female enrollees. Regression analyses found that victims of intimate partner violence were significantly younger and had more hospitalizations, general clinic use, mental health services use, and out-of-plan referrals. Use of emergency room services was the same across groups. CONCLUSIONS. Women who were victims of intimate partner violence cost this health plan approximately 92% more than a random sample of general female enrollees. Contrary to the findings of other studies, use of emergency room services was not a driving factor in the higher costs. Findings of significantly higher mental health service use are supported by other studies. C1 Univ Cincinnati, Dept Family Med, Cincinnati, OH 45267 USA. Smith Kline Beecham, Hlth Care Serv Dept, Bloomington, IN USA. Univ Calif San Diego, Dept Family & Prevent Med, La Jolla, CA 92093 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Zink, TM (reprint author), Univ Cincinnati, Dept Family Med, POB 670582, Cincinnati, OH 45267 USA. NR 31 TC 135 Z9 137 U1 1 U2 7 PU DOWDEN PUBLISHING CORP PI MONTVALE PA 110 SUMMIT AVE, MONTVALE, NJ 07645-1712 USA SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD JUN PY 1999 VL 48 IS 6 BP 439 EP 443 PG 5 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 314UW UT WOS:000087076800004 PM 10386487 ER PT J AU D'Aunno, T Vaughn, TE McElroy, P AF D'Aunno, T Vaughn, TE McElroy, P TI An institutional analysis of HIV prevention efforts by the nation's outpatient drug abuse treatment units SO JOURNAL OF HEALTH AND SOCIAL BEHAVIOR LA English DT Article ID ORGANIZATIONAL INNOVATION; ADOPTION; ISOMORPHISM; PERSPECTIVE; PERFORMANCE; DIFFUSION; FIELDS AB Drawing from an institutional-theory perspective on innovations in organizations, this paper examines the use of human immunodeficiency virus (HIV) prevention practices by the nations outpatient substance abuse treatment units during a critical period from 1988 to 1995. An institutional perspective argues that organizations adopt new practices not only for technical reasons, but also because external actors actively promote or model the use of particular practices. We examine the extent to which treatment units use several practices to prevent HN infection among their clients and among drug-users not in treatment. Results from random-effects regression analyses of national survey data show that treatment units significantly increased their use of HIV prevention practices from 1988 to 1995. Further; the results show that treatment units' use of prevention practices tvas related to clients' risk for HIV infection, unit resources available to support these practices, and organizational support for the practices. Implications are discussed for an institutional view of organizational innovation as well as for research on HIV prevention. C1 Univ Chicago, Sch Social Serv Adm, Chicago, IL 60637 USA. Univ Chicago, Dept Hlth Studies, Chicago, IL 60637 USA. Univ Iowa, Iowa City, IA 52242 USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP D'Aunno, T (reprint author), Univ Chicago, Sch Social Serv Adm, 969 E 60th St, Chicago, IL 60637 USA. FU NIDA NIH HHS [5R01-DA03272] NR 55 TC 89 Z9 90 U1 5 U2 8 PU AMER SOCIOLOGICAL ASSOC PI WASHINGTON PA 1307 NEW YORK AVE NW #700, WASHINGTON, DC 20005-4712 USA SN 0022-1465 J9 J HEALTH SOC BEHAV JI J. Health Soc. Behav. PD JUN PY 1999 VL 40 IS 2 BP 175 EP 192 DI 10.2307/2676372 PG 18 WC Public, Environmental & Occupational Health; Psychology, Social SC Public, Environmental & Occupational Health; Psychology GA 209NU UT WOS:000081055300007 PM 10467763 ER PT J AU Noel, JS Fankhauser, RL Ando, T Monroe, SS Glass, RI AF Noel, JS Fankhauser, RL Ando, T Monroe, SS Glass, RI TI Identification of a distinct common strain of "Norwalk-like viruses" having a global distribution. SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 17th Meeting of the American-Society-for-Virology CY JUL 11-15, 1998 CL VANCOUVER, CANADA SP Amer Soc Virol ID ROUND-STRUCTURED VIRUSES; POLYMERASE CHAIN-REACTION; HUMAN ENTERIC CALICIVIRIDAE; CAPSID SEQUENCE DIVERSITY; SNOW MOUNTAIN AGENT; MOLECULAR CHARACTERIZATION; VIRAL GASTROENTERITIS; UNITED-KINGDOM; SOUTH-AFRICA; INTERNATIONAL OUTBREAK AB "Norwalk-like viruses" (NLVs) are the most common cause of outbreaks of nonbacterial gastroenteritis. During molecular surveillance of NLV strains from 152 outbreaks of gastroenteritis that occurred in the US between August 1993 and July 1997, we identified an NLV strain that predominated during the 1995-1996 season. The "95/96-US" strain caused GO outbreaks in geographically distant locations within the US and was identified, by sequence comparisons, in an additional 7 countries on 5 continents during the same period. This is the first demonstration linking a single NLV strain globally and suggests that the circulation of these strains might involve patterns of transmission not previously considered. The diagnostic techniques are now available to establish a global network for surveillance of NLV strains that would highlight the importance of NLVs worldwide and allow molecular identification of common strains having a global distribution so as to consider interventions for their control. C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect G04, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis,Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Emory Univ, Sch Med, Dept Pediat, Atlanta, GA USA. Vet Adm Med Ctr, Atlanta, GA 30033 USA. RP Noel, JS (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect G04, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis,Natl Ctr Infect Dis, 1600 Clifton Rd, Atlanta, GA 30333 USA. OI Monroe, Stephan/0000-0002-5424-716X NR 63 TC 259 Z9 270 U1 1 U2 11 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1334 EP 1344 DI 10.1086/314783 PG 11 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100004 PM 10228052 ER PT J AU Mermin, JH Villar, R Carpenter, J Roberts, L Samaridden, A Gasanova, L Lomakina, S Bopp, C Hutwagner, L Mead, P Ross, B Mintz, ED AF Mermin, JH Villar, R Carpenter, J Roberts, L Samaridden, A Gasanova, L Lomakina, S Bopp, C Hutwagner, L Mead, P Ross, B Mintz, ED TI A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 07-16, 1997 CL SAN FRANCISCO, CALIFORNIA SP Infect Dis Soc Amer ID SALMONELLA-TYPHI; IMMUNOLOGIC CONTROL; RISK; CIPROFLOXACIN; PATHOGENESIS; TRANSMISSION; CHILDREN AB From 1 January through 30 June 1997, 8901 cases of typhoid fever and 95 associated deaths were reported in Dushanbe, Tajikistan. Of 29 Salmonella serotype Typhi isolates tested, 27 (93%) were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. In a case-control study of 45 patients and 123 controls, Salmonella Typhi infection was associated with drinking unboiled water(matched odds ratio, 7; 95% confidence interval, 3-24; P<.001). Of tap water samples, 97% showed fecal coliform contamination (mean level, 175 cfu/100 mt). Samples taken from water treatment plants revealed that fecal coliform contamination occurred both before and after treatment. Lack of chlorination, equipment failure, and back-siphonage in the water distribution system led to contamination of drinking water. After chlorination and coagulation were begun at the treatment plants and a water conservation campaign was initiated to improve water pressure, the incidence of typhoid fever declined dramatically. C1 Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Biostat & Informat Management Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Hosp Infect Program, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA USA. Ctr Dis Control & Prevent, Refugee Hlth Unit, Natl Ctr Environm Hlth, Atlanta, GA USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Int Hlth, Epidemiol Program Off, Atlanta, GA USA. Hosp 2, Dushanbe Sanitary & Epidemiol Serv, Dushanbe, Tajikstan. Hosp 2, Microbiol Lab, Dushanbe, Tajikstan. RP Mintz, ED (reprint author), Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Biostat & Informat Management Branch, Mailstop A-38,1600 Clifton Rd, Atlanta, GA 30333 USA. RI Mermin, Jonathan/J-9847-2012 NR 24 TC 104 Z9 110 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1416 EP 1422 DI 10.1086/314766 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100015 PM 10228063 ER PT J AU Haydock, AK Martin, DH Morse, SA Cammarata, C Mertz, KJ Totten, PA AF Haydock, AK Martin, DH Morse, SA Cammarata, C Mertz, KJ Totten, PA TI Molecular characterization of Haemophilus ducreyi strains from Jackson, Mississippi, and New Orleans, Louisiana SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID IMMUNODEFICIENCY-VIRUS INFECTION; DEPENDENT RABBIT MODEL; UNITED-STATES; GENITAL ULCERS; IN-VITRO; EPIDEMIOLOGY; TYPE-1; TRANSMISSION; OUTBREAK; FEMALE AB Chancroid, a sexually transmitted disease caused by Haemophilus ducreyi, is one of the most common genital ulcer diseases in developing countries. In the United States, while less common, the disease has been associated with outbreaks in inner cities, particularly among persons who engage in sex for drugs or money, Two outbreaks of chancroid were recently studied in the United States, one in New Orleans (from 1990 to 1992) and one in Jackson, Mississippi (from 1994 to 1995), By use of ribotyping, plasmid content, and antibiotic susceptibility, the chancroid cases in New Orleans were found to be due to a limited number of strains, consistent with a limited introduction of H. ducreyi into this community. The H. ducreyi isolates from New Orleans and Jackson had different ribotype patterns, suggesting that the two outbreaks were probably not linked. C1 Univ Washington, Harborview Med Ctr, Dept Med, Div Infect Dis, Seattle, WA 98104 USA. Louisiana State Univ, Sch Med, Infect Dis Sect, Dept Med, New Orleans, LA USA. Ctr Dis Control & Prevent, Div Aids, Sexually Transmitted Dis & TB Lab Res, Atlanta, GA USA. Ctr Dis Control & Prevent, Div STD Prevent, Atlanta, GA USA. RP Totten, PA (reprint author), Univ Washington, Harborview Med Ctr, Dept Med, Div Infect Dis, Box 359779,325 9th Ave, Seattle, WA 98104 USA. NR 39 TC 13 Z9 13 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1423 EP 1432 DI 10.1086/314771 PG 10 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100016 PM 10228064 ER PT J AU Hutchins, WA Carlone, GM Westerink, MAJ AF Hutchins, WA Carlone, GM Westerink, MAJ TI Elderly immune response to a TI-2 antigen: Heavy and light chain use and bactericidal activity to Neisseria meningitidis serogroup C polysaccharide SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID INFLUENZAE TYPE-B; AGE-ASSOCIATED CHANGES; CAPSULAR POLYSACCHARIDE; ANTIBODY-RESPONSE; STREPTOCOCCUS-PNEUMONIAE; HUMAN-IGG; REPERTOIRE DIVERSITY; GROUP-A; MENINGOCOCCAL POLYSACCHARIDE; PHOSPHORYLCHOLINE-ANTIBODY AB Previous studies of the elderly immune response to TI-2 antigens failed to correlate specific antibody levels with function and to compare responses with those of young adults. Neisseria meningitidis serogroup C capsular polysaccharide (MCPS) was used as a model TI-2 antigen. Anti-MCPS antibody levels were determined in elderly individuals and correlated with bactericidal activity. The anti-MCPS response in most persons was characterized by predominant IgG usage, with IgG2 > IgG1, No light chain or IgA subclass predominated, but some responses showed a particular chain type, Bactericidal activity correlated best with IgG2 levels. Elderly subjects had lower anti-MCPS responses than the young adults did in all chain-specific anti-MCPS levels, and levels declined more rapidly. Bactericidal activity following immunization was significantly lower in the elderly persons. These results suggest the anti-MCPS antibody repertoire in the elderly is likely maintained, and the lower level of function is related to the lower antibody levels. C1 Med Coll Ohio, Dept Med, Toledo, OH 43699 USA. Med Coll Ohio, Dept Pathol, Toledo, OH 43699 USA. Ctr Dis Control, Resp Dis Branch, Div Bacterial & Mycot Dis, Atlanta, GA 30333 USA. RP Westerink, MAJ (reprint author), Med Coll Ohio, Dept Med, POB 10008,3000 Arlington Ave, Toledo, OH 43699 USA. NR 63 TC 13 Z9 14 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1433 EP 1440 DI 10.1086/314750 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100017 PM 10228065 ER PT J AU Paddock, CD Greer, PW Ferebee, TL Singleton, J McKechnie, DB Treadwell, TA Krebs, JW Clark, MJ Holman, RC Olson, JG Childs, JE Zaki, SR AF Paddock, CD Greer, PW Ferebee, TL Singleton, J McKechnie, DB Treadwell, TA Krebs, JW Clark, MJ Holman, RC Olson, JG Childs, JE Zaki, SR TI Hidden mortality attributable to rocky mountain spotted fever: Immunohistochemical detection of fatal, serologically unconfirmed disease SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID ACUTE-RENAL-FAILURE; RICKETTSIA-RICKETTSII; DIAGNOSIS; IMMUNOPEROXIDASE; SURVEILLANCE; SPECIMENS; LESIONS; TISSUE; TESTS; RISK AB Rocky Mountain spotted fever (RMSF) is the most severe tickborne infection in the United States and is a nationally notifiable disease. Since 1981, the annual case-fatality ratio for RMSF has been determined from laboratory-confirmed cases reported to the Centers for Disease Control and Prevention (CDC), Herein, a description is given of patients with fatal, serologically unconfirmed RMSF for whom a diagnosis of RMSF was established by immunohistochemical (IHC) staining of tissues obtained at autopsy. During 1996-1997, acute-phase serum and tissue samples from patients with fatal disease compatible with RMSF were tested at the CDC. As determined by indirect immunofluorescence assay, no patient serum demonstrated IgG or IgM antibodies reactive with Rickettsia rickettsii at a diagnostic titer (i.e,, greater than or equal to 64); however, IHC staining confirmed diagnosis of RMSF in all patients. Polymerase chain reaction validated the IHC findings for 2 patients for whom appropriate samples were available for testing. These findings suggest that dependence on serologic assays and limited use of IHC staining for confirmation of fatal RMSF results in underestimates of mortality and of case-fatality ratios for this disease. C1 Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Off Director, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA USA. RP Paddock, CD (reprint author), Ctr Dis Control & Prevent, Viral & Rickettsial Zoonoses Branch, Mailstop G-13,1600 Clifton Rd NE, Atlanta, GA 30333 USA. RI Childs, James/B-4002-2012 NR 55 TC 86 Z9 91 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1469 EP 1476 DI 10.1086/314776 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100021 PM 10228069 ER PT J AU Montenegro, SML Miranda, P Mahanty, S Abath, FGC Teixeira, KM Coutinho, EM Brinkman, J Goncalves, I Domingues, LAW Domingues, ALC Sher, A Wynn, TA AF Montenegro, SML Miranda, P Mahanty, S Abath, FGC Teixeira, KM Coutinho, EM Brinkman, J Goncalves, I Domingues, LAW Domingues, ALC Sher, A Wynn, TA TI Cytokine production in acute versus chronic human schistosomiasis mansoni: The cross-regulatory role of interferon-gamma and interleukin-10 in the responses of peripheral blood mononuclear cells and splenocytes to parasite antigens SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT International Congress for Schistosomiasis Research CY OCT, 1997 CL BELO HORIZONT, BRAZIL ID HUMAN LYMPHATIC FILARIASIS; MURINE SCHISTOSOMIASIS; IMMUNE-RESPONSES; IN-VIVO; HEPATOSPLENIC DISEASE; GRANULOMA-FORMATION; DOWN-REGULATION; TH2 CYTOKINES; KALA-AZAR; IFN-GAMMA AB The contribution of interleukin (IL)-10 and interferon (IFN)-gamma to the regulation of type 1 and type 2 cytokine responses was investigated in Brazilians with different clinical forms of schistosomiasis mansoni. Cells from members of a family with acute intestinal schistosomiasis responded to schistosomal soluble egg antigen (SEA) or soluble adult worm antigen preparation (SWAP) with greater amounts of IFN-gamma than did cells from several patients with chronic intestinal schistosomiasis; IL-10 levels were similar, Neutralization of IL-10 had no effect on the SEA-specific IFN-gamma response in patients with acute infection, whereas SWAP-induced IFN-gamma was increased in both groups. Anti-IL-10 also up-regulated SEA-specific IFN-gamma protein and mRNA responses in most splenocyte cultures from hepatosplenic schistosomiasis patients but had no effect on antigen-specific IL-4 or IL-5 production. Neutralization of IFN-gamma resulted in a comparable increase in SWAP-specific IL-10 and IL-5, while IL-4 was not affected. These studies demonstrate that early disease in schistosomiasis is associated with a significant IFN-gamma response and that IL-10 contributes to the suppression of that response during both early and chronic infection. C1 NIAID, Immunobiol Sect, Parasit Dis Lab, NIH, Bethesda, MD 20892 USA. Univ Fed Pernambuco, Dept Imunol, Ctr Pesquisas Aggeu Magalhaes, FIOCRUZ, Recife, PE, Brazil. Univ Fed Pernambuco, Lab Imunopatol Keizo Asami, Recife, PE, Brazil. Ctr Dis Control & Prevent, Special Pathogens Branch, Atlanta, GA USA. RP Wynn, TA (reprint author), NIAID, Immunobiol Sect, Parasit Dis Lab, NIH, 9000 Rockville Pike,Bldg 4-126, Bethesda, MD 20892 USA. RI Wynn, Thomas/C-2797-2011 NR 46 TC 81 Z9 85 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUN PY 1999 VL 179 IS 6 BP 1502 EP 1514 DI 10.1086/314748 PG 13 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 200VQ UT WOS:000080561100025 PM 10228073 ER PT J AU Oberste, MS Maher, K Pallansch, MA AF Oberste, MS Maher, K Pallansch, MA TI Specific detection of echoviruses 22 and 23 in cell culture supernatants by RT-PCR SO JOURNAL OF MEDICAL VIROLOGY LA English DT Article DE RT-PCR; echovirus 22; echovirus 23; molecular detection ID POLYMERASE CHAIN-REACTION; PICORNAVIRUS GROUP; ENTEROVIRUSES; IDENTIFICATION; AMPLIFICATION; HYBRIDIZATION; POLIOVIRUSES; SEQUENCE AB Reverse transcription-polymerase chain reaction (RT-PCR) methods are available for the rapid detection of enteroviruses in clinical specimens or virus isolates. Pan-enterovirus PCR primers, however, fail to amplify echovirus (E) type 22 or 23 because of their extreme sequence divergence from the other enteroviruses. We have developed an RT-PCR method to detect specifically E22 and E23 RNA directly in tissue culture supernatants without a viral RNA purification step. The E22/E23 primers successfully amplified 20 of 20 clinical isolates of E22 and 4 of 4 E23 isolates representing viruses isolated in 15 states over a 19-year period, as well as E22 and E23 prototype strains isolated in the 1950s. The primers did not amplify any of the other 64 enterovirus prototype strains. J. Med. Virol. 58: 178-181, 1999, Published 1999Wiley-Liss, Inc. C1 Ctr Dis Control & Prevent, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Oberste, MS (reprint author), Ctr Dis Control & Prevent, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 17 TC 30 Z9 32 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 USA SN 0146-6615 J9 J MED VIROL JI J. Med. Virol. PD JUN PY 1999 VL 58 IS 2 BP 178 EP 181 DI 10.1002/(SICI)1096-9071(199906)58:2<178::AID-JMV13>3.0.CO;2-Q PG 4 WC Virology SC Virology GA 193DQ UT WOS:000080121000013 PM 10335867 ER PT J AU Purcell, DW AF Purcell, DW TI Sociolegal control of homosexuality: A multi-nation comparison. SO JOURNAL OF NERVOUS AND MENTAL DISEASE LA English DT Book Review C1 Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA 30333 USA. RP Purcell, DW (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA 30333 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0022-3018 J9 J NERV MENT DIS JI J. Nerv. Ment. Dis. PD JUN PY 1999 VL 187 IS 6 BP 387 EP 388 DI 10.1097/00005053-199906000-00013 PG 2 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 205KN UT WOS:000080820000013 ER PT J AU Eberhard, ML Nace, EK Freeman, AR AF Eberhard, ML Nace, EK Freeman, AR TI Survey for Cyclospora cayetanensis in domestic animals in an endemic area in Haiti SO JOURNAL OF PARASITOLOGY LA English DT Article AB From January 1997 through July 1998, we examined stool samples from 327 domestic animals, including pigs, cattle, horses, goats, dogs, cats, guinea pigs, chicken, ducks, turkeys, and pigeons in Leogane, Haiti, for the presence of Cyclospora cayetanensis infection. No coccidian oocysts morphologically compatible with C. cayetanensis were detected in any of the animal samples, despite their living in, or near, households with infected individuals. These results suggest that domestic animals are not reservoir hosts for C. cayetanensis and that in this endemic area, humans: are the only natural host for this parasite. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. RP Eberhard, ML (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, F13,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 5 TC 25 Z9 27 U1 1 U2 3 PU AMER SOC PARASITOLOGISTS PI LAWRENCE PA 810 EAST 10TH STREET, LAWRENCE, KS 66044 USA SN 0022-3395 J9 J PARASITOL JI J. Parasitol. PD JUN PY 1999 VL 85 IS 3 BP 562 EP 563 DI 10.2307/3285797 PG 2 WC Parasitology SC Parasitology GA 209EB UT WOS:000081034300031 PM 10386455 ER PT J AU Kaste, LM Drury, TF Horowitz, AM Beltran, E AF Kaste, LM Drury, TF Horowitz, AM Beltran, E TI An evaluation of NHANES III estimates of early childhood caries SO JOURNAL OF PUBLIC HEALTH DENTISTRY LA English DT Article DE early childhood caries; dental caries; infant; prevalence; United States; Mexican-American; National Health and Nutrition Examination Survey III; NHANES III; estimates ID HEALTH; ISSUES AB Objectives: The purposes of this study were to estimate and evaluate the prevalence for the United States of early childhood caries (ECC) among children 12 to 23 months of age. Methods: The 1988-94 National Health and Nutrition Examination Survey (NHANES III) public-use data set was analyzed using SUDAAN. Two ECC case definitions were used. Definition #1 was restricted to the caries score called by the examiner. Definition #2 liberally included children identified by definition #1 and those possibly having questionable caries scores. Results: The NHANES III six-year prevalence estimates of caries in the maxillary anterior incisors of children 12 to 23 months of age were 1.0 percent for definition #1 and 1.7 percent for definition #2. Mexican-American and economically disadvantaged children were disproportionally represented with ECC. Conclusions: The prevalence of ECC among children 12 to 23 months of age is barely detectable at the national level. Alternative study designs and improved case definitions are needed for further advances in ECC. C1 Med Univ S Carolina, Coll Dent Med, Dept Stomatol, Div Dent Publ Hlth & Oral Epidemiol, Charleston, SC 29425 USA. Med Univ S Carolina, Coll Med, Dept Biometry & Epidemiol, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Hlth Care Res, Charleston, SC 29425 USA. NIDCR, Hlth Policy Anal & Dev Branch, Bethesda, MD USA. Ctr Dis Control & Prevent, Surveillance Invest Res Branch, Atlanta, GA USA. RP Kaste, LM (reprint author), Med Univ S Carolina, Coll Dent Med, Dept Stomatol, Div Dent Publ Hlth & Oral Epidemiol, 173 Ashley Ave,POB 250507, Charleston, SC 29425 USA. NR 8 TC 32 Z9 34 U1 2 U2 2 PU AAPHD NATIONAL OFFICE PI PORTLAND PA 3760 SW LYLE COURT, PORTLAND, OR 97221 USA SN 0022-4006 J9 J PUBLIC HEALTH DENT JI J. Public Health Dent. PD SUM PY 1999 VL 59 IS 3 BP 198 EP 200 DI 10.1111/j.1752-7325.1999.tb03269.x PG 3 WC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health SC Dentistry, Oral Surgery & Medicine; Public, Environmental & Occupational Health GA 253KE UT WOS:000083555100008 PM 10649592 ER PT J AU Thompson, MP Saltzman, LE Bibel, D AF Thompson, MP Saltzman, LE Bibel, D TI Applying NIBRS data to the study of intimate partner violence: Massachusetts as a case study SO JOURNAL OF QUANTITATIVE CRIMINOLOGY LA English DT Article; Proceedings Paper CT 48th Annual Meeting of the American-Society-of-Criminology CY NOV 20-23, 1996 CL CHICAGO, ILLINOIS SP Amer Soc Criminol DE NIBRS; intimate partner violence; offender-victim relationship; women; violence; incident-based reporting AB Using data from Massachusetts, we illustrate three ways in which National Incident-Based Reporting System (NIBRS) data can improve the collection of important information on intimate partner violence. First, because NIBRS uses incident-based reporting, data are collected on all crimes associated with each incident. In our sample of women victimized by an intimate partner, 10% had experienced more than one crime during the incident. Second, NIBRS involves expanded data collection on the offender-victim relationship, as well as reporting about additional offenses. For female victims, partners were more likely than nonpartners to commit the crimes of simple assault, intimidation, and aggravated assault. For crimes involving male victims, an aquaintance was most likely to be the offender. Third, NIBRS data allow us to connect information about the incident, the offender(s), and the victim(s). Our data indicted that several victim-, offender-, and incident-related variables were risk factors for injury, including victim's ethnicity, offender's relationship to the victim, offender's use of a weapon, whether or not the case was cleared, type of crime committed, and whether or not drugs and/or alcohol were involved in the incident. Although there are several limitations to NIBRS data, its potential usefulness to the study of intimate partner violence deserves further attention. C1 Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Div Violence Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA USA. Massachusetts State Police, Div Invest & Intelligence, Framingham, MA USA. RP Thompson, MP (reprint author), Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. NR 12 TC 23 Z9 23 U1 0 U2 3 PU KLUWER ACADEMIC/PLENUM PUBL PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0748-4518 J9 J QUANT CRIMINOL JI J. Quant. Criminol. PD JUN PY 1999 VL 15 IS 2 BP 163 EP 180 DI 10.1023/A:1007522721430 PG 18 WC Criminology & Penology SC Criminology & Penology GA 227CF UT WOS:000082060200004 ER PT J AU St Lawrence, JS AF St Lawrence, JS TI Emerging behavioral strategies for the prevention of HIV in rural areas SO JOURNAL OF RURAL HEALTH LA English DT Article ID AIDS RISK ACTIVITIES; INTERVENTION; ADOLESCENTS; WOMEN AB HIV/AIDS prevention efforts have been concentrated in urban areas, despite increases in HIV in nonmetropolitan areas. This study reviews behavioral prevention programs initiated in rural areas and programs that could be adapted for rural contexts. Outcomes from these interventions demonstrate that preventive interventions at the population, community, targeted populations subgroups, and small group levels can reduce high-risk behavior in rural environments and are cost effective to deliver. C1 Ctr Dis Control & Prevent, Behav Intervent & Res Branch, Div STD Prevent, Natl Ctr HIV STD & TB Prevent, Atlanta, GA 30333 USA. RP St Lawrence, JS (reprint author), Ctr Dis Control & Prevent, Behav Intervent & Res Branch, Div STD Prevent, Natl Ctr HIV STD & TB Prevent, 1600 Clifton Rd NE,MS-E44, Atlanta, GA 30333 USA. NR 32 TC 6 Z9 6 U1 0 U2 0 PU NATL RURAL HEALTH ASSOC PI KANSAS CITY PA ONE WEST ARMOUR BLVD, STE 301, KANSAS CITY, MO 64111 USA SN 0890-765X J9 J RURAL HEALTH JI J. Rural Health PD SUM PY 1999 VL 15 IS 3 BP 335 EP 343 PG 9 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 407NY UT WOS:000167278700007 PM 11942566 ER PT J AU Goldberg, J Rudd, RE Dietz, W AF Goldberg, J Rudd, RE Dietz, W TI Using 3 data sources and methods to shape a nutrition campaign SO JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION LA English DT Article ID AFRICAN-AMERICAN WOMEN; RISK-FACTORS; NATIONAL-HEALTH; BLOOD-PRESSURE; WHITE WOMEN; OBESITY; BLACK; HYPERTENSION; DISEASE; EPIDEMIOLOGY AB The first objective of this research was to define a target population of African-American women more clearly. The second was to provide specific information about the needs and preferences of that population in order to design an effective, culturally relevant, community-based communications campaign to promote more healthful lifestyles. Data collection and analysis included the following: interviews with 10 community nutritionists and the director of the State Office of Nutrition, 6 focus groups with a total of 47 members of the target population, and direct observation and documentation of key community resources. This approach, called "triangulation," permits more in-depth understanding of issues, provides different perspectives on the problem, and helps ensure accuracy of conclusions. Interviews with nutritionists identified young African-American women as the appropriate target population for the campaign. These interviews and the focus-group discussions confirmed the acceptability of higher weight and better body-esteem among African-American women than among white women. Both the nutritionists and the focus-group members identified the need and desire for information and skills related to food preparation and provided specific direction for program content. Community observation confirmed the need for food markets with merchandise of consistently high quality, especially in the fresh and frozen produce sections. Observation also helped identify community services and programs. The 3 sets of data, which augmented a comprehensive literature review, provided a firm foundation for the campaign's design and development. Dietitians and nutritionists working in community settings can use triangulation to gain a better understanding of their populations in order to develop more effective interventions. C1 Tufts Univ, Sch Nutr Sci & Policy, Ctr Nutr Commun, Medford, MA 02155 USA. Harvard Univ, Sch Publ Hlth, Dept Hlth & Social Behav, Educ Programs, Boston, MA 02115 USA. Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, Atlanta, GA USA. Floating Hosp, New England Med Ctr, Div Clin Nutr, Boston, MA USA. RP Goldberg, J (reprint author), Tufts Univ, Sch Sci & Policy, Ctr Nutr Commun, Medford, MA 02155 USA. FU NIDDK NIH HHS [N01-DK-4-2203] NR 35 TC 14 Z9 14 U1 0 U2 1 PU AMER DIETETIC ASSOC PI CHICAGO PA 216 W JACKSON BLVD #800, CHICAGO, IL 60606-6995 USA SN 0002-8223 J9 J AM DIET ASSOC JI J. Am. Diet. Assoc. PD JUN PY 1999 VL 99 IS 6 BP 717 EP 722 DI 10.1016/S0002-8223(99)00171-6 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 201AA UT WOS:000080571400021 PM 10361535 ER PT J AU Morrison, AC Costero, A Edman, JD Clark, GG Scott, TW AF Morrison, AC Costero, A Edman, JD Clark, GG Scott, TW TI Increased fecundity of Aedes aegypti fed human blood before release in a mark-recapture study in Puerto Rico SO JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION LA English DT Article DE Aedes aegypti; fecundity; sugar-feeding; gonotrophic cycle; mark-release-recapture; Puerto Rico; survival; fitness ID PLUS SUGAR; CULICIDAE; DIPTERA; SURVIVORSHIP; MOSQUITOS; FITNESS; ASSAY; SIZE AB Laboratory experiments suggest that utilization of blood rather than natural sugar sources for energetic needs affords female Aedes aegypti a reproductive advantage over conspecifics that use sugar To test this hypothesis under field conditions, we carried out a mark-release-recapture study in Florida, PR. Adult females (F-1) reared from field-collected eggs were provided with a diet of human blood alone or human blood plus a 20% honey solution before their release. Backpack aspirators were used to collect mosquitoes from release houses for 5 consecutive days beginning the 2nd day after release. Survival was estimated from the slope of the regression line of the log-transformed daily number of recaptures for each treatment group. To compare fecundity of the treatment groups, each recaptured female was dissected, ovaries were removed, oocytes counted, and Christophers' stages of oocyte development scored. Recapture rates were 30% for the blood-only group and 23% for blood plus honey group. The daily survival rate of the blood-only group (55%) was not statistically different from that of the blood plus honey group (69%) (t = 0.32, P > 0.05). By analysis of variance, fecundity (average number of stage m-V oocytes) was significantly higher in the females fed human blood alone (n = 103, 109 oocytes/female) than in the group fed on blood and honey (n = 50, 95 oocytes/female) (P = 0.0007). The observed gonotrophic cycle length of the recaptured females ranged from 3 to 7 days. Results from our field study are consistent with laboratory life-table experiments that suggest feeding exclusively on human blood provides a reproductive advantage fur female A. aegypti. C1 Univ Calif Davis, Dept Entomol, Davis, CA 95616 USA. Univ Massachusetts, Dept Entomol, Amherst, MA 01003 USA. Ctr Dis Control & Prevent, Dengue Branch, San Juan, PR 00921 USA. RP Morrison, AC (reprint author), Univ Calif Davis, Dept Entomol, 1 Shields Ave, Davis, CA 95616 USA. FU NIAID NIH HHS [AI-22119] NR 32 TC 21 Z9 21 U1 2 U2 10 PU AMER MOSQUITO CONTROL ASSOC PI MOUNT LAUREL PA 15000 COMMERCE PARKWAY, SUITE C, MOUNT LAUREL, NJ 08054 USA SN 8756-971X EI 1943-6270 J9 J AM MOSQUITO CONTR JI J. Am. Mosq. Control Assoc. PD JUN PY 1999 VL 15 IS 2 BP 98 EP 104 PG 7 WC Entomology SC Entomology GA 212MF UT WOS:000081219900003 PM 10412105 ER PT J AU Collins, WE Jeffery, GM AF Collins, WE Jeffery, GM TI A historical review of the F-1 strain of Anopheles freeborni as a host and vector for studies of malaria SO JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION LA English DT Review DE Anopheles freeborni; Plasmodium; malaria; mosquitoes ID SAIMIRI-SCIUREUS-BOLIVIENSIS; UGANDA-I/CDC STRAIN; AOTUS-TRIVIRGATUS MONKEYS; LEMURINUS-GRISEIMEMBRA MONKEYS; BLOCKING VACCINE CANDIDATE; NORTH KOREAN STRAIN; SALVADOR-II STRAIN; SANTA-LUCIA STRAIN; NEW-WORLD MONKEYS; PLASMODIUM-VIVAX AB A reveiw was made of the use of a specific strain of Anopheles freeborni from California (F-1) that has been used extensively in experimental investigations of malaria for more than 50 years. The F-1 strain of An. freeborni has been shown to be a suitable experimental host and vector for different species of Plasmodium that cause malaria in humans and nonhuman primates for biologic, immunologic, and chemotherapeutic studies. Eleven species of Plasmodium fully completed sporogonic development; development of sporozoites within mature oocysts occurred in an additional 7 species. Transmission through An. freeborni from human to human, monkey to human, or monkey to monkey has been demonstrated for 9 species of Plasmodium. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. RP Collins, WE (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. NR 165 TC 1 Z9 2 U1 1 U2 2 PU AMER MOSQUITO CONTROL ASSOC PI MOUNT LAUREL PA 15000 COMMERCE PARKWAY, SUITE C, MOUNT LAUREL, NJ 08054 USA SN 8756-971X EI 1943-6270 J9 J AM MOSQUITO CONTR JI J. Am. Mosq. Control Assoc. PD JUN PY 1999 VL 15 IS 2 BP 117 EP 127 PG 11 WC Entomology SC Entomology GA 212MF UT WOS:000081219900006 PM 10412108 ER PT J AU Lounibos, LP Coetzee, M Duzak, D Nishimura, N Linley, JR Service, MW Cornel, AJ Fontenille, D Mukwaya, LG AF Lounibos, LP Coetzee, M Duzak, D Nishimura, N Linley, JR Service, MW Cornel, AJ Fontenille, D Mukwaya, LG TI A description and morphometric comparison of eggs of species of the Anopheles gambiae complex SO JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION LA English DT Article DE Africa; egg attributes; malaria; morphology; scanning electron microscopy; vectors ID CULICIDAE; DIPTERA; IDENTIFICATION; AFRICA AB Eggs of the 6 named species of the Anopheles gambiae complex: are described from scanning electron micrographs of specimens obtained from laboratory colonies or wild-caught females. Morphometric measurements of eggs from 5 sources of Anopheles arabiensis, 2 of Anopheles gambiae, one of Anopheles quadriannulatus, 2 of Anopheles bwambae, 2 of Anopheles merus, and one of Anopheles melas are compared, and relationships are analyzed by multivariate statistics. No morphologic characters were species-diagnostic, although tendencies of the saltwater species An. merus and All. melas to have wider decks and shorter floats were confirmed. Species and populations overlapped considerably in principal components and discriminant function analyses based on 10 attributes of eggs. Nevertheless, discriminant functions revealed similarities in eggs of species believed to be most closely related, namely, An. gambiae and An. arabiensis, An. merus and An. melas, and An. quadriannulatus and An. bwambae. C1 Univ Florida, Florida Med Entomol Lab, Vero Beach, FL 32962 USA. S African Inst Med Res, Dept Med Entomol, ZA-2000 Johannesburg, South Africa. Univ Liverpool, Liverpool Sch Trop Med, Liverpool L3 5QA, Merseyside, England. Ctr Dis Control & Prevent, Div Parasit Dis, Entomol Branch, Chamblee, GA 30341 USA. ORSTOM, Inst Pasteur, Lab Zool Med, Dakar, Senegal. Uganda Virus Res Inst, Mosquito Res Programme, Entebbe, Uganda. RP Lounibos, LP (reprint author), Univ Florida, Florida Med Entomol Lab, 200 9th St SE, Vero Beach, FL 32962 USA. RI FONTENILLE, didier/G-4091-2013 FU NIAID NIH HHS [AI-31034] NR 32 TC 11 Z9 12 U1 0 U2 0 PU AMER MOSQUITO CONTROL ASSN INC PI LAKE CHARLES PA 2200 E PRIEN LAKE RD, LAKE CHARLES, LA 70601 USA SN 8756-971X J9 J AM MOSQUITO CONTR JI J. Am. Mosq. Control Assoc. PD JUN PY 1999 VL 15 IS 2 BP 157 EP 185 PG 29 WC Entomology SC Entomology GA 212MF UT WOS:000081219900010 PM 10412112 ER PT J AU Moore, CG AF Moore, CG TI Aedes albopictus in the United States: Current status and prospects for further spread SO JOURNAL OF THE AMERICAN MOSQUITO CONTROL ASSOCIATION LA English DT Article DE Aedes albopictus; exotic pests; invasion biology; emerging diseases ID CULICIDAE; DIPTERA; TIRES; USA AB Since its initial discovery in the continental USA in 1985, the Asian tiger mosquito, Aedes albopictus, has spread rapidly throughout the eastern part of the country. Infestations of Ae, albopictus now have been reported to the Centers for Disease Control and Prevention from 919 counties in 26 states in the continental USA. This species is believed to be established in 911 counties in 25 states. Single individuals or small numbers of Ae. albopictus have been intercepted and destroyed in 3 additional states (California, New Mexico, and Washington). Five states (Florida, Georgia, North Carolina, South Carolina, and Tennessee) have reported infestations in all of their counties. The current reported distribution of Ae. albopictus was compared to ecoregions of the U.S. Environmental Protection Agency's Level III ecoregion map. Several areas are identified as probable candidates for extension of this species based on ecological characteristics of the landscape. In other areas, populations seem likely to become locally abundant in urban or suburban eases that do not reflect the native ecology of the region. The ability of Ae. albopictus to transmit a variety of pathogens of human and veterinary public health importance, coupled with its ability to colonize diverse ecological settings makes continued surveillance an important issue. C1 US Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Ft Collins, CO 80522 USA. RP Moore, CG (reprint author), US Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Ft Collins, CO 80522 USA. NR 20 TC 98 Z9 105 U1 3 U2 18 PU AMER MOSQUITO CONTROL ASSN INC PI LAKE CHARLES PA 2200 E PRIEN LAKE RD, LAKE CHARLES, LA 70601 USA SN 8756-971X J9 J AM MOSQUITO CONTR JI J. Am. Mosq. Control Assoc. PD JUN PY 1999 VL 15 IS 2 BP 221 EP 227 PG 7 WC Entomology SC Entomology GA 212MF UT WOS:000081219900015 PM 10412117 ER PT J AU Qu, Y Hadgu, A AF Qu, Y Hadgu, A TI A model for evaluating sensitivity and specificity for correlated diagnostic tests in efficacy studies with an imperfect reference test (vol 93, pg 920, 1998) SO JOURNAL OF THE AMERICAN STATISTICAL ASSOCIATION LA English DT Correction C1 Cleveland Clin Fdn, Cleveland, OH 44195 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Qu, Y (reprint author), Cleveland Clin Fdn, 9500 Euclid Ave, Cleveland, OH 44195 USA. NR 2 TC 0 Z9 0 U1 0 U2 2 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0162-1459 J9 J AM STAT ASSOC JI J. Am. Stat. Assoc. PD JUN PY 1999 VL 94 IS 446 BP 660 EP 660 PG 1 WC Statistics & Probability SC Mathematics GA 209QB UT WOS:000081058500035 ER PT J AU Freedman, DO Kozarsky, PE Weld, LH Cetron, MS AF Freedman, DO Kozarsky, PE Weld, LH Cetron, MS CA GeoSentinel Study Grp TI GeoSentinel: The global emerging infections sentinel network of the International Society of Travel Medicine SO JOURNAL OF TRAVEL MEDICINE LA English DT Article ID DISEASES AB GeoSentinel is a network of 22 member travel/tropical medicine clinics (14 in the United States and 8 in other countries) initiated in 1995 by the International Society of Travel Medicine (ISTM). GeoSentinel is based on the concept that these clinics are ideally situated to effectively detect geographic and temporal trends in morbidity among travelers. The core surveillance toot is a single-page faxable form submitted to a central data site for each post-travel patient, including immigrants, refugees, and foreign visitors. Diagnoses are entered either as specific etiologies or as syndromes and are then linked to geographic locations, reference dates, and clinical presentations. In addition, electronic communication with the larger body of worldwide ISTM member clinics is periodically done to obtain broader data collection in response to specific inquiries. The scope of GeoSentinel has broadened from the initial vision of a provider-based sentinel network tracking emerging infections at their point of entry into developed countries. its present goals are (1) to monitor global trends in disease occurrence among travelers; (2) to ascertain risk factors and morbidity in groups of travelers categorized by travel purpose and type of traveler; (3) to respond to urgent public health queries; (4) to develop educational priorities for travelers' health; and (5) to effect a rapid response by electronically disseminating alerts to surveillance sites, to all ISTM members in 55 countries, and to public health authorities. In addition, a major byproduct of the network, and now one of its strongest assets, has been the growth of partnerships between ISTM, Centers for Disease Control and Prevention and health-care providers around the world, as well as other medical societies, government, and private organizations. The demographic data, travel patterns, and clinical presentations for the first 2813 patient records analyzed from the GeoSentinel sites are summarized in this paper. C1 Univ Alabama, Div Geog Med, Birmingham, AL 35294 USA. Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA USA. Ctr Dis Control & Prevent, Surveillance & Epidemiol Branch, Div Quarantine, Natl Ctr Infect Dis, Atlanta, GA USA. RP Freedman, DO (reprint author), Univ Alabama, Div Geog Med, 845 19th St S 203, Birmingham, AL 35294 USA. NR 8 TC 77 Z9 80 U1 0 U2 0 PU DECKER PERIODICALS INC PI HAMILTON PA 4 HUGHSON STREET SOUTH PO BOX 620, LCD 1, HAMILTON, ONTARIO L8N 3K7, CANADA SN 1195-1982 J9 J TRAVEL MED JI J. Travel Med. PD JUN PY 1999 VL 6 IS 2 BP 94 EP 98 DI 10.1111/j.1708-8305.1999.tb00839.x PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 247LY UT WOS:000083223300008 PM 10381961 ER PT J AU Piesman, J Clark, KL Dolan, MC Happ, CM Burkot, TR AF Piesman, J Clark, KL Dolan, MC Happ, CM Burkot, TR TI Geographic survey of vector ticks (Ixodes scapularis and Ixodes pacificus) for infection with the Lyme disease spirochete, Borrelia burgdorferi SO JOURNAL OF VECTOR ECOLOGY LA English DT Article DE ticks; Ixodes scapularis; Ixodes pacificus; Lyme disease; Borrelia burgdorferi ID LIZARD SCELOPORUS-OCCIDENTALIS; BLACK-LEGGED TICK; ENDEMIC AREA; NEW-YORK; WESTCHESTER-COUNTY; HUMAN BABESIOSIS; UNITED-STATES; ACARI; IXODIDAE; TRANSMISSION AB Populations of adult Ixodes scapularis and Ixodes pacificus, the two principal vectors of Lyme disease spirochetes in the United States, were collected from 17 sites in 12 states. Female ticks were fed on experimental rabbits; ticks and rabbits were subsequently examined for infection with Borrelia burgdorferi. Fourteen rabbits were exposed to I. scapularis ticks from the northeastern states of Connecticut, New York, New Jersey, and Maryland; all 14 rabbits became infected with B. burgdorferi. A total of 165/226 (73%) of these northeastern ticks was infected. Similarly, ticks from the midwestern states of Michigan, Wisconsin, and Minnesota transmitted infection to all three exposed rabbits; 29/51 (57%) of these midwestern I. scapularis were infected. In marked contrast, none of the 12 rabbi ts exposed to I. scapularis ticks from the southeastern states of South Carolina, Georgia, Florida, and Mississippi acquired infection with B. burgdorferi, and 0/284 (0%) of these ticks contained spirochetes. Four rabbits were exposed to I. pacificus collected from one location in California; 2/4 of these rabbits acquired infection and 2/57 (4%) of the I. pacificus were infected with B. burgdorferi. The antigenic profiles of all 58 strains tested were consistent with an identity of B. burgdorferi sensu late. The availability of a human Lyme disease vaccine adds urgency to our efforts to calculate the ecological transmission risk throughout the United States, as an aid to the judicious use of such a vaccine. C1 Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Publ Hlth Serv, US Dept HHS, Ft Collins, CO 80522 USA. Univ So Mississippi, Ctr Community Hlth, Hattiesburg, MS 39406 USA. RP Piesman, J (reprint author), Ctr Dis Control & Prevent, Div Vector Borne Infect Dis, Publ Hlth Serv, US Dept HHS, POB 2087, Ft Collins, CO 80522 USA. RI Burkot, Thomas/C-6838-2013 NR 42 TC 21 Z9 21 U1 1 U2 21 PU SOC VECTOR ECOLOGY PI SANTA ANA PA PO BOX 87, SANTA ANA, CA 92702 USA SN 1081-1710 J9 J VECTOR ECOL JI J. Vector Ecol. PD JUN PY 1999 VL 24 IS 1 BP 91 EP 98 PG 8 WC Entomology SC Entomology GA 212RH UT WOS:000081229700008 PM 10436883 ER PT J AU Ahluwalia, IB Johnson, C Rogers, M Melvin, C AF Ahluwalia, IB Johnson, C Rogers, M Melvin, C CA PRAMS Working Grp TI Observations from the CDC - Pregnancy Risk Assessment Monitoring System (PRAMS): Unintended pregnancy among women having a live birth SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Article C1 Ctr Dis Control, Atlanta, GA 30341 USA. RP Ahluwalia, IB (reprint author), Ctr Dis Control, 4770 Buford Highway NE,Mailstop K20, Atlanta, GA 30341 USA. NR 6 TC 6 Z9 6 U1 0 U2 3 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD JUN PY 1999 VL 8 IS 5 BP 587 EP 589 DI 10.1089/jwh.1.1999.8.587 PG 3 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 230ZQ UT WOS:000082281900008 PM 10839641 ER PT J AU Galuska, DA Sowers, MR AF Galuska, DA Sowers, MR TI Menstrual history and bone density in young women SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Article ID MINERAL DENSITY; EARLY MENARCHE; PREMENOPAUSAL WOMEN; LUMBAR SPINE; FEMORAL-NECK; ENDOCRINE CHARACTERISTICS; PERIMENOPAUSAL WOMEN; PHYSICAL-ACTIVITY; BREAST-CANCER; RISK-FACTORS AB Adequate levels of reproductive and pituitary hormones are needed for the initiation and maintenance of regular menstrual cycles as well as for the achievement of peak bone mineral density (BMD). Therefore, in the absence of direct hormone measures, menstrual history may serve as a surrogate for the adequacy of hormonal functioning and be a marker for bone status in young women. In our cross-sectional study of white college women aged 19-26 years, we examined the association of six characteristics of menstrual history with bone density at the lumbar spine and the femoral neck. To characterize associations, we used multiple linear regression models that also accounted for the contribution of body mass index, dietary calcium intake, height, level of physical activity, smoking, and alcohol use. The associations between each of the six menstrual characteristics and BMD were stronger at the lumbar spine than at the femoral neck. Age at menarche explained the most variance at both the lumbar spine (partial r(2) 100 = 5.9%) and the femoral neck (partial r(2) 100 = 2.1%). For each year that menarche was delayed, bone density was lower by -0.023 g/cm(2) (p = 0.0024) at the lumbar spine and -0.0129 g/cm(2) (p = 0.0565) at the femoral neck. At the lumbar spine, a higher number of lifetime menstrual cycles was also significantly associated with increased bone density (adjusted beta = 0.0010, p = 0.0052, partial r(2).100 = 4.4%). This association was not significant after adjusting for age at menarche. Neither reproductive years (age - age at menarche) nor a history of irregular cycles (either at menarche, in the past year, or ever) was associated with bone density at either site. Menstrual function appears to affect the bone density of these young women. Studies that include measures of reproductive and pituitary hormones are needed to further explore the role of hormones in the potential link between menstrual history and bone density. C1 Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA. RP Galuska, DA (reprint author), Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Nutr & Phys Act, Mailstop K-26,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 47 TC 24 Z9 27 U1 1 U2 1 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD JUN PY 1999 VL 8 IS 5 BP 647 EP 656 DI 10.1089/jwh.1.1999.8.647 PG 10 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 230ZQ UT WOS:000082281900018 PM 10839651 ER PT J AU Duerr, A AF Duerr, A TI HIV and other STDs in women SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Meeting Abstract C1 Ctr Dis Control, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD JUN PY 1999 VL 8 IS 5 BP 700 EP 700 PG 1 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 230ZQ UT WOS:000082281900043 ER PT J AU Stevens, JA Marcus, M Kleinbaum, DG AF Stevens, JA Marcus, M Kleinbaum, DG TI Current calcium intake and hip fracture risk in an elderly population SO JOURNAL OF WOMENS HEALTH & GENDER-BASED MEDICINE LA English DT Meeting Abstract C1 Ctr Dis Control, Atlanta, GA 30322 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 USA SN 1524-6094 J9 J WOMEN HEALTH GEN-B JI J. WOMENS HEALTH GENDER-BASED MED. PD JUN PY 1999 VL 8 IS 5 BP 714 EP 714 PG 1 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 230ZQ UT WOS:000082281900097 ER PT J AU Mootnick, AR Ostrowski, SR AF Mootnick, AR Ostrowski, SR TI Procedures utilized for primate import quarantine at the International Center for Gibbon Studies SO JOURNAL OF ZOO AND WILDLIFE MEDICINE LA English DT Article DE sanitation; infectious waste; quarantine; shipping containers; nonhuman primates AB The intent of the Foreign Quarantine requirements (42 CFR 71.53) for nonhuman primates (NHPs) is to prevent the importation of potentially serious infectious diseases that are not endemic to the United States. In 1990, prompted by an outbreak of Ebola (Reston) hemorrhagic fever at an (NHP) quarantine facility, the Centers for Disease Control and Prevention (CDC) initiated unannounced inspections of all NHP importers' quarantine facilities. During the inspections, the majority did not meet the required infection control and containment standards. Numerous discrepancies were identified in infection control and NHP quarantine protocols. Zoos should have knowledge of CDC requirements and recommendations for the importation of NHPs into the United States. Zoos planning to import NHPs should register with the CDC and have their NHP quarantine facility and protocols inspected and approved by CDC's Division of Quarantine. Specific areas addressed must include protocols for in-transit shipping and handling, transport to the quarantine facility, biocontainment procedures (transfer of NHPs from shipping containers to quarantine cages, entering/exiting the quarantine room, routine daily and emergency procedures, protective clothing, infection control, infectious waste disposal), occupational health, and employee training. Here, we provide information on the approved protocols used for import quarantine at a single registered importer facility specializing in importation of gibbons (Hylobatidae) for species conservation purposes. These procedures are site specific and are not intended to be applicable to the needs of all NHP import facilities. C1 Int Ctr Gibbon Studies, Santa Clarita, CA 91380 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Quarentine, Atlanta, GA 30333 USA. RP Mootnick, AR (reprint author), Int Ctr Gibbon Studies, POB 800249, Santa Clarita, CA 91380 USA. NR 15 TC 1 Z9 2 U1 0 U2 0 PU AMER ASSOC ZOO VETERINARIANS PI MEDIA PA 6 NORTH PENNELL ROAD, MEDIA, PA 19063 USA SN 1042-7260 J9 J ZOO WILDLIFE MED JI J. Zoo Wildl. Med. PD JUN PY 1999 VL 30 IS 2 BP 201 EP 207 PG 7 WC Veterinary Sciences SC Veterinary Sciences GA 219LC UT WOS:000081607900001 PM 10484134 ER PT J AU Anderson, LA Caplan, LS Buist, DSM Newton, KM Curry, SJ Scholes, D LaCroix, AZ AF Anderson, LA Caplan, LS Buist, DSM Newton, KM Curry, SJ Scholes, D LaCroix, AZ TI Perceived barriers and recommendations concerning hormone replacement therapy counseling among primary care providers SO MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY LA English DT Article DE providers; physicians; barriers; strategies; hormone replacement therapy ID PHYSICIAN; MENOPAUSE; VIEWS AB Objective: To increase our understanding of the factors that impede or promote counseling about hormone replacement therapy, we asked clinicians to provide information concerning barriers and strategies to promote counseling. Design: We asked clinicians to consider two different scenarios: (1) what they do in their current practice and (2) what they would do if their health care systems implemented the United States Preventive Services Task Force recommendation regarding hormone replacement therapy counseling. A total of 49 of 50 invited clinicians participated in one of six focus group interviews (three women's groups and three men's groups). Our analysis consisted of four steps: (1) identifying segments and classifying them into themes, (2) categorizing themes into topic areas, (3) establishing a final consensus of themes and topics, and (4) ascertaining similarities and contrasts among,groups. Transcripts of sessions were analyzed across groups for themes using a text-based analysis system. Conceptualization of themes was derived using a system model of preventive care. Interrater agreement before consensus was good: Kappa (kappa) ranged from 0.70 to 1.00. Results: For current practice, identified barriers included lack of information about risks and benefits, unique challenges of counseling, and lack of resources to conduct counseling. The major strategies suggested were to develop and distribute patient education materials. Discussions about barriers to implementing the United States Task Force recommendation focused on lack of information and resources. Conclusions: Suggested strategies were multiple, involving individual-, relationship; and system-level interventions. We expect the strategies identified to be supportive of future efforts to promote counseling for hormone replacement therapy, (Menopause 1999,6:161-166, (C) 1999, The North American Menopause Society.) C1 Ctr Dis Control & Prevent K45, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98195 USA. RP Anderson, LA (reprint author), Ctr Dis Control & Prevent K45, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway NE, Atlanta, GA 30341 USA. FU PHS HHS [U48/CCU009654-04] NR 21 TC 24 Z9 24 U1 5 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1072-3714 J9 MENOPAUSE JI Menopause-J. N. Am. Menopause Soc. PD SUM PY 1999 VL 6 IS 2 BP 161 EP 166 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 202UB UT WOS:000080669600014 PM 10374224 ER PT J AU Keenan, NL Anderson, LA LaCroix, AZ Newton, KM Buist, DSM AF Keenan, NL Anderson, LA LaCroix, AZ Newton, KM Buist, DSM TI Untitled SO MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY LA English DT Letter ID HORMONE REPLACEMENT THERAPY C1 Ctr Dis Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Keenan, NL (reprint author), Ctr Dis Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. NR 6 TC 0 Z9 1 U1 5 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1072-3714 J9 MENOPAUSE JI Menopause-J. N. Am. Menopause Soc. PD SUM PY 1999 VL 6 IS 2 BP 179 EP 180 DI 10.1097/00042192-199906020-00017 PG 2 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 202UB UT WOS:000080669600017 PM 10374227 ER PT J AU Colley, DG Montesano, MA Freeman, GL Secor, WE AF Colley, DG Montesano, MA Freeman, GL Secor, WE TI Infection-stimulated or perinatally initiated idiotypic interactions can direct differential morbidity and mortality in schistosomiasis SO MICROBES AND INFECTION LA English DT Article ID DIFFERENT CLINICAL FORMS; NECROSIS-FACTOR-ALPHA; IMMUNE-RESPONSES; PATHOLOGICAL SYNDROMES; GRANULOMA-FORMATION; MANSONI INFECTIONS; CBA/J MICE; ANTIBODY; MODULATION; IDIOTOPES AB In this and previous publications, we have described two areas of study that now converge, and that we propose provide insights into immunoregulatory processes that may develop during chronic endemic diseases and contribute to the balance and chronicity of the essential host/parasite relationship. The first area of study is that of idiotypic/antiidiotypic interactions within human and experimental immune systems during Schistosoma mansoni infections. The companion study concerns a naturally developing differential development of morbidity and mortality during chronic experimental schistosomiasis mansoni. Based on the data presented and reviewed, we propose that either by six weeks of infection, or through perinatal idiotypic manipulation, the immune system of the infected host is 'programmed' into responding either with regulatory cross-reactive idiotypes or not, and that this commitment differentially controls multiple subsequent immune responses and can determine the degree of consequent morbidity and mortality due to schistosomiasis. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. RP Colley, DG (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. NR 28 TC 10 Z9 10 U1 0 U2 0 PU EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER PI PARIS CEDEX 15 PA 23 RUE LINOIS, 75724 PARIS CEDEX 15, FRANCE SN 1286-4579 J9 MICROBES INFECT JI Microbes Infect. PD JUN PY 1999 VL 1 IS 7 BP 517 EP 524 DI 10.1016/S1286-4579(99)80091-4 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 212YE UT WOS:000081244600007 PM 10603568 ER PT J AU Hillis, SD Marchbanks, PA Tylor, LR Peterson, HB AF Hillis, SD Marchbanks, PA Tylor, LR Peterson, HB CA US Collaborative Review Sterilization TI Poststerilization regret: Findings from the United States collaborative review of sterilization SO OBSTETRICS AND GYNECOLOGY LA English DT Review ID LONG-TERM RISK; TUBAL-STERILIZATION; HYSTERECTOMY; WOMEN AB Objective: To evaluate the cumulative probability of regret after tubal sterilization, and to identify risk factors for regret that are identifiable before sterilization. Methods: We used a prospective, multicenter cohort study to evaluate the cumulative probability of regret within 14 years after tubal sterilization. Participants included 11,232 women aged 18-44 years who had tubal sterilizations between 1978 and 1987. Actuarial life tables and Cox proportional hazards models were used to identify those groups at greatest risk of experiencing regret. Results: The cumulative probability of expressing regret during a follow-up interview within 14 years after tubal sterilization was 20.3% for women aged 30 or younger at the time of sterilization and 5.9% for women over age 30 at sterilization (adjusted relative risk [RR] 1.9; 95% confidence interval [CI] 1.6, 2.3). For the former group, the cumulative probability of regret was similar for women sterilized during the postpartum period (after cesarean, 20.3%, 95% CI 14.5, 26.0; after vaginal delivery, 23.7%, 95% CI 17.6, 29.8) and for women sterilized within 1 year after the birth of their youngest child (22.3%, 95% CI 16.4, 28.2). For women aged 30 or younger at sterilization, the cumulative probability of regret decreased as time since the birth of the youngest child increased (2-3 years, 16.2%, 95% CI 11.4, 21.0; 4-7 years, 11.3%, 95% CI 7.8, 14.8; 8 or more years, 8.3%, 95% CI 5.1, 11.4) and was lowest among women who had no previous births (6.3%, 95% CI 3.1, 9.4). Conclusion: Although most women expressed no regret after tubal sterilization, women 30 years of age and younger at the time of sterilization had an increased probability of expressing regret during follow-up interviews within 14 years after the procedure. C1 Ctr Dis Control & Prevent, DRH, NCCDPHP K34, Atlanta, GA 30333 USA. RP Hillis, SD (reprint author), Ctr Dis Control & Prevent, DRH, NCCDPHP K34, 1600 Clifton Rd, Atlanta, GA 30333 USA. RI Potter, Joseph/A-3122-2008 FU NICHD NIH HHS [3-YO2-HD41075-10] NR 22 TC 125 Z9 131 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD JUN PY 1999 VL 93 IS 6 BP 889 EP 895 DI 10.1016/S0029-7844(98)00539-0 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 201FG UT WOS:000080583900001 PM 10362150 ER PT J AU Marsh, JVR Brett, KM Miller, LC AF Marsh, JVR Brett, KM Miller, LC TI Racial differences in hormone replacement therapy prescriptions SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID ENDOMETRIAL CANCER; WOMEN; PHYSICIAN; USERS AB Objective: To examine racial differences in hormone replacement therapy (HRT) use by analyzing the relative risks and rates of HRT prescriptions for black and white women. Methods: Data on visits to hospital outpatient departments and office-based physicians by black and white women aged 45-64 years were obtained from 25,203 visits sampled in the 1993-1995 National Ambulatory Medical Care Surveys and National Hospital Ambulatory Medical Care Surveys. The relative effect of race on the provision of an HRT prescription at an ambulatory visit was estimated by controlling confounders using logistic regression. Population-based rates of physician visits and visits with HRT prescriptions were also calculated to address issues involving access to care. Results: Approximately 98,787,000 annual visits were made by black and white women 45-64 years of age, 9.2% of which involved prescriptions for HRT. The percentage of visits by black women in which prescriptions for HRT were reported (4.5%) was roughly half that of white women (9.7%). The association persisted after controlling for type of physician, practice type, geographic region, payment source, and non-HRT prescription(s) (odds ratio 2.1; 95% confidence interval 1.5, 2.9). The rate of ambulatory care among black women (3.82 visits per year per woman) was virtually identical to that of white women (3.94 visits per year), whereas the rate of visits with HRT prescriptions for white women was twice as high as for black women (0.38 and 0.17 visits per year, respectively). Conclusion: Apparent racial differences in HRT use persist after controlling for physician and visit factors not explored in previous studies. (Obstet Gynecol 1999;93:999-1003. (C) 1999 by The American College of Obstetricians and Gynecologists.). C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA. Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Div Epidemiol, Hyattsville, MD 20782 USA. Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. RP Marsh, JVR (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Epidemiol, 615 N Wolfe St,Box 1368, Baltimore, MD 21205 USA. NR 21 TC 16 Z9 16 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD JUN PY 1999 VL 93 IS 6 BP 999 EP 1003 DI 10.1016/S0029-7844(98)00540-7 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 201FG UT WOS:000080583900021 PM 10362170 ER PT J AU Berry, DS Miller, RS Hooke, JA Massung, RF Bennett, J Ottolini, MG AF Berry, DS Miller, RS Hooke, JA Massung, RF Bennett, J Ottolini, MG TI Ehrlichial meningitis with cerebrospinal fluid morulae SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE Ehrlichia; diagnosis; meningitis; morulae; polymerase chain reaction C1 Uniformed Serv Univ Hlth Sci, Dept Pediat Infect Dis, Bethesda, MD 20814 USA. Walter Reed Army Med Ctr, Infect Dis Serv, Washington, DC 20307 USA. Walter Reed Army Med Ctr, Dept Pathol, Washington, DC 20307 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Atlanta, GA USA. RP Berry, DS (reprint author), Uniformed Serv Univ Hlth Sci, Dept Pediat Infect Dis, Bethesda, MD 20814 USA. NR 10 TC 14 Z9 17 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUN PY 1999 VL 18 IS 6 BP 552 EP 555 DI 10.1097/00006454-199906000-00016 PG 4 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA 205CU UT WOS:000080804400015 PM 10391189 ER PT J AU Shah, SS Sinkowitz-Cochran, RL Keyserling, HL Jarvis, WR AF Shah, SS Sinkowitz-Cochran, RL Keyserling, HL Jarvis, WR TI Vancomycin use in pediatric cardiothoracic surgery patients SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Article DE vancomycin; cardiothoracic surgery; antimicrobial resistance; antimicrobial use ID EPIDEMIOLOGY; CRITERIA; USAGE C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. Emory Univ, Egleston Childrens Hosp, Atlanta, GA 30322 USA. RP Sinkowitz-Cochran, RL (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Mailstop E-69,1600 Clifton Rd, Atlanta, GA 30333 USA. OI Shah, Samir/0000-0001-7902-7000 NR 10 TC 8 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD JUN PY 1999 VL 18 IS 6 BP 558 EP 560 DI 10.1097/00006454-199906000-00019 PG 3 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA 205CU UT WOS:000080804400018 PM 10391192 ER PT J AU Freedman, DS Dietz, WH Srinivasan, SR Berenson, GS AF Freedman, DS Dietz, WH Srinivasan, SR Berenson, GS TI The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa heart study SO PEDIATRICS LA English DT Article DE overweight; lipids; blood pressure; insulin; children; adolescents ID BODY-MASS INDEX; BLOOD-PRESSURE; UNITED-STATES; TOTAL CHOLESTEROL; FAT DISTRIBUTION; SCHOOL-CHILDREN; YOUNG-ADULTS; NATIONAL-HEALTH; OBESITY; DISEASE AB Background. Although overweight and obesity in childhood are related to dyslipidemia, hyperinsulinemia, and hypertension, most studies have examined levels of these risk factors individually or have used internal cutpoints (eg, quintiles) to classify overweight and risk factors. Objective. We used cutpoints derived from several national studies to examine the relation of overweight (Quetelet index, >95th percentile) to adverse risk factor levels and risk factor clustering. Design. The sample consisted of 9167 5- to 17-year-olds examined in seven cross-sectional studies conducted by the Bogalusa Heart Study between 1973 and 1994. Results. About 11% of examined schoolchildren were considered overweight. Although adverse lipid, insulin, and blood pressure levels did not vary substantially with the Quetelet index at levels <85th percentile, risk factor prevalences increased greatly at higher levels of the Quetelet index. Overweight schoolchildren were 2.4 times as likely as children with a Quetelet index <85th percentile to have an elevated level of total cholesterol. Odds ratios for other associations were 2.4 (diastolic blood pressure), 3.0 (low-density lipoprotein cholesterol), 3.4 (high-density lipoprotein cholesterol), 4.5 (systolic blood pressure), 7.1 (triglycerides), and 12.6 (fasting insulin). Several of these associations differed between whites and blacks, and by age. Of the 813 overweight schoolchildren, 475 (58%) were found to have at least one risk factor. Furthermore, the use of overweight as a screening tool could identify 50% of schoolchildren who had two or more risk factors. Conclusions. Because overweight is associated with various risk factors even among young children, it is possible that the successful prevention and treatment of obesity in childhood could reduce the adult incidence of cardiovascular disease. C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Atlanta, GA USA. Tulane Univ, Sch Publ Hlth & Trop Med, Tulane Ctr Cardiovasc Hlth, New Orleans, LA 70118 USA. RP Freedman, DS (reprint author), CDC Mailstop K-26,4770 Buford Hwy, Atlanta, GA 30341 USA. FU NHLBI NIH HHS [HL 15103, HL 32194] NR 49 TC 1220 Z9 1304 U1 7 U2 75 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD JUN PY 1999 VL 103 IS 6 BP 1175 EP 1182 DI 10.1542/peds.103.6.1175 PN 1 PG 8 WC Pediatrics SC Pediatrics GA 201UF UT WOS:000080613400020 PM 10353925 ER PT J AU Massoudi, MS Walsh, J Stokley, S Rosenthal, J Stevenson, J Miljanovic, B Mann, J Dini, E AF Massoudi, MS Walsh, J Stokley, S Rosenthal, J Stevenson, J Miljanovic, B Mann, J Dini, E TI Assessing immunization performance of private practitioners in Maine: Impact of the Assessment, Feedback, Incentives, and Exchange strategy SO PEDIATRICS LA English DT Article DE immunizations; assessments; private providers; CASA; health services; performance measurement; managed care ID INFLUENZA AB Introduction. A provider-based vaccination strategy that has strong supportive evidence of efficacy at raising immunization coverage level is known as Assessment, Feedback, Incentives, and Exchange. The Maine Immunization Program, and the Maine Chapter of the American Academy of Pediatrics collaborated on the implementation and evaluation of this strategy among private providers. Methods. Between November 1994 and June 1996, the Maine Immunization Program conducted baseline immunization assessments of all private practices administering childhood vaccines to children 24 to 35 months of age. Coverage level assessments were conducted using the Clinic Assessment Software Application. Follow-up assessments were among the largest practices, delivering 80% of all vaccines. Results. Of the 231 practices, 58 were pediatric and 149 were family practices. The median up-to-date vaccination coverages among all providers for 3 doses of diphtheria-tetanus-pertussis vaccine and 2 doses of oral polio vaccine, and 4 doses of diphtheria-tetanuspertussis vaccine, 3 doses of oral polio vaccine, and 1 dose of measles-mumps-rubella vaccine at age 12 and 24 months were 90% and 78%, respectively, and did not vary by number of providers in a practice or by specialty. Urban practices had higher coverage than rural practices at 12 months (92% vs 88%). The median up-to-date coverage for 4 doses of diphtheria-tetanuspertussis vaccine, 3 doses of oral polio vaccine, and 1 dose of measles-mumps-rubella vaccine at 24 months of age improved significantly among those practices assessed 1 year later (from 78% at baseline to 87% at the second assessment). On average, the assessments required 21/2 person-days of effort. Conclusions. We document the feasibility and impact of a public/private partnership to improve immunization delivery on a statewide basis. Implications. Other states should consider using public/private partnerships to conduct private practice assessments. More cost-effective methods of assessing immunization coverage levels in private practices are needed. C1 Ctr Dis Control & Prevent, Natl Immunizat Program, Atlanta, GA USA. Maine Dept Human Serv, Bur Hlth, Immunizat Program, Augusta, ME USA. Amer Acad Pediat, Maine Chapter, Augusta, ME USA. RP Massoudi, MS (reprint author), CDC, NIP, 1600 Clifton Rd,MS E-52, Atlanta, GA 30333 USA. NR 27 TC 21 Z9 21 U1 1 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD JUN PY 1999 VL 103 IS 6 BP 1218 EP 1223 DI 10.1542/peds.103.6.1218 PN 1 PG 6 WC Pediatrics SC Pediatrics GA 201UF UT WOS:000080613400027 PM 10353932 ER PT J AU Halsey, NA Moulton, LH O'Donovan, JC Walcher, JR Thoms, ML Margolis, HS Krause, DS AF Halsey, NA Moulton, LH O'Donovan, JC Walcher, JR Thoms, ML Margolis, HS Krause, DS TI Hepatitis B vaccine administered to children and adolescents at yearly intervals SO PEDIATRICS LA English DT Article DE vaccine; hepatitis B; hepatitis B vaccine; antigen; dose; schedule; immunization; adolescent AB Objective. Hepatitis B vaccines are usually administered on a schedule of 0, 1 to 2, and 6 months. Longer intervals between the second and third doses have been studied, but the effectiveness of hepatitis B vaccine administered at intervals of >2 months between the first and second doses have not been studied. Our objective was to compare the antibody response in recipients of Engerix-B hepatitis B vaccine administered at 12-month intervals to the response to vaccine administered at 0, 1-, and 6-month intervals. Methods. A total of 389 children, 5 through 16 years of age, were randomized to receive Engerix-B (10 mg) at a schedule of either 0-, 1-, and 6-month intervals or 0-, 12-, and 24-month intervals. Blood was drawn before and 1 month after the third dose. Results. Immediately before the third dose of vaccine, 92.3% of children who received vaccine on the 0-, 1-, and 6-month schedule and 88.8% of children who received the 0-, 12-, and 24-month schedule had antibody to hepatitis B surface (anti-HBs) antigen concentrations greater than or equal to 10 mIU/mL. Of the children in the 0-, 1-, and 6-month schedule, 95% received the third dose according to protocol versus 90% of those in the 0-, 12-, 24-month schedule. The geometric mean anti-HBs concentration just before the third dose for recipients of the 0-, Ii and 6-month schedule (117.9 mIU/mL) was somewhat lower than that for the children who had received vaccine on the 0-, 12-, and 24-month schedule (162.1 mIU/mL). One month after the third dose, >98% of all children had anti-HBs concentrations greater than or equal to 10 mIU/mL and high geometric mean antibody concentrations were observed in both groups: 5687 mIU/mL for children on the 0-, 1-, and 6-month schedule and 3159 mIU/mL for children on the 0-, 12-, and 24-month schedule. Body mass index was correlated inversely with final antibody concentration, but age was not a fatter after adjustment for body mass index. Discussion. Engerix-B administered on a 0-, 12-, and 24-month schedule is highly immunogenic. Providers should consider this alternate immunization schedule for children who are at low risk of immediate exposure to hepatitis B infections. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD 21205 USA. Drs ODonovan Ahluwalia & Fertsch, Baltimore, MD USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Viral & Rickettsial Dis, Hepatitis Branch, Atlanta, GA USA. SmithKline Beecham Pharmaceut, Collegeville, PA USA. RP Halsey, NA (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, 615 N Wolfe St, Baltimore, MD 21205 USA. OI Moulton, Lawrence/0000-0001-7041-7387 NR 12 TC 28 Z9 31 U1 0 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD,, ELK GROVE VILLAGE, IL 60007-1098 USA SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD JUN PY 1999 VL 103 IS 6 BP 1243 EP 1247 DI 10.1542/peds.103.6.1243 PN 1 PG 5 WC Pediatrics SC Pediatrics GA 201UF UT WOS:000080613400031 PM 10353936 ER PT J AU Brogdon, WG McAllister, JC Corwin, AM Cordon-Rosales, C AF Brogdon, WG McAllister, JC Corwin, AM Cordon-Rosales, C TI Oxidase-based DDT-pyrethroid cross-resistance in guatemalan Anopheles albimanus SO PESTICIDE BIOCHEMISTRY AND PHYSIOLOGY LA English DT Article ID MOSQUITO PROTEIN MICROASSAY; DROSOPHILA-MELANOGASTER; HOUSE-FLY; CYTOCHROME-P450 GENE; MUSCA-DOMESTICA; STRAINS; DELTAMETHRIN; EXPRESSION; PERMETHRIN; ESTERASES AB An oxidase resistance mechanism producing DDT-pyrethroid cross-resistance has been identified in an isofemale line of Guatemalan Anopheles albimanus Wiedemann through application of bottle bioassays and biochemical analysis. The resistance is fully synergized by piperonyl butoxide. Oxidase resistance in individuals may be detected and levels measured using a microplate assay. Only adult female mosquitoes express the oxidase mechanism. In the parent strain, an additional pyrethroid resistance mechanism, an elevated esterase, coexists with the oxidase. Mosquitoes with the oxidase resistance show induction by phenobarbital and sublethal pyrethroid exposure. (C)1999 Academic Press. C1 Ctr Dis Control & Prevent, Entomol Branch, Div Parasit Dis,Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. Univ Valle, Ctr Invest Enfermedades Trop, Guatemala City, Guatemala. RP Brogdon, WG (reprint author), Ctr Dis Control & Prevent, Entomol Branch, Div Parasit Dis,Natl Ctr Infect Dis, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30341 USA. NR 33 TC 18 Z9 21 U1 2 U2 4 PU ACADEMIC PRESS INC PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0048-3575 J9 PESTIC BIOCHEM PHYS JI Pest. Biochem. Physiol. PD JUN PY 1999 VL 64 IS 2 BP 101 EP 111 DI 10.1006/pest.1999.2415 PG 11 WC Biochemistry & Molecular Biology; Entomology; Physiology SC Biochemistry & Molecular Biology; Entomology; Physiology GA 221NW UT WOS:000081734000005 ER PT J AU Thomas, CW Guy, SM Ogilvie, LP AF Thomas, CW Guy, SM Ogilvie, LP TI An evaluation of a practitioner training program designed to assist families of people with severe psychiatric disorders SO PSYCHIATRIC REHABILITATION JOURNAL LA English DT Article ID MENTAL-HEALTH PROFESSIONALS; ILLNESS; RESOURCES; EDUCATION; SERVICES; CONTACT AB The purpose of this study was to implement and evaluate the effectiveness of a public mental health practitioner training program. The training was designed to increase practitioners' knowledge of families caring for a relative with a severe psychiatric disorder, improve attitudes about working with such families, and increase the frequency of contact with such families. Participants were 70 practitioners assigned to either an experimental or control group. Comparisons between practitioners who received six training sessions and those practitioners who did not indicate an increase in knowledge and an improvement in attitudes towards working with families of individuals with a severe psychiatric disorder, however no change in actual patterns of contact was shown. The results suggest that this educational model has potential as an effective method of training mental health professionals to work with families of individuals with a severe psychiatric disorder. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Intervent Res & Support, Atlanta, GA USA. Mental Hlth Adm, Riverside Cty Dept, Riverside, CA USA. RP Thomas, CW (reprint author), Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Intervent Res & Support, Atlanta, GA USA. NR 21 TC 2 Z9 2 U1 1 U2 1 PU CENTER PSYCHIATRIC REHABILITATION PI BOSTON PA BOSTON UNIV, 930 COMMONWEALTH AVE, BOSTON, MA 02215 USA SN 1095-158X J9 PSYCHIATR REHABIL J JI Psychiatr. Rehabil. J. PD SUM PY 1999 VL 23 IS 1 BP 34 EP 41 PG 8 WC Psychiatry; Rehabilitation SC Psychiatry; Rehabilitation GA 309CM UT WOS:000086750000006 ER PT J AU Sanderson, WT Almaguer, D Kirk, LH AF Sanderson, WT Almaguer, D Kirk, LH TI Ozone-induced respiratory illness during the repair of a portland cement kiln SO SCANDINAVIAN JOURNAL OF WORK ENVIRONMENT & HEALTH LA English DT Article DE electrostatic precipitator; eye irritation; kiln maintenance; ozone; respiratory irritation; SIC 3241 AB Objectives Workers at a portland cement plant had experienced acute respiratory and eye irritation when performing maintenance inside a kiln. These episodes were associated with a bleach-like odor, which was only reported during maintenance operations. An industrial hygiene investigation was conducted to determine the cause of the illness. Methods While workers replaced refractory brick inside the kiln, air samples were collected for chlorine, sulfur dioxide, inorganic acid, ozone, and dust. After the rebricking was completed and all the workers had exited the kiln, its electrostatic precipitator was reduced to half power and the induced-draft (ID) fan was turned off to recreate conditions present during illness episodes. Results Chlorine, inorganic acid, and ozone were not detected, and only trace concentrations of sulfur dioxide were detected while workers were inside the kiln. However, when conditions present during previous episodes were recreated, the bleach-like odor was soon evident. Chlorine was not detected, but 0.09 to 0.11 ppm of ozone was measured at the discharge end of the kiln, and 4.5 ppm was measured at the inlet end. Within a half hour after the electrostatic precipitator was turned off and the ID fan was turned on, the ozone concentrations decreased to background levels of 0.02-0.03 ppm. Conclusions Somewhat lower ozone exposures may have occurred during previous kiln maintenance operations due to more open access portals, but previous episodes of eye and respiratory irritation were probably caused when ozone, generated by the electrostatic precipitator, back-drafted into the kiln after the ID fan was turned off. C1 NIOSH, Div Surveillance Hazard Evaluat & Field Studies, Cincinnati, OH 45226 USA. Lehigh Portland Cement Co, Union Bridge, MD USA. RP Sanderson, WT (reprint author), NIOSH, Div Surveillance Hazard Evaluat & Field Studies, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA. NR 11 TC 4 Z9 4 U1 0 U2 0 PU SCAND J WORK ENV HEALTH PI HELSINKI PA TOPELIUKSENKATU 41A, SF-00250 HELSINKI, FINLAND SN 0355-3140 J9 SCAND J WORK ENV HEA JI Scand. J. Work Environ. Health PD JUN PY 1999 VL 25 IS 3 BP 227 EP 232 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 219CD UT WOS:000081589600007 PM 10450773 ER PT J AU Partanen, TJ Hogstedt, C Ahasan, R Aragon, A Arroyave, ME Jeyaratnam, J Kurppa, K Loewenson, R Lundberg, I Ngowi, AVF Mbakaya, CFL Stayner, L Steenland, K Weiderpass, E Wesseling, C AF Partanen, TJ Hogstedt, C Ahasan, R Aragon, A Arroyave, ME Jeyaratnam, J Kurppa, K Loewenson, R Lundberg, I Ngowi, AVF Mbakaya, CFL Stayner, L Steenland, K Weiderpass, E Wesseling, C TI Collaboration between developing and developed countries and between developing countries in occupational health research and surveillance SO SCANDINAVIAN JOURNAL OF WORK ENVIRONMENT & HEALTH LA English DT Editorial Material DE cooperation; empowerment; infrastructure; impact; priorities; sponsorship; sustainability; training; tropics ID HEMATITE MINE WORKERS; COSTA-RICA; PESTICIDE POISONINGS; RESEARCH NEEDS; FARM-WORKERS; CHINA; MORTALITY; NICARAGUA; CANCER AB Collaborative occupational health and safety studies between counterparts in developing and developed countries and between developing countries have demonstrated their potential for improving occupational health and safety. Such collaboration in occupational health and safety is encouraged in the development of infrastructure in research empowerment and capacity building. This action includes the setting of priorities, the identification and documentation of problems, sponsorship, data bases and surveillance systems, technical support, methodology, publishing, research and training programs, controlled intervention, information exchange, and networking. Examples of priorities in occupational health and safety in the developing world include the informal sector (informally hired and independent workers), temporary work, pesticides, accidents, dusts, carcinogens, solvents, ergonomics, women and child labor, human immunodeficiency virus/acquired immunodeficiencey syndrome (HIV/AIDS), and transfer of hazardous materials and technologies. The sustainability of occupational health and safety structures and functions in the developing countries is a primary concern. Socioethical principles emphasize local, national, mutual and global gains. Examples of collaboration are given. Pervasive problems and strategies toward their solution are highlighted. C1 Finnish Inst Occupat Hlth, Dept Epidemiol & Biostat, FIN-00250 Helsinki, Finland. Natl Inst Working Life, Solna, Sweden. Bangladesh Univ Engn & Technol, Dept Ind & Prod Engn, Dhaka 1000, Bangladesh. Autonomous Univ Nicaragua, Leon, Nicaragua. Seguro Social, Bogota, Colombia. Natl Univ Singapore, Singapore 117548, Singapore. Zimbabwe Congress Trade Unions, Harare, Zimbabwe. Karolinska Inst, Stockholm, Sweden. Trop Pesticide Res Inst, Arusha, Tanzania. Kenya Govt Med Res Ctr, Nairobi, Kenya. NIOSH, Cincinnati, OH 45226 USA. Univ Fed Pelotas, Sch Med, Pelotas, Brazil. Univ Nacl, Cent Amer Inst Studies Tox Subst, Heredia, Costa Rica. RP Partanen, TJ (reprint author), Finnish Inst Occupat Hlth, Dept Epidemiol & Biostat, Topeliuksenkatu 41A, FIN-00250 Helsinki, Finland. EM timo.partanen@occuphealth.fi RI Banks, Tamara/G-3007-2012; Weiderpass, Elisabete/M-4029-2016 OI Weiderpass, Elisabete/0000-0003-2237-0128 NR 60 TC 12 Z9 12 U1 3 U2 8 PU SCANDINAVIAN JOURNAL WORK ENVIRONMENT & HEALTH PI HELSINKI PA TOPELIUKSENKATU 41A, SF-00250 HELSINKI, FINLAND SN 0355-3140 J9 SCAND J WORK ENV HEA JI Scand. J. Work Environ. Health PD JUN PY 1999 VL 25 IS 3 BP 296 EP 300 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 219CD UT WOS:000081589600017 PM 10450783 ER PT J AU Crosby, AE Cheltenham, MP Sacks, JJ AF Crosby, AE Cheltenham, MP Sacks, JJ TI Incidence of suicidal ideation and behavior in the United States, 1994 SO SUICIDE AND LIFE-THREATENING BEHAVIOR LA English DT Article ID PSYCHIATRIC-DISORDERS; GENERAL POPULATION; PREVALENCE AB Completed suicides reflect only a portion of the impact of suicidal behavior; sublethal behaviors cause morbidity and can signal treatable problems such as depression. There is no national quantification of nonlethal suicidal behaviors. The present study used a random-digit-dialed telephone survey to estimate the 12-month incidence of suicidal ideation, planning, and attempts among U.S. adults. Of 5,238 respondents, 5.6% (representing about 10.5 million persons) reported suicidal ideation, 2.7% (about 2.7 million) made a specific suicide plan, and 0.7% (about 700,000) made a suicide attempt (estimate = 1.1 million attempts). Hence, suicidal behaviors are not uncommon and occur along a continuum ranging from ideation to completed suicides. Preventing nonlethal precursor behaviors may prevent deaths. C1 Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. RP Crosby, AE (reprint author), Ctr Dis Control & Prevent, Mailstop K-60,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 32 TC 111 Z9 115 U1 1 U2 1 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 USA SN 0363-0234 J9 SUICIDE LIFE-THREAT JI Suicide Life-Threat. Behav. PD SUM PY 1999 VL 29 IS 2 BP 131 EP 140 PG 10 WC Psychiatry; Psychology, Multidisciplinary SC Psychiatry; Psychology GA 212DY UT WOS:000081202700005 PM 10407966 ER PT J AU McDonnell, SM Grindon, AJ Preston, BL Barton, JC Edwards, CQ Adams, PC AF McDonnell, SM Grindon, AJ Preston, BL Barton, JC Edwards, CQ Adams, PC TI A survey of phlebotomy among persons with hemochromatosis SO TRANSFUSION LA English DT Article ID LONG-TERM SURVIVAL; HEREDITARY HEMOCHROMATOSIS; UNITED-STATES; BLOOD-DONORS; TRANSFERRIN SATURATION; EARLY DIAGNOSIS; EXPRESSION; MANAGEMENT; POPULATION; PREVALENCE AB BACKGROUND: One in 10 whites in the United States is a carrier for hemochromatosis and an estimated 1 in 200 is clinically affected. Early treatment with therapeutic phlebotomy to remove excess iron can prevent associated chronic diseases. However, little information is available on the amount of blood withdrawn or the rates of withdrawal from hemochromatosis patients. The patterns of therapeutic phlebotomy and the magnitude of charges in persons with hemochromatosis were surveyed, STUDY DESIGN AND METHODS: Surveys were mailed to persons with hemochromatosis identified by health care providers, blood centers, patient advocacy groups, and the Internet. There were 2362 respondents to the survey from the United States. RESULTS: Thirty-seven percent of respondents reported being voluntary blood donors prior to diagnosis. The mean rate of therapeutic phlebotomy for iron depletion was 2.6 units per month (mean duration, 13 months). The mean rate of maintenance phlebotomy was 0.5 units per month. Therapeutic phlebotomy rates Varied by sex, age, reason for diagnosis, and severity of symptoms. Seventy-six percent of respondents reported full or partial insurance coverage of therapeutic phlebotomy charges. Seventy-six percent received therapeutic phlebotomy services in a hospital or physician's office and 30 percent in a blood center. Charges for therapeutic phlebotomy varied by site, with a mean cost of $90 in hospitals and $52 in blood centers. Fifty-four percent of respondents attempted to donate blood after their diagnosis but were excluded. CONCLUSION: The amount of brood withdrawn from persons with hemochromatosis is substantial. The location where patients received phlebotomy services appears to be influenced by charges and time since diagnosis. C1 Ctr Dis Control & Prevent, Div Int Hlth, Atlanta, GA 30303 USA. Ctr Dis Control & Prevent, Div Nutr & Phys Activ, Atlanta, GA 30303 USA. Amer Red Cross, Blood Serv, Atlanta, GA USA. Georgia Inst Technol, Sch Biol, Atlanta, GA 30332 USA. Brookwood Med Ctr, Birmingham, AL USA. LDS Hosp, Dept Med, Salt Lake City, UT USA. Univ Western Ontario, Dept Gastroenterol, London Hlth Sci Ctr, London, ON, Canada. RP McDonnell, SM (reprint author), Ctr Dis Control & Prevent, Div Int Hlth, MS C-08,1600 Clifton Rd, Atlanta, GA 30303 USA. RI Preston, Benjamin/B-9001-2012 OI Preston, Benjamin/0000-0002-7966-2386 NR 34 TC 28 Z9 28 U1 0 U2 1 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 USA SN 0041-1132 J9 TRANSFUSION JI Transfusion PD JUN PY 1999 VL 39 IS 6 BP 651 EP 656 DI 10.1046/j.1537-2995.1999.39060651.x PG 6 WC Hematology SC Hematology GA 205ZG UT WOS:000080850700017 PM 10378847 ER PT J AU Nolte, KB Zumwalt, RE AF Nolte, KB Zumwalt, RE TI Fatal peyote ingestion associated with Mallory-Weiss lacerations SO WESTERN JOURNAL OF MEDICINE LA English DT Letter C1 Univ New Mexico, Sch Med, Off Med Investigator, Albuquerque, NM 87131 USA. Ctr Dis Control & Prevent, Med Examiner Coroner Informat Sharing Program, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Nolte, KB (reprint author), Univ New Mexico, Sch Med, Off Med Investigator, Albuquerque, NM 87131 USA. NR 5 TC 9 Z9 9 U1 0 U2 1 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 0093-0415 J9 WESTERN J MED JI West. J. Med. PD JUN PY 1999 VL 170 IS 6 BP 328 EP 328 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 220XA UT WOS:000081692500004 PM 10443159 ER PT J AU Kim, P Eng, TR Deering, MJ Maxfield, A AF Kim, P Eng, TR Deering, MJ Maxfield, A TI Review of published criteria for evaluating health-related websites SO WESTERN JOURNAL OF MEDICINE LA English DT Review ID WORLD-WIDE-WEB; INFORMATION; INTERNET; CHALLENGE; QUALITY C1 US Dept HHS, Off Dis Prevent & Hlth Promot, Washington, DC 20201 USA. Ctr Dis Control & Prevent, NIOSH, Washington, DC 20201 USA. RP Eng, TR (reprint author), US Dept HHS, Off Dis Prevent & Hlth Promot, 200 Independence Ave SW,Room 738G, Washington, DC 20201 USA. NR 25 TC 2 Z9 2 U1 0 U2 2 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 USA SN 0093-0415 J9 WESTERN J MED JI West. J. Med. PD JUN PY 1999 VL 170 IS 6 BP 329 EP 332 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 220XA UT WOS:000081692500005 PM 18751150 ER PT J AU Vernon, A Burman, W Benator, D Khan, A Bozeman, L AF Vernon, A Burman, W Benator, D Khan, A Bozeman, L CA TB Trials Consortium TI Acquired rifamycin monoresistance in patients with HIV-related tuberculosis treated with once-weekly rifapentine and isoniazid SO LANCET LA English DT Article ID DIRECTLY OBSERVED THERAPY; RESISTANT TUBERCULOSIS; MYCOBACTERIUM-TUBERCULOSIS; RIFAMPIN; CHEMOTHERAPY; RIFABUTIN; INFECTION; MICE AB Background. Rifapentine is a cyclopentyl-substituted rifamycin whose serum half-life is five times that of rifampin. The US Public Health Service Study 22 compared a once-weekly regimen of isoniazid and rifapentine with twice weekly isoniazid and rifampin in the continuation phase (the last 4 months) of treatment for pulmonary tuberculosis in HIV-seropositive and HIV-seronegative patients. This report concerns only the HIV-seropositive part of the trial, which has ended, The HIV-seronegative part will stop follow-up in 2001. Methods. Adults with culture-positive, drug-susceptible pulmonary tuberculosis who completed 2 months of four-drug (isoniazid, rifampin, pyrazinamide, ethambutol) treatment (induction phase) were randomly assigned 900 mg isoniazid and 600 mg rifapentine once weekly, or 900 mg isoniazid and 600 mg rifampin twice weekly. All therapy was directly observed. Statistical analysis used univariate, Kaplan-Meier, and logistic and proportional hazards regression methods. Findings. 71 HIV-seropositive patients were enrolled: 61 completed therapy and were assessed for relapse, Five of 30 patients in the once-weekly isoniazid/rifapentine group relapsed, compared with three of 31 patients in the twice-weekly isoniazid/rifampin group (log rank chi(2) = 0.69, p = 0.41). However, four of five relapses in the once-weekly isoniazid/rifapentine group had monoresistance to rifamycin, compared with none of three in the rifampin group (p = 0.05). Patients who relapsed with rifamycin monoresistance were younger (median age 29 vs 41 years), had lower baseline CD4 cell counts (median 16 vs 144 mu L), and were more likely to have extrapulmonary involvement (75% vs 18%, p = 0.03) and concomitant therapy with antifungal agents (75% vs 9%, p = 0.006). No rifamycin monoresistant relapse has occurred among 1004 HIV-seronegative patients enrolled to date. Interpretation. Relapse with rifamycin monoresistant tuberculosis occurred among HIV-seropositive tuberculosis patients treated with a once-weekly isoniazid/rifapentine continuation-phase regimen. Until more effective regimens have been identified and assessed in clinical trials, HIV-seropositive people with tuberculosis should not be treated with a once-weekly isoniazid/rifapentine regimen. C1 Ctr Dis Control & Prevent, Div TB Eliminat, Atlanta, GA 30333 USA. Denver Hlth & Hosp, Dept Publ Hlth, Denver, CO USA. Vet Affairs Med Ctr, Washington, DC 20422 USA. Georgetown Univ, Washington, DC USA. RP Vernon, A (reprint author), Ctr Dis Control & Prevent, Div TB Eliminat, Mailstop E-10, Atlanta, GA 30333 USA. NR 42 TC 227 Z9 234 U1 0 U2 3 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD MAY 29 PY 1999 VL 353 IS 9167 BP 1843 EP 1847 DI 10.1016/S0140-6736(98)11467-8 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 202TG UT WOS:000080667800014 PM 10359410 ER PT J AU Hu, DJ Buve, A Baggs, J van der Groen, G Dondero, TJ AF Hu, DJ Buve, A Baggs, J van der Groen, G Dondero, TJ TI What role does HIV-1 subtype play in transmission and pathogenesis? An epidemiological perspective SO AIDS LA English DT Review DE HIV-1; HIV-2; strain; subtypes; genotypes; epidemiology; transmissibility; pathogenesis ID IMMUNODEFICIENCY-VIRUS TYPE-1; LANGERHANS CELL TROPISM; CHEMOKINE RECEPTOR GENE; CORECEPTOR USAGE; UNITED-STATES; NEUTRALIZATION SEROTYPES; PHYLOGENETIC ANALYSIS; BIOLOGICAL PROPERTIES; DISEASE PROGRESSION; ENZYME-IMMUNOASSAY C1 Ctr Dis Control & Prevent, Int Act Branch, Div HIV AIDS Prevent, NCHSTP, Atlanta, GA 30333 USA. EDS, Plano, TX USA. Inst Trop Med, B-2000 Antwerp, Belgium. RP Hu, DJ (reprint author), Ctr Dis Control & Prevent, Int Act Branch, Div HIV AIDS Prevent, NCHSTP, E-50, Atlanta, GA 30333 USA. OI Baggs, James/0000-0003-0757-4683 NR 120 TC 67 Z9 67 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD MAY 28 PY 1999 VL 13 IS 8 BP 873 EP 881 DI 10.1097/00002030-199905280-00002 PG 9 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 199VG UT WOS:000080504300002 PM 10475680 ER PT J AU Simon, PA Thometz, E Bunch, JG Sorvillo, F Detels, R Kerndt, PR AF Simon, PA Thometz, E Bunch, JG Sorvillo, F Detels, R Kerndt, PR TI Prevalence of unprotected sex among men with AIDS in Los Angeles County, California, 1995-1997 SO AIDS LA English DT Article DE sexual behavior; prevention of sexual transmission; epidemiology; surveillance ID HUMAN-IMMUNODEFICIENCY-VIRUS; SEROPOSITIVE GAY MEN; HIV RISK BEHAVIORS; EARLY INTERVENTION; BISEXUAL MEN; PREVENTION; INFECTION; PROJECT AB Objective: To determine the prevalence of unprotected sex among men with AIDS in Los Angeles County. Design: Cross-sectional study. Methods: All men aged greater than or equal to 18 years who were newly reported to the local health department with AIDS and completed a standardized interview between January 1995 and lune 1997 were included in the study. Men were classified as having unprotected sex if they reported one or more sex partners during the past year with whom they had vaginal or anal sex and did not always use a condom. Results: Of 617 men interviewed, 29% reported unprotected sex in the past year. The prevalence of unprotected sex was highest among men < 30 years of age (43%) and those who had first learned of their HIV-positive status < 12 months prior to interview (44%). In all, 323 (52%) men reported one or more male sex partners in the past year. Of these, 22% reported unprotected insertive anal sex and 27% unprotected receptive anal sex. One or more female partners in the past year was reported by 131 (21%) men. Of these, 53% reported unprotected vaginal sex and 18% unprotected anal sex. Conclusions: The findings highlight the importance of early HIV detection efforts, coupled with targeted and sustained HIV prevention services for those who test positive, to prevent ongoing transmission of the virus. (C) 1999 Lippincott Williams & Wilkins. C1 Los Angeles Cty Dept Hlth Serv, HIV Epidemiol Program, Los Angeles, CA 90012 USA. Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA USA. Univ Calif Los Angeles, Dept Epidemiol, Los Angeles, CA USA. RP Simon, PA (reprint author), Los Angeles Cty Dept Hlth Serv, HIV Epidemiol Program, 313 N Figueroa,Room 127, Los Angeles, CA 90012 USA. FU PHS HHS [U62-CCU906253] NR 15 TC 14 Z9 14 U1 3 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD MAY 28 PY 1999 VL 13 IS 8 BP 987 EP 990 DI 10.1097/00002030-199905280-00016 PG 4 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 199VG UT WOS:000080504300016 PM 10371181 ER PT J AU Akapo, SO Dimandja, JMD Kojiro, DR Valentin, JR Carle, GC AF Akapo, SO Dimandja, JMD Kojiro, DR Valentin, JR Carle, GC TI Gas chromatography in space SO JOURNAL OF CHROMATOGRAPHY A LA English DT Review DE reviews; space research; hydrocarbons ID MOLECULAR-WEIGHT HYDROCARBONS; SILOXANE BONDED PHASES; PLOT CAPILLARY COLUMN; TITANS ATMOSPHERE; PERMANENT GASES; LIGHT-HYDROCARBONS; SILICA COLUMNS; NITRILES; SAMPLE; MARS AB Gas chromatography has proven to be a very useful analytical technique for in situ analysis of extraterrestrial environments as demonstrated by its successful operation on spacecraft missions to Mars and Venus. The technique is also one of the six scientific instruments aboard the Huygens probe to explore Titan's atmosphere and surface. A review of gas chromatography in previous space missions and some recent developments in the current environment of fiscal constraints and payload size limitations are presented. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Analyze, Chandler, AZ 85224 USA. Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. NASA, Ames Res Ctr, Exobiol Branch, Moffett Field, CA 94035 USA. RP Akapo, SO (reprint author), Analyze, 318 S Bracken Lane, Chandler, AZ 85224 USA. NR 53 TC 10 Z9 10 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0021-9673 J9 J CHROMATOGR A JI J. Chromatogr. A PD MAY 28 PY 1999 VL 843 IS 1-2 BP 147 EP 162 DI 10.1016/S0021-9673(98)00947-9 PG 16 WC Biochemical Research Methods; Chemistry, Analytical SC Biochemistry & Molecular Biology; Chemistry GA 207RM UT WOS:000080949600007 PM 10399853 ER PT J AU Xiang, H Stallones, L Hariri, S Darragh, A Chiu, Y Gibbs-Long, J AF Xiang, H Stallones, L Hariri, S Darragh, A Chiu, Y Gibbs-Long, J TI Back pain among persons working on small or family farms - Eight Colorado counties, 1993-1996 (Reprinted from MMWR, vol 48, pg 301-304, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Colorado State Univ, Dept Environm Hlth, Colorado Injury Control Res Ctr, Ft Collins, CO 80523 USA. CDC, Natl Inst Occupat Safety & Hlth, Surveillance Branch, Div Surveillance,Injury Control Res Ctr, Atlanta, GA 30333 USA. RP Xiang, H (reprint author), Colorado State Univ, Dept Environm Hlth, Colorado Injury Control Res Ctr, Ft Collins, CO 80523 USA. RI Darragh, Amy/E-2946-2011 NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 26 PY 1999 VL 281 IS 20 BP 1885 EP 1886 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 198ME UT WOS:000080427300011 ER PT J AU Cook, KA Swerdlow, DL AF Cook, KA Swerdlow, DL TI Are enteric infections associated with unpasteurized orange juice? Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Cook, KA (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 26 PY 1999 VL 281 IS 20 BP 1892 EP 1893 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 198ME UT WOS:000080427300023 ER PT J AU Garcia, HH Gilman, RH Gonzalez, AE Pacheco, R Verastegui, M Tsang, VCW AF Garcia, HH Gilman, RH Gonzalez, AE Pacheco, R Verastegui, M Tsang, VCW CA Cysticerosis Working Grp TI Human and porcine Taenia solium infection in a village in the highlands of Cusco, Peru SO ACTA TROPICA LA English DT Article DE cysticercosis; Taenia solium; epidemiology; enzyme-linked immunoelectrotransfer; blot assay ID MAJOR CAUSE; CYSTICERCOSIS; NEUROCYSTICERCOSIS; PREVALENCE; COMMUNITY; MEXICO; ASSAY; PIGS AB A serological survey was performed using the enzyme-linked immunoelectrotransfer blot assay (EITB) in a village in the highlands of Peru where there are three distinct but close neighborhoods, to determine if there is a direct relationship between human and porcine Taenia solium infection. One hundred and eight out of 365 individuals were sampled, and 14 were seropositive (human seroprevalence 13%). Most seropositive individuals were neurologically asymptomatic. Thirty-eight out of 89 sampled pigs (43%) were seropositive. There was a clear geographical clustering of cases, and positive correlation between human and porcine seroprevalence was found when comparing the three neighborhoods. Cysticercosis is an important cause of neurological morbidity in most developing countries, and control/eradication trials are now being increasingly applied. Porcine serology provides an appropriate indicator of T. solium environmental contamination and should be used to estimate the risk of infection when evaluating control measures. (C) 1999 Elsevier Science B.V. All rights reserved. C1 Univ Peruana Cayetano Heredia, Dept Microbiol, Lima 31, Peru. Univ Peruana Cayetano Heredia, Dept Pathol, Lima 31, Peru. Inst Nacl Ciencias Neurol, Dept Transmissible Dis, Lima, Peru. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD 21205 USA. Univ Nacl Mayor San Marcos, Sch Vet Med, Lima 14, Peru. Univ Nacl San Antonio Abad, Sch Biol, Cusco, Peru. Ctr Dis Control, Parasit Dis Branch, Atlanta, GA 30333 USA. RP Garcia, HH (reprint author), Univ Peruana Cayetano Heredia, Dept Microbiol, Av H Delgado 430, Lima 31, Peru. FU PHS HHS [1-U01A135894-01] NR 16 TC 26 Z9 30 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0001-706X J9 ACTA TROP JI Acta Trop. PD MAY 25 PY 1999 VL 73 IS 1 BP 31 EP 36 DI 10.1016/S0001-706X(99)00011-X PG 6 WC Parasitology; Tropical Medicine SC Parasitology; Tropical Medicine GA 203EW UT WOS:000080695700004 PM 10379814 ER PT J AU Liu, ZY Shilkret, KL Ellis, HM AF Liu, ZY Shilkret, KL Ellis, HM TI Predictors of sputum culture conversion among patients with tuberculosis in the era of tuberculosis resurgence SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID DRUG-RESISTANT TUBERCULOSIS; NEW-YORK-CITY; UNITED-STATES; NEW-JERSEY; EPIDEMIOLOGY AB Background: Sputum culture conversion among patients with tuberculosis (TB) is the most important indicator for the effectiveness of treatment and the infectivity of the disease. We sought to investigate predictors for documented sputum culture conversion among TB cases reported in the surveillance system. Methods: This study included 780 patients with pulmonary TB who were initially sputum culture positive in New Jersey in 1994-1995. These patients were followed up for at least 1 week and up to 1 year. Kaplan-Meier curves and Cox proportional hazards models were performed to analyze the data. Results: Overall, 469 (60.1%) of the 780 patients had documented sputum culture conversion. The elderly (36%) and non-Hispanic whites (41.3%) were the least likely to have documented sputum conversion. Patients who were initially given 4 or more drugs were 36% more likely to have documented sputum conversion than those who were initially given fewer than 4 drugs, after adjusting for other factors. Patients who were under the care of chest clinics and the model TB center were about 3 times more likely to have documented sputum conversion than those under care of private physicians. Sex, recurrent TB, foreign-born status, homelessness, injecting drug use, human immunodeficiency virus infection and drug-resistant TB were not significantly associated with the documentation of sputum culture conversion. Conclusions: A substantial proportion of sputum culture-positive TB patients have no documented sputum culture conversion. The type of care provider was the predominant determinant for the documentation of sputum culture conversion. C1 New Jersey Dept Hlth & Senior Serv, Div Communicable Dis, Trenton, NJ 08625 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Liu, ZY (reprint author), New Jersey Dept Hlth & Senior Serv, Div Communicable Dis, POB 369,3635 Quakerbridge Rd, Trenton, NJ 08625 USA. NR 26 TC 26 Z9 26 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAY 24 PY 1999 VL 159 IS 10 BP 1110 EP 1116 DI 10.1001/archinte.159.10.1110 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 196GL UT WOS:000080300600012 PM 10335689 ER PT J AU Binder, S Levitt, AM Sacks, JJ Hughes, JM AF Binder, S Levitt, AM Sacks, JJ Hughes, JM TI Emerging infectious diseases: Public health issues for the 21st century SO SCIENCE LA English DT Editorial Material ID VACCINE; SURVEILLANCE; BIOSENSOR; INFLUENZA AB Infectious diseases are the third leading cause of death in the United States and the Leading cause worldwide. As the new millennium approaches, the public health community must replenish capacity depleted during years of inadequate funding while simultaneously incorporating new technologies and planning for the Longer term. Among the challenges facing the public health community is the need for coordinated, global, multisectoral approaches to preventing and controlling complex infectious disease problems. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Off Director, Natl Ctr Infect Dis, Brooklyn, NY 11215 USA. Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Binder, S (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Natl Ctr Infect Dis, F-22,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 45 TC 126 Z9 135 U1 2 U2 22 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 USA SN 0036-8075 J9 SCIENCE JI Science PD MAY 21 PY 1999 VL 284 IS 5418 BP 1311 EP 1313 DI 10.1126/science.284.5418.1311 PG 3 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA 198NN UT WOS:000080430600041 PM 10334978 ER PT J AU Smith, KE Besser, JM Hedberg, CW Leano, FT Bender, JB Wicklund, JH Johnson, BP Moore, KA Osterholm, MT AF Smith, KE Besser, JM Hedberg, CW Leano, FT Bender, JB Wicklund, JH Johnson, BP Moore, KA Osterholm, MT CA Invest Team TI Quinolone-resistant Campylobacter jejuni infections in Minnesota, 1992-1998 SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CIPROFLOXACIN-RESISTANT; ANTIMICROBIAL SUSCEPTIBILITIES; VETERINARY-MEDICINE; EMERGENCE; COLI; FLUOROQUINOLONES; TYPHIMURIUM; NORFLOXACIN; SPECTRUM; DIARRHEA AB Background Increasing resistance to quinolones among campylobacter isolates from humans has been reported in Europe and Asia, but not in the United States. We evaluated resistance to quinolones among campylobacter isolates from Minnesota residents during the period from 1992 through 1998. Methods All 4953 campylobacter isolates from humans received by the Minnesota Department of Health were tested for resistance to nalidixic acid. Resistant isolates and selected sensitive isolates were tested for resistance to ciprofloxacin. We conducted a case-comparison study of patients with ciprofloxacin-resistant Campylobacter jejuni isolated during 1996 and 1997. Domestic chicken was evaluated as a potential source of quinolone-resistant campylobacter. Results The proportion of quinolone-resistant C. jejuni isolates from humans increased from 1.3 percent in 1992 to 10.2 percent in 1998 (P<0.001). During 1996 and 1997, infection with quinolone-resistant C. jejuni was associated with foreign travel and with the use of a quinolone before the collection of stool specimens. However, quinolone use could account for no more than 15 percent of the cases from 1996 through 1998. The number of quinolone-resistant infections that were acquired domestically also increased during the period from 1996 through 1998. Ciprofloxacin-resistant C. jejuni was isolated from 14 percent of 91 domestic chicken products obtained from retail markets in 1997. Molecular subtyping showed an association between resistant C. jejuni strains from chicken products and domestically acquired infections in Minnesota residents. Conclusions The increase in quinolone-resistant C. jejuni infections in Minnesota is largely due to infections acquired during foreign travel. However, the number of quinolone-resistant infections acquired domestically has also increased, largely because of the acquisition of resistant strains from poultry. The use of fluoroquinolones in poultry, which began in the United States in 1995, has created a reservoir of resistant C, jejuni. (N Engl J Med 1999;340:1525-32.) (C)1999, Massachusetts Medical Society. C1 Minnesota Dept Hlth, Acute Dis Epidemiol Sect, Minneapolis, MN 55440 USA. Minnesota Dept Hlth, Div Publ Hlth Labs, Minneapolis, MN 55440 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. RP Smith, KE (reprint author), Minnesota Dept Hlth, Acute Dis Epidemiol Sect, 717 Delaware St SE, Minneapolis, MN 55440 USA. FU PHS HHS [U50/CCU511190] NR 37 TC 393 Z9 403 U1 1 U2 8 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAY 20 PY 1999 VL 340 IS 20 BP 1525 EP 1532 DI 10.1056/NEJM199905203402001 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 197HG UT WOS:000080358900001 PM 10332013 ER PT J AU Crowe, L Lau, W McLeod, L Anand, CM Ciebin, B LeBer, C McCartney, S Easy, R Clark, C Rodgers, F Ellis, A Thomas, A Shields, L Tate, B Klappholz, A LaBerge, I Sato, H Lehnkering, E Mascola, L Waddell, J Waterman, S Suarez, J Hammond, R Hopkins, R Neves, P Horine, MS Kludt, P DeMaria, A Hedberg, C Wicklund, J Besser, J Boxrud, D Hubner, B Osterholm, M Wu, FM Beuchat, L AF Crowe, L Lau, W McLeod, L Anand, CM Ciebin, B LeBer, C McCartney, S Easy, R Clark, C Rodgers, F Ellis, A Thomas, A Shields, L Tate, B Klappholz, A LaBerge, I Sato, H Lehnkering, E Mascola, L Waddell, J Waterman, S Suarez, J Hammond, R Hopkins, R Neves, P Horine, MS Kludt, P DeMaria, A Hedberg, C Wicklund, J Besser, J Boxrud, D Hubner, B Osterholm, M Wu, FM Beuchat, L TI Outbreaks of Shigella sonnei infection associated with eating fresh parsley - United States and Canada, July-August 1998 (Reprinted from MMWR, vol 48, pg 285-289, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 Calgary Reg Hlth Author, Calgary, AB, Canada. Prov Lab So Alberta, Calgary, AB, Canada. Ontario Minist Hlth, Toronto, ON M5W 1R5, Canada. Ottawa Carleton Hlth Unit, Ottawa, ON, Canada. Hlth Canada, Natl Enter Lab, Edmonton, AB, Canada. Canadian Food Inspect Agcy, Ottawa, ON, Canada. Los Angeles Cty Dept Hlth Serv, Los Angeles, CA USA. Calif Dept Hlth Serv, Berkeley, CA 94704 USA. Miami Dade Cty Hlth Dept, Miami, FL USA. Massachusetts Dept Publ Hlth, Boston, MA 02111 USA. Massachusetts Div Food & Drugs, Boston, MA USA. Florida Dept Hlth, Tallahassee, FL USA. Minnesota Dept Hlth, Minneapolis, MN 55414 USA. Univ Georgia, Ctr Food Safety & Qual Enhancement, Athens, GA 30602 USA. CDC, US FDA, Epidemiol Branch, Div Parasit Dis, Atlanta, GA 30333 USA. CDC, Hosp Environm Lab Branch, Hosp Infect Program, Atlanta, GA 30333 USA. CDC, Foodborne & Diarrheal Dis Branch, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Crowe, L (reprint author), Calgary Reg Hlth Author, Calgary, AB, Canada. NR 1 TC 1 Z9 2 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 19 PY 1999 VL 281 IS 19 BP 1785 EP 1787 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 196BH UT WOS:000080288800009 ER PT J AU Cody, SH Abbott, SL Marfin, AA Schulz, B Wagner, P Robbins, K Mohle-Boetani, JC Vugia, DJ AF Cody, SH Abbott, SL Marfin, AA Schulz, B Wagner, P Robbins, K Mohle-Boetani, JC Vugia, DJ TI Two outbreaks of multidrug-resistant Salmonella serotype Typhimurium DT104 infections linked to raw-milk cheese in northern California SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article; Proceedings Paper CT 35th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 07-16, 1997 CL SAN FRANCISCO, CALIFORNIA SP Infect Dis Soc Amer ID UNITED-STATES AB Context Salmonella serotype Typhimurium definitive type 104 (DT104), with resistance to 5 drugs (ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline), has emerged as the most common multidrug-resistant Salmonella strain in the United States, However, illnesses resulting from this strain have not been associated definitively with a source in this country. Objective To determine the source of 2 outbreaks of Salmonella Typhimurium DT104. Design Matched case-control study conducted between March 24 and April 5, 1997 (outbreak 1), enhanced surveillance for new cases dating from February 1, 1997 (outbreak 2), and environmental and laboratory investigations. Setting and Participants The case-control study included residents of 2 adjacent counties in northern California infected with the outbreak strain of Salmonella Typhimurium var Copenhagen and age-matched controls. For enhanced surveillance, a case was defined as Salmonella Typhimurium infection in a person exposed to fresh Mexican-style cheese. Main Outcome Measures Risk factors for infection and source of implicated food. Results Outbreak 1 peaked in February 1997; 31 patients were confirmed by culture as' having Salmonella Typhimurium var Copenhagen infection, isolates of which showed indistinguishable pulsed-field gel electrophoresis (PFGE) patterns. The outbreak strain was phage type DT104 with the 5-drug resistance pattern. Sixteen cases and 25 controls were enrolled in the case-control study; 15 of 16 Salmonella Typhimurium var Copenhagen cases compared with 14 of 24 matched controls reported eating unpasteurized Mexican-style cheese, (matched odds ratio, 7.9; 95% confidence interval, 1.1-354.9). Enhanced surveillance uncovered outbreak 2, which peaked in April 1997 and was caused by a non-Copenhagen variant of Salmonella Typhimurium. During outbreak 2, Salmonella Typhimurium was isolated from 79 persons who ate fresh Mexican-style cheese from street vendors and from cheese samples and raw milk. The PFGE pattern of the milk isolate matched 1 of the 3 patterns recovered from patients; all strains were phage type DT104b with the 5-drug resistance pattern. Conclusion Raw-milk products pose a risk for multidrug-resistant Salmonella Typhimurium DT104 infections. C1 Calif Dept Hlth Serv, Div Communicable Dis Control, Berkeley, CA 94704 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Atlanta, GA USA. Santa Clara Valley Hlth & Hosp Syst, Dept Publ Hlth, San Jose, CA USA. San Mateo Cty Dept Hlth, San Mateo, CA USA. Calif Dept Food & Agr, Milk & Dairy Branch, Sacramento, CA 95814 USA. RP Cody, SH (reprint author), Santa Clara Cty Dept Publ Hlth, 2220 Moorpark Ave 115, San Jose, CA 95128 USA. NR 19 TC 108 Z9 110 U1 1 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 19 PY 1999 VL 281 IS 19 BP 1805 EP 1810 DI 10.1001/jama.281.19.1805 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 196BH UT WOS:000080288800033 PM 10340367 ER PT J AU Villar, RG Macek, MD Simons, S Hayes, PS Goldoft, MJ Lewis, JH Rowan, LL Hursh, D Patnode, M Mead, PS AF Villar, RG Macek, MD Simons, S Hayes, PS Goldoft, MJ Lewis, JH Rowan, LL Hursh, D Patnode, M Mead, PS TI Investigation of multidrug-resistant Salmonella serotype Typhimurium DT104 infections linked to raw-milk cheese in Washington State SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ESCHERICHIA-COLI O157-H7; UNITED-STATES; MULTIRESISTANT STRAINS; SOFT CHEESE; OUTBREAK; CATTLE AB Context Multidrug-resistant Salmonella Typhimurium DT104 has recently emerged as a cause of human and animal illness in Europe and North America. In early 1997, health officials in Yakima County, Washington, noted a 5-fold increase in salmonellosis among the county's Hispanic population. Objectives To characterize bacterial strains and identify risk factors for infection with Salmonella Typhimurium in Yakima County. Design Laboratory, case-control, and environmental investigations. Setting and Participants Patients with culture-confirmed Salmonella Typhimurium infection living in Yakima County and age- and neighborhood-matched control subjects. Main Outcome Measures Food vehicle implication based on case-control study and outbreak control. Results Between January 1 and May 5, 1997, 54 culture-confirmed cases of Salmonella Typhimurium were reported. The median age of patients was 4 years and 91% were Hispanic. Patients reported diarrhea (100%), abdominal cramps (93%), fever (93%), bloody stools (72%), and vomiting (53%); 5 patients (9%) were hospitalized. Twenty-two patients and 61 control subjects were enrolled in the case-control study. Seventeen case patients (77%) reported eating unpasteurized Mexican-style soft cheese in the 7 days before onset of illness compared with 17 control subjects (28%) (matched odds ratio, 32.3; 95% confidence interval, 3.0-874.6). All case-patient isolates were phage definitive type 104 (DT104) (n = 10) or DT104b (n = 12), and 20 (91%) were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline. The cheese produced and eaten by 2 unrelated patients was made with raw milk traced to the same local farm. Milk samples from nearby dairies yielded Salmonella Typhimurium DT104. The incidence of Salmonella Typhimurium infections in Yakima County returned to pre-1992 levels following interventions based on these findings. Conclusions Multidrug-resistant Salmonella Typhimurium DT104 emerged as a cause of salmonellosis in Yakima County, and Mexican-style soft cheese made with unpasteurized milk is an important vehicle for Salmonella Typhimurium DT104 transmission. We postulate that recent increases in human salmonellosis reflect the emergence of Salmonella Typhimurium DT104 among dairy cows in the region. Continued efforts are needed to discourage consumption of raw milk products, promote healthier alternatives, and study the ecology of multidrug-resistant Salmonella Typhimurium. C1 Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30333 USA. Natl Ctr Hlth Stat, Illness & Disabil Stat Branch, Div Hlth Interview Stat, Hyattsville, MD 20782 USA. Washington State Dept Hlth, Seattle, WA USA. Washington State Univ, Cooperat Extens, Pullman, WA 99164 USA. Yakima Cty Hlth Dist, Yakima, WA USA. RP Mead, PS (reprint author), Ctr Dis Control & Prevent, Foodborne & Diarrheal Dis Branch, Natl Ctr Infect Dis, 1600 Clifton Rd,MS A-38, Atlanta, GA 30333 USA. NR 29 TC 94 Z9 95 U1 2 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 19 PY 1999 VL 281 IS 19 BP 1811 EP 1816 DI 10.1001/jama.281.19.1811 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 196BH UT WOS:000080288800034 PM 10340368 ER PT J AU Qian, HW Whong, WZ Olsen, L Nath, J Ong, T AF Qian, HW Whong, WZ Olsen, L Nath, J Ong, T TI Induction of micronuclei in V79 cells by fractions of roofing asphalt fume condensate SO MUTATION RESEARCH-GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS LA English DT Article DE roofing asphalt fume; fraction; micronucleus; binucleated cell; V79 cell; in vitro ID CHROMOSOME-ABERRATIONS; CANCER RISK; CULTURES; RAT AB More than 50,000 workers in the United States are exposed to roofing asphalt fumes that may pose genotoxic and potential carcinogenic hazards. The Type III roofing asphalt is most frequently used in roof-application. Results of our previous studies showed that fume condensates of Type III roofing asphalts induced micronuclei (MN) in vitro in cultured V79 cells and DNA adduct formation in vivo in rat lung cells. In this study, the genotoxicity of whole fume condensates (WFC) of Type III roofing asphalt and its five chemical fractions (A, B, C, D and E) was determined by the micronucleus assay using V79 cells. Linear regressions were determined for the dose response of MN frequencies and percent of binucleated and multinucleated cells (MTC) following the treatment. Results showed that the numbers of micronucleated cells in cultures treated with Type LU roofing asphalt WFC and its fractions B, C, D and E were significantly higher than that in the control culture, and that the slopes of the linear regression Line for fractions B and C were greater than those for the WFC and fractions D and E. A clear dose response of binucleated cells was also induced by the WFC and fractions B and C. These findings indicate that: (1) WFC and all fractions, except fraction A, induced MN formation in cultured V79 cells; (2) fractions B and C possess the highest genotoxic activity; (3) the roofing asphalt WFC contains chemicals or chemical classes that induce not only chromosomal aberrations but also binucleation in V79 cells. (C) 1999 Elsevier Science B.V. All rights reserved. C1 NIOSH, ALOSH, Morgantown, WV 26505 USA. W Virginia Univ, Morgantown, WV 26506 USA. NIOSH, Cincinnati, OH 45226 USA. RP Ong, T (reprint author), NIOSH, ALOSH, Room 3014,1095 Willowdale Rd, Morgantown, WV 26505 USA. NR 25 TC 8 Z9 8 U1 1 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1383-5718 J9 MUTAT RES-GEN TOX EN JI Mutat. Res. Genet. Toxicol. Environ. Mutagen. PD MAY 17 PY 1999 VL 441 IS 2 BP 163 EP 170 DI 10.1016/S1383-5718(99)00045-5 PG 8 WC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology SC Biotechnology & Applied Microbiology; Genetics & Heredity; Toxicology GA 199GP UT WOS:000080472800001 PM 10333530 ER PT J AU Fischer, M Carlone, GM Holst, J Williams, D Stephens, DS Perkins, BA AF Fischer, M Carlone, GM Holst, J Williams, D Stephens, DS Perkins, BA TI Neisseria meningitidis serogroup B outer membrane vesicle vaccine in adults with occupational risk for meningococcal disease SO VACCINE LA English DT Article DE Neisseria meningitidis; serogroup B; vaccine ID CONJUGATE VACCINE; ANTIBODY-RESPONSES; PROTEIN VACCINE; IMMUNOGENICITY; CHILDREN; POLYSACCHARIDE; EFFICACY; INFANTS; SAFETY AB Vaccination provides a safe and effective means of reducing the risk of laboratory-acquired infection due to some Neisseria meningitidis serogroups. However, there is currently no serogroup B meningococcal vaccine licensed for use in the US. We used an investigational N. meningitidis serogroup B outer membrane vesicle (B:15:P1.7,16) vaccine produced by the National Institute of Public Health (NIPH) in Norway to immunize 20 researchers with occupational risk for disease. Three doses of vaccine were administered via intramuscular injection at 8-week intervals. The vaccine produced moderate or severe pain with 19 (33%) of the 58 doses administered. Reactions were similar following first, second and third doses. The number and severity of reactions peaked at 24 h postvaccination and then gradually waned. Of 16 vaccinees with results available from all blood draws, 12 (75%) showed a fourfold or greater rise in serum bactericidal activity (SBA) against the Vaccine type-strain following two doses of vaccine, and 15 (94%) responded after three doses. Geometric mean titers increased by more than sixfold following two doses of vaccine when compared with prevaccination levels, and by more than Ii-fold following a third dose. There was no significant difference between SEA measured using the vaccinee's own complement versus a donor complement source. The NIPH vaccine elicited an excellent bactericidal response against the vaccine type-strain in researchers with an occupational risk for disease. It may be useful for other laboratory personnel who routinely work with meningococcal strains containing similar outer membrane antigens. These findings reconfirm that the NIPH vaccine is immunogenic in adults and support the validity of using properly screened human donor complement in serum bactericidal assays against serogroup B meningococci. (C) 1999 Elsevier Science Ltd. All rights reserved. C1 Childrens Hosp & Reg Med Ctr, Dept Pediat, Seattle, WA USA. Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Ctr Dis Control & Prevent, Atlanta, GA USA. Emory Univ, Sch Med, Div Infect Dis, Atlanta, GA 30322 USA. Natl Inst Publ Hlth, Dept Vaccinol, N-0462 Oslo, Norway. RP Perkins, BA (reprint author), 1600 Clifton Rd NE,MS C-09, Atlanta, GA 30333 USA. RI Stephens, David/A-8788-2012 NR 30 TC 17 Z9 19 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD MAY 14 PY 1999 VL 17 IS 19 BP 2377 EP 2383 DI 10.1016/S0264-410X(99)00036-5 PG 7 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 205BF UT WOS:000080800900007 PM 10392619 ER PT J AU Inglesby, TV Henderson, DA Bartlett, JG Ascher, MS Eitzen, E Friedlander, AM Hauer, J McDade, J Osterholm, MT O'Toole, T Parker, G Perl, TM Russell, PK Tonat, K AF Inglesby, TV Henderson, DA Bartlett, JG Ascher, MS Eitzen, E Friedlander, AM Hauer, J McDade, J Osterholm, MT O'Toole, T Parker, G Perl, TM Russell, PK Tonat, K CA Working Grp Civilian Biodefense TI Anthrax as a biological weapon - Medical and public health management SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ORAL-OROPHARYNGEAL ANTHRAX; BACILLUS-ANTHRACIS; INHALATION ANTHRAX; WARFARE; TERRORISM; INFECTION; OUTBREAK; VACCINES; FUTURE AB Objective To develop consensus-based recommendations for measures to be taken by medical and public health professionals following the use of anthrax as a biological weapon against a civilian population. Participants The working group included 21 representatives from staff of major academic medical centers and research, government, military, public health, and emergency management institutions and agencies. Evidence MEDLINE databases were searched from January 1966 to April 1998, using the Medical Subject Headings anthrax, Bacillus anthracis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of references identified by this search led to identification of relevant references published prior to 1966, In addition, participants identified other unpublished references and sources. Consensus Process The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. Members of the working group provided formal written comments which were incorporated into the second draft of the statement. The working group reviewed the second draft on June 12, 1998. No significant disagreements existed and comments were incorporated into a third draft. The fourth and final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members. Conclusions Specific consensus recommendations are made regarding the diagnosis of anthrax, indications for vaccination, therapy for those exposed, postexposure prophylaxis, decontamination of the environment, and additional research needs. C1 Johns Hopkins Univ, Johns Hopkins Ctr Civilian Biodef Studies, Baltimore, MD 21202 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD USA. Johns Hopkins Univ, Sch Publ Hlth, Baltimore, MD USA. Calif State Dept Hlth, Berkeley, CA USA. USA, Med Res Inst Infect Dis, Frederick, MD USA. Office Emergency Management, New York, NY USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Minnesota Dept Hlth, Minneapolis, MN USA. US Dept HHS, Office Emergency Preparedness, Rockville, MD USA. RP Inglesby, TV (reprint author), Johns Hopkins Univ, Johns Hopkins Ctr Civilian Biodef Studies, Candler Bldg,Suite 850,111 Market Pl, Baltimore, MD 21202 USA. NR 72 TC 499 Z9 511 U1 6 U2 40 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 12 PY 1999 VL 281 IS 18 BP 1735 EP 1745 DI 10.1001/jama.281.18.1735 PG 11 WC Medicine, General & Internal SC General & Internal Medicine GA 193WR UT WOS:000080161200032 PM 10328075 ER PT J AU Qureshi, AI Giles, WH Croft, JB AF Qureshi, AI Giles, WH Croft, JB TI Racial differences in the incidence of intracerebral hemorrhage - Effects of blood pressure and education SO NEUROLOGY LA English DT Article ID BLACK-WHITE DIFFERENCES; RISK-FACTORS; CEREBRAL-HEMORRHAGE; FOLLOW-UP; CEREBROVASCULAR-DISEASE; NATIONAL-HEALTH; STROKE; HYPERTENSION; POPULATION; INFARCTION AB Objective: To determine the relative risk (RR) of intracerebral hemorrhage (ICH) among African Americans compared with that among whites. Methods: Data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study were used to determine the incidence of ICH (n = 78) in 10,851 whites and 1,802 African Americans during a 20-year follow-up period. Cox proportional hazards analyses were used to determine the RR of ICH among African Americans compared with that among whites. Results: The estimated annual incidence of ICH was 50 per 100,000 among African Americans and 28 per 100,000 among whites. The age- and sex-adjusted RR for ICH among African Americans was 1.9 (95% confidence interval [CI], 1.1 to 3.2). With the addition of systolic blood pressure and educational attainment to the Cox proportional hazards model, the RR decreased to 1.6 (95% CI, 0.9 to 2.7). The adjustment for additional cerebrovascular disease risk factors did not change this risk estimate appreciably. Conclusions: Compared with whites, African Americans have a twofold increased risk for ICH. Most of this risk may be explained by differences in educational attainment and systolic blood pressure. Unless additional efforts are undertaken to reduce racial differences in the prevalence of stroke risk factors, mainly systolic blood pressure and socioeconomic status, the African American-white disparities in the risk for ICH will likely continue. C1 Ctr Dis Control & Prevent, Cardiovasc Hlth Branch, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Johns Hopkins Univ, Dept Neurol, Div Neurosci & Crit Care Med, Baltimore, MD 21218 USA. RP Giles, WH (reprint author), Ctr Dis Control & Prevent, Cardiovasc Hlth Branch, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Hwy,MS K-45, Atlanta, GA 30341 USA. NR 34 TC 43 Z9 45 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD MAY 12 PY 1999 VL 52 IS 8 BP 1617 EP 1621 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 195DJ UT WOS:000080233600019 PM 10331687 ER PT J AU Van der Stuyft, P Gianella, A Pirard, M Cespedes, J Lora, J Peredo, C Pelegrino, JL Vorndam, V Boelaert, M AF Van der Stuyft, P Gianella, A Pirard, M Cespedes, J Lora, J Peredo, C Pelegrino, JL Vorndam, V Boelaert, M TI Urbanisation of yellow fever in Santa Cruz, Bolivia SO LANCET LA English DT Article ID COST-EFFECTIVENESS; ENCEPHALITIS; INFECTIONS; DENGUE AB Background Reinvasion by Aedes aegypti of cities in the Americas poses a threat of urbanisation of yellow fever. After detection of yellow-fever infection in a resident of the city of Santa Cruz, Bolivia, in December, 1997, we investigated all subsequent suspected cases. Methods We introduced active surveillance of yellow fever in the Santa Cruz area. Hospitals and selected urban and rural health centres reported all suspected cases. Patients were serologically screened for yellow fever, dengue, hepatitis A and B, and leptospirosis. We collected clinical and epidemiological information from patients' records and through interviews. We also carried out a population-based serosurvey in the neighbourhood of one case. Findings Between December, 1997, and June, 1998, symptomatic yellow-fever infection was confirmed in six residents of Santa Cruz, five of whom died. Five lived in the southern sector of the city. Two had not left the city during the incubation period, and one had visited only an area in which sylvatic transmission was deemed impossible. Of the 281 people covered in the serosurvey 16 (6%) were positive for IgM antibody to yellow fever. Among five people for whom this result could not be explained by recent vaccination, there were two pairs of neighbours. Interpretation Urban transmission of yellow fever in Santa Cruz was limited in space and time. Low yellow-fever immunisation coverage and high infestation with A aegypti in the city, and the existence of endemic areas in the region present a risk for future urban outbreaks. We recommend immediate large-scale immunisation of the urban population, as well as tightened surveillance and appropriate vector control. C1 Inst Trop Med, Epidemiol Unit, B-2000 Antwerp 1, Belgium. Ctr Nacl Enfermedades Trop, Santa Cruz, Bolivia. Belgian Agcy Dev Cooperat, CENETROP Project, Santa Cruz, Bolivia. Direcc Dept Salud, Secc Control Vectores, Santa Cruz, Bolivia. Inst Med Trop Pedro Kouri, La Havana, Cuba. Ctr Dis Control & Prevent, San Juan, PR USA. RP Van der Stuyft, P (reprint author), Inst Trop Med, Epidemiol Unit, B-2000 Antwerp 1, Belgium. RI Boelaert, Marleen/E-2698-2012; Pelegrino Martinez de la Cotera, Jose Luis/F-9040-2016 OI Boelaert, Marleen/0000-0001-8051-6776; Pelegrino Martinez de la Cotera, Jose Luis/0000-0003-0833-653X NR 20 TC 57 Z9 61 U1 2 U2 17 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD MAY 8 PY 1999 VL 353 IS 9164 BP 1558 EP 1562 DI 10.1016/S0140-6736(99)03291-2 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 195XW UT WOS:000080278300010 PM 10334253 ER PT J AU Belay, ED Bresee, JS Holman, RC Khan, AS Shahriari, A Schonberger, LB AF Belay, ED Bresee, JS Holman, RC Khan, AS Shahriari, A Schonberger, LB TI Reye's syndrome in the United States from 1981 through 1997 SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID PUBLIC-HEALTH-SERVICE; ASPIRIN USE; CHILDREN; MEDICATIONS; PATTERN; RISK AB Background Reye's syndrome is characterized by encephalopathy and fatty degeneration of the liver, usually after influenza or varicella. Beginning in 1980, warnings were issued about the use of salicylates in children with those viral infections because of the risk of Reye's syndrome. Methods To describe the pattern of Reye's syndrome in the United States, characteristics of the patients, and risk factors for poor outcomes, we analyzed national surveillance data collected from December 1980 through November 1997. The surveillance system is based on voluntary reporting with the use of a standard case-report form. Results From December 1980 through November 1997 (surveillance years 1981 through 1997), 1207 cases of Reye's syndrome were reported in patients less than 18 years of age. Among those for whom data on race and sex were available, 93 percent were white and 52 percent were girls. The number of reported cases of Reye's syndrome declined sharply after the association of Reye's syndrome with aspirin was reported. After a peak of 555 cases in children reported in 1980, there have been no more than 36 cases per year since 1987. Antecedent illnesses were reported in 93 percent of the children, and detectable blood salicylate levels in 82 percent. The overall case fatality rate was 31 percent. The case fatality rate was highest in children under five years of age (relative risk, 1.8; 95 percent confidence interval, 1.5 to 2.1) and in those with a serum ammonia level above 45 mu g per deciliter (26 mu mol per liter) (relative risk, 3.4; 95 percent confidence interval, 1.9 to 6.2). Conclusions Since 1980, when the association between Reye's syndrome and the use of aspirin during varicella or influenza-like illness was first reported, there has been a sharp decline in the number of infants and children reported to have Reye's syndrome. Because Reye's syndrome is now very rare, any infant or child suspected of having this disorder should undergo extensive investigation to rule out the treatable inborn metabolic disorders that can mimic Reye's syndrome. (N Engl J Med 1999;340:1377-82.) (C) 1999, Massachusetts Medical Society. C1 Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Belay, ED (reprint author), Ctr Dis Control & Prevent, Div Viral & Rickettsial Dis, Natl Ctr Infect Dis, Mailstop A-39,1600 Clifton Rd NE, Atlanta, GA 30333 USA. RI Belay, Ermias/A-8829-2013 NR 32 TC 152 Z9 165 U1 2 U2 7 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAY 6 PY 1999 VL 340 IS 18 BP 1377 EP 1382 DI 10.1056/NEJM199905063401801 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 192QN UT WOS:000080090600001 PM 10228187 ER PT J CA CDC TI Screening for colorectal cancer - United States, 1997 (Reprinted from MMWR, vol 48, pg 116-121, 1999) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID FECAL OCCULT BLOOD C1 CDC, Epidemiol & Hlth Svcs Res Br, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. RP CDC, Epidemiol & Hlth Svcs Res Br, Div Canc Prevent & Control, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30333 USA. NR 10 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAY 5 PY 1999 VL 281 IS 17 BP 1581 EP 1582 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 191MJ UT WOS:000080025900010 ER PT J AU Steenland, K Piacitelli, L Deddens, J Fingerhut, M Chang, LI AF Steenland, K Piacitelli, L Deddens, J Fingerhut, M Chang, LI TI Cancer, heart disease, and diabetes in workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID FOLLOW-UP; MORTALITY; COHORT; 2,3,7,8-TCDD; HERBICIDES; VETERANS; DIOXIN AB Background: In 1997, the International Agency for Research on Cancer classified 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) as a group 1 human carcinogen, based largely on four highly exposed industrial cohorts that showed an excess of all cancers combined. In this study, we extended the follow-up period for the largest of these cohorts By 6 years and developed a job-exposure matrix. Methods: We did cohort mortality analyses involving 5132 chemical workers at 12 U.S. plants by use of life table techniques (U.S. population referent) and Cox regression (internal referent). We conducted exposure-response analyses for 69% of the cohort with adequate work history data and adequate plant data on TCDD contamination, All P values are two-sided. Results: The standardized mortality ratio (SMR) for all cancers combined was 1.13 (95% confidence interval = 1.02-1.25). We found statistically significant positive linear trends in SMRs with increasing exposure for all cancers combined and for lung cancer. The SMR for all cancers combined for the highest exposure group was 1.60 (95% confidence interval = 1.15-1.82). SMRs for heart disease showed a weak increasing trend with higher exposure (P = .14). Diabetes (any mention on the death certificate) showed a negative exposure-response trend. Internal analyses with Cox regression found statistically significant trends for cancer (15-year lag time) and heart disease (no lag). Conclusions: Our analyses suggest that high TCDD exposure results in an excess of all cancers combined, without any marked specificity, However, excess cancer was limited to the highest exposed workers, with exposures that were likely to have been 100-1000 times higher than those experienced by the general population and similar to the TCDD levels used in animal studies. C1 NIOSH, Cincinnati, OH 45226 USA. RP Steenland, K (reprint author), Int Agcy Res Canc, 150 Cours Albert Thomas, F-69372 Lyon, France. NR 29 TC 192 Z9 199 U1 1 U2 10 PU NATL CANCER INSTITUTE PI BETHESDA PA 9030 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0027-8874 J9 J NATL CANCER I JI J. Natl. Cancer Inst. PD MAY 5 PY 1999 VL 91 IS 9 BP 779 EP 786 DI 10.1093/jnci/91.9.779 PG 8 WC Oncology SC Oncology GA 193ND UT WOS:000080142100012 PM 10328108 ER PT J AU Bresee, JS Glass, RI Ivanoff, B Gentsch, JR AF Bresee, JS Glass, RI Ivanoff, B Gentsch, JR TI Current status and future priorities for rotavirus vaccine development, evaluation and implementation in developing countries SO VACCINE LA English DT Article; Proceedings Paper CT Consensus Workshop on Rotavirus Vaccines for Use in Developing Countries CY JAN 09-10, 1997 CL GENEVA, SWITZERLAND SP Global Programme Vaccines, WHO, Childrens Vaccine Iniat, Ctr Dis Control & Prevent ID 1ST 2 YEARS; TOXIGENIC ESCHERICHIA-COLI; REOVIRUS-LIKE AGENT; RHESUS-ROTAVIRUS; YOUNG-CHILDREN; BOVINE ROTAVIRUS; PROTECTIVE EFFICACY; ACUTE GASTROENTERITIS; REASSORTANT VACCINE; DIARRHEAL DISEASE C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Respiratory & Enter Viruses Branch, Publ Hlth Serv,US Dept Hlth & Human Serv, Atlanta, GA 30333 USA. WHO, Vaccine Res & Dev, CH-1211 Geneva, Switzerland. RP Bresee, JS (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Sect, Respiratory & Enter Viruses Branch, Publ Hlth Serv,US Dept Hlth & Human Serv, Mailstop GO4,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 148 TC 182 Z9 190 U1 2 U2 3 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD MAY 4 PY 1999 VL 17 IS 18 BP 2207 EP 2222 DI 10.1016/S0264-410X(98)00376-4 PG 16 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 193QA UT WOS:000080146500001 PM 10403588 ER PT J AU Frace, AM Klimov, AI Rowe, T Black, RA Katz, JM AF Frace, AM Klimov, AI Rowe, T Black, RA Katz, JM TI Modified M2 proteins produce heterotypic immunity against influenza A virus SO VACCINE LA English DT Article DE influenza; M2 protein; immunity ID GLUTATHIONE-S-TRANSFERASE; M(2) ION-CHANNEL; A-VIRUS; ESCHERICHIA-COLI; MONOCLONAL-ANTIBODY; INSECT CELLS; M2-PROTEIN; MICE; PH; HEMAGGLUTININ AB Vaccination with the influenza A transmembrane protein M2 provides enhanced viral clearance and recovery from influenza A virus infection in mice. However, the high degree of hydrophobicity of the protein limits its purification for vaccine purposes. We have attempted to alter the structure of the M2 protein to allow high level recombinant expression in Escherichia coli, to reduce its hydrophobicity and improve protein solubility, thus improving its properties as a vaccine subunit candidate. Constructs investigated include deletion of the transmembrane domain of M2 (residues 26-43) and an extended deletion (residues 26-55). A full-length M2 protein was not pursued because of poor expression, even in the presence of amantadine. Expressed as glutathione S-transferase fusion proteins and used to vaccinate mice: either deletion construct was found to raise M2-specific serum antibodies and enhance viral clearance in mice challenged with homologous and heterologous influenza A viruses. Enzymatic cleavage from the GST fusion domain produces soluble protein giving similar results. The results demonstrate that large alterations of M2 protein structure can improve its isolation and purification characteristics without detracting from its immunogenic properties. (C) 1999 Elsevier Science Ltd. All rights reserved. C1 Pasteur Merieux Connaught Inc, Swiftwater, PA 18370 USA. Natl Ctr Infect Dis, Ctr Dis Control & Prevent, Influenza Branch, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. RP Frace, AM (reprint author), Pasteur Merieux Connaught Inc, Route 611,POB 187, Swiftwater, PA 18370 USA. NR 26 TC 107 Z9 128 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD MAY 4 PY 1999 VL 17 IS 18 BP 2237 EP 2244 DI 10.1016/S0264-410X(99)00005-5 PG 8 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 193QA UT WOS:000080146500004 PM 10403591 ER PT J AU Sohn, YM Park, MS Rho, HO Chandler, LJ Shope, RE Tsai, TF AF Sohn, YM Park, MS Rho, HO Chandler, LJ Shope, RE Tsai, TF TI Primary and booster immune responses to SA14-14-2 Japanese encephalitis vaccine in Korean infants SO VACCINE LA English DT Article ID SAFETY AB Attenuated SA14-14-2 Japanese encephalitis (JE) vaccine has been administered safely and effectively to more than 100 million children in China since 1988 and recently, licensure of the vaccine in Korea has been sought. In the first clinical evaluation of the vaccine outside of China, we monitored side effects in 84 children and evaluated antibody responses to a single dose given as primary JE vaccination in 68 children, 1-3 years old (mean age 27 months). No significant adverse events were noted. Neutralizing antibodies (geometric mean titer [GMT] of 188) were produced in 96% of the 68 subjects, In 10 other children who previously had been immunized with two or three doses of inactivated JE vaccine, the booster administration of SA14-14-2 vaccine produced an anamnestic response in all. with a GMT of 3378. In a comparison group of 25 children previously immunized with two doses of inactivated vaccine, neutralizing antibody titers were detected in 16 (64%), Viral specific IgM was detected in nine primary vaccinees (13%) but in others, IgM may have declined to undetectable levels in the four week postimmunization sample. Live attenuated SA14-13-2 JE vaccine is a promising alternative to the only commercially available JE vaccine for national childhood immunization programs in Asia. (C) 1999 Elsevier Science Ltd. All rights reserved. C1 Natl Ctr Infect Dis, CDC, Div Vector Borne Infect Dis, Ft Collins, CO 80522 USA. Univ Texas, Med Branch, Dept Pathol, Galveston, TX 77555 USA. Yonsei Univ, Coll Med, Dept Pediat, Seoul, South Korea. RP Tsai, TF (reprint author), Natl Ctr Infect Dis, CDC, Div Vector Borne Infect Dis, POB 2081,Foothills Campus, Ft Collins, CO 80522 USA. NR 15 TC 40 Z9 47 U1 0 U2 2 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD MAY 4 PY 1999 VL 17 IS 18 BP 2259 EP 2264 DI 10.1016/S0264-410X(99)00006-7 PG 6 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 193QA UT WOS:000080146500006 PM 10403593 ER PT J AU Deye, GJ Gao, P Baron, PA Fernback, J AF Deye, GJ Gao, P Baron, PA Fernback, J TI Performance evaluation of a fiber length classifier SO AEROSOL SCIENCE AND TECHNOLOGY LA English DT Article ID SEPARATION; PARTICLES; DIELECTROPHORESIS; AEROSOLS AB A performance evaluation was conducted on a differential mobility classifier that separates fibers according to length using dielectrophoresis. The classifier had been constructed and used for several applications in previous studies. The performance of the classifier was predicted using a two-dimensional axisymmetric model of the flow field and then calculating particle trajectories for a variety of conditions. Based on the flow calculations, several regions of the classifier mere improved to reduce likelihood of turbulent losses. For a given total flow through the classifier and a maximum voltage across the electrodes, the performance of the classifier was found to depend on the ratios of the aerosol flow to the inner and the outer sheath flows. It was found that the minimum classifiable length, the minimum length distribution width, and the throughput of classified fibers can each be optimized, but not independently, Several approaches to testing the resolution of the classifier were tried The first was to measure the length distribution of fibers passing through the classifier under different conditions using electron microscopy, However, this was a slow and imprecise measure of performance, Two approaches using monodisperse latex spheres were used; one operated the instrument as an electrical mobility (electrophoresis) analyzer and the other evaluated only the flow system accuracy, All measures indicate that the classifier operates close to theoretical performance, but improvements are still possible. Suggested improvements require redesign of the flow system and improved electrode alignment. C1 NIOSH, Cincinnati, OH 45226 USA. NIOSH, Morgantown, WV 26505 USA. RP Deye, GJ (reprint author), NIOSH, Cincinnati, OH 45226 USA. NR 22 TC 11 Z9 11 U1 1 U2 6 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0278-6826 J9 AEROSOL SCI TECH JI Aerosol Sci. Technol. PD MAY PY 1999 VL 30 IS 5 BP 420 EP 437 DI 10.1080/027868299304471 PG 18 WC Engineering, Chemical; Engineering, Mechanical; Environmental Sciences; Meteorology & Atmospheric Sciences SC Engineering; Environmental Sciences & Ecology; Meteorology & Atmospheric Sciences GA 196GZ UT WOS:000080301800004 ER PT J AU Smith, J Bartley, D Watkins, D AF Smith, J Bartley, D Watkins, D TI Development of a large particle aerosol distribution system for testing manikin-mounted samplers SO AEROSOL SCIENCE AND TECHNOLOGY LA English DT Article ID DUST AB Personal samplers used to determine the inhalable fraction of workplace dust are tested while mounted on a manikin, which simulates a worker. To understand the mechanisms affecting the performance of such samplers, researchers must measure the airflow around the body where the samplers are mounted, Therefore, wind tunnel facilities to determine both airflow conditions around samplers and sampling efficiency are needed. A wind tunnel system was developed that was large enough to accommodate the top half of a life-sized manikin and employed a laser Doppler velocimeter for velocity measurements around the manikin. For generating particles up to 70 mu m, an aerosol generation system, using a two-dimensional scanning system to cover an extended area, aas developed and tested. The generation system had carriages with linear bearings mounted on rod assemblies for scanning in the horizontal and vertical directions. Screw drives, powered by stepper motors under computer control, moved the carriages in a preprogrammed pattern. The generation system was characterized for its ability to generate uniform concentrations of aerosols over an extended area at wind speeds of 0.5 and 2 m/s and particle sizes of 7 and 70 mu m. Uniformity of concentration over the area studied, in the absence of the manikin, was 10% relative standard deviation (RSD) or better, except for 7 mu m particles at a wind speed of 0.5 m/s where some nonuniformity was observed. The uniformity under these conditions was improved by rearranging We distances between components in the wind tunnel. C1 NIOSH, Div Phys Sci & Engn, Ctr Dis Control, Cincinnati, OH 45226 USA. RP Smith, J (reprint author), NIOSH, Div Phys Sci & Engn, Ctr Dis Control, Cincinnati, OH 45226 USA. NR 10 TC 7 Z9 7 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0278-6826 J9 AEROSOL SCI TECH JI Aerosol Sci. Technol. PD MAY PY 1999 VL 30 IS 5 BP 454 EP 466 DI 10.1080/027868299304499 PG 13 WC Engineering, Chemical; Engineering, Mechanical; Environmental Sciences; Meteorology & Atmospheric Sciences SC Engineering; Environmental Sciences & Ecology; Meteorology & Atmospheric Sciences GA 196GZ UT WOS:000080301800006 ER PT J AU Weniger, BG Modlin, JF Snider, DE Clover, RD DeBuono, BA Fleming, DW Glode, MP Griffin, MR Guerra, FA Helms, CM Le, CT Sherrod, JL Breiman, RF Evans, GS Graydon, RT Hardegree, MC La Montagne, J Nichol, KL Trump, DH Zimmerman, RK Peter, G Pickering, LK Halsey, NA Gilmet, G Gall, SA Gardner, P Schaffner, W Marchessault, V Siegel, JD Glezen, WP Faggett, W Douglas, GR Santos, JI AF Weniger, BG Modlin, JF Snider, DE Clover, RD DeBuono, BA Fleming, DW Glode, MP Griffin, MR Guerra, FA Helms, CM Le, CT Sherrod, JL Breiman, RF Evans, GS Graydon, RT Hardegree, MC La Montagne, J Nichol, KL Trump, DH Zimmerman, RK Peter, G Pickering, LK Halsey, NA Gilmet, G Gall, SA Gardner, P Schaffner, W Marchessault, V Siegel, JD Glezen, WP Faggett, W Douglas, GR Santos, JI CA Advisory Comm Immunization Practices American Academy Pediatrics American Academy Family Physicians TI Combination vaccines for childhood immunization SO AMERICAN FAMILY PHYSICIAN LA English DT Article AB An increasing number of new and improved vaccines to prevent childhood diseases are being introduced. Combination vaccines represent one solution to the problem of increased numbers of injections during single clinic visits. This statement provides general guidance on the use of combination vaccines and related issues and questions. To minimize the number of injections children receive, parenteral combination vaccines should be used, if licensed and indicated for the patient's age, instead of their equivalent component vaccines. Hepatitis A, hepatitis B, and Haemophilus influenzae type b vaccines, in either monovalent or combination formulations from the same or different manufacturers, are interchangeable for sequential doses in the vaccination series. However, using acellular pertussis vaccine product(s) from the same manufacturer is preferable for at least the first three doses, until studies demonstrate the interchangeability of these vaccines. Immunization providers should stock sufficient types of combination and monovalent vaccines needed to vaccinate children against ail diseases for which vaccines are recommended, but they need not stock ail available types or brand-name products. When patients have already received the recommended vaccinations for some of the components in a combination vaccine, administering the extra antigen(s) in the combination is often permissible if doing so will reduce the number of injections required. To overcome recording errors and ambiguities in the names of vaccine combinations, improved systems are needed to enhance the convenience and accuracy of transferring vaccine-identifying information into medical records and immunization registries. Further scientific: and programmatic research is needed on specific questions related to the use of combination vaccines. C1 CDC, Epidemiol & Surveillance Div, Natl Immunizat Program, Atlanta, GA 30333 USA. RP Weniger, BG (reprint author), CDC, Epidemiol & Surveillance Div, Natl Immunizat Program, Atlanta, GA 30333 USA. OI Weniger, Bruce/0000-0002-5450-5464; Zimmerman, Richard/0000-0001-5941-6092 NR 0 TC 3 Z9 3 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 USA SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD MAY 1 PY 1999 VL 59 IS 9 BP 2565 EP + PG 10 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 194YR UT WOS:000080222800017 ER PT J AU Coffey, CC Campbell, DL Myers, WR AF Coffey, CC Campbell, DL Myers, WR TI Comparison of six respirator fit-test methods with an actual measurement of exposure in a simulated health care environment: Part III - Validation SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE biological sampling; exposure dose; fit factor; Freon (R)-113; quantitative fit-test; respirator AB This article, the last in a series of three, describes the validation phase of a study conducted to test the correlation of respirator fit factors to the subject's actual exposure using biological sampling. The study consisted of three phases: protocol development, method comparison testing, and validation. Six quantitative fit-test methods were evaluated in the method comparison testing phase. The two fit methods with the highest correlation with the wearers' measured exposure were a corn oil method (R-2 = 0.81) and an ambient aerosol method (R-2 = 0.78). Because the ambient aerosol method is more commonly used in the workplace, it was selected for further analysis. In this validation phase, the fit factors measured during the ambient aerosol fit-test were used to calculate the exposures to Freon(R)-113 by using the model determined in the method comparison testing phase of the study. The actual Freon-113 exposures were then measured and compared with the predicted exposures. The results verified that the ambient aerosol mettled fit factors are highly correlated to the total Freon-113 exposure dose and thus that the model had a predictive ability. C1 NIOSH, Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent,Div Resp Dis Studies, Morgantown, WV 26505 USA. W Virginia Univ, Coll Engn & Mineral Resources Ind & Management Sy, Morgantown, WV 26506 USA. RP Coffey, CC (reprint author), NIOSH, Dept Hlth & Human Serv, Publ Hlth Serv, Ctr Dis Control & Prevent,Div Resp Dis Studies, 1095 Willowdale Rd, Morgantown, WV 26505 USA. RI Coffey, Christopher/I-2471-2012 NR 10 TC 7 Z9 7 U1 0 U2 2 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD MAY-JUN PY 1999 VL 60 IS 3 BP 363 EP 366 DI 10.1080/00028899908984454 PG 4 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 206YT UT WOS:000080908700013 PM 10386357 ER PT J AU Feng, HA Schlecht, P AF Feng, HA Schlecht, P TI Environmental lead proficiency analytical testing (ELPAT) program - September and December 1998 SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article C1 NIOSH, HHS, PHS, CDC,Robert A Taft Labs, Cincinnati, OH 45226 USA. RP Feng, HA (reprint author), NIOSH, HHS, PHS, CDC,Robert A Taft Labs, 4676 Columbia Pkwy MS-R8, Cincinnati, OH 45226 USA. NR 16 TC 0 Z9 0 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 USA SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD MAY-JUN PY 1999 VL 60 IS 3 BP 412 EP 416 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA 206YT UT WOS:000080908700021 ER PT J AU Williams, LO Decoufle, P AF Williams, LO Decoufle, P TI Is maternal age a risk factor for mental retardation among children? SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE abnormalities; child; cognition; maternal age; mental retardation ID ATLANTA DEVELOPMENTAL-DISABILITIES; CONGENITAL-MALFORMATIONS; ADOLESCENT MOTHERS; UNITED-STATES; MEIOSIS-I; PREVALENCE; NONDISJUNCTION; PREGNANCY; RECOMBINATION; CHROMOSOME-21 AB The purpose of this study was to determine whether older or very young maternal age at delivery is associated with mental retardation in children. Ten-year-old children with mental retardation tan intelligence quotient of 70 or less) were identified in 1985-1987 from multiple sources in the metropolitan Atlanta, Georgia, area. These children were subdivided into two case groups according to whether they had concomitant developmental disabilities or birth defects affecting the central nervous system (codevelopmental retardation) or did not have such disabilities (isolated retardation). Control children were randomly chosen from the regular education files of the public school systems in the study area. Data on sociodemographic variables were gathered from birth certificates. Children of teenaged mothers were not at increased risk for either form of retardation and children of mothers aged greater than or equal to 30 years were not at increased risk for isolated retardation, in comparison with children of mothers aged 20-29 years. A markedly elevated risk of codevelopmental retardation was seen among black children of mothers aged greater than or equal to 30 years that was not attributable to Down syndrome. A modest increase in risk for codevelopmental retardation was observed among white children born to older mothers, but it was entirely due to Down syndrome. C1 Ctr Dis Control & Prevent F15, Natl Ctr Environm Hlth, Div Birth Defects & Dev Disabil, Dev Disabil Branch, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Div Lab Syst, Lab Practice Assessment Branch, Atlanta, GA 30341 USA. RP Decoufle, P (reprint author), Ctr Dis Control & Prevent F15, Natl Ctr Environm Hlth, Div Birth Defects & Dev Disabil, Dev Disabil Branch, 4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 54 TC 15 Z9 15 U1 2 U2 6 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD MAY 1 PY 1999 VL 149 IS 9 BP 814 EP 823 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 190FW UT WOS:000079952900005 PM 10221318 ER PT J AU Fox, J Remington, P Layde, P Klein, G AF Fox, J Remington, P Layde, P Klein, G TI The effect of hysterectomy on the risk of an abnormal screening Papanicolaou test result SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE vaginal cytology; hysterectomy; screening; Papanicolaou smear ID BENIGN DISEASE; CANCER AB OBJECTIVE: Our aim was to determine the risk of cytologic abnormality on a screening Papanicolaou test for women greater than or equal to 50 years old with and without a uterine cervix. STUDY DESIGN: The effect of hysterectomy on abnormal screening Papanicolaou test rates was determined in a cross-sectional analysis of 21,152 women aged greater than or equal to 50 years who had screening Papanicolaou tests between January and August 1995. We then conducted a nested 1:1 case-control study of 172 case patients and 172 age-matched randomly selected control patients from the cohort. To control for potential confounders, conditional logistic regression was used to assess the effect of hysterectomy status on the risk of an abnormal Papanicolaou test. RESULTS: Compared with age-matched women with a uterine cervix, those who had a hysterectomy had a 10-fold lower risk of a screening Papanicolaou test abnormality (odds ratio 0.09, 95% confidence interval 0.02-0.24). The risk was further reduced among women taking estrogens (odds ratio 0.02, 95% confidence interval 0.004-0.14) compared with women not using estrogens (odds ratio 0.14, 95% confidence interval 0.04-0.56). CONCLUSIONS: The reduced risk of Papanicolaou test abnormalities among women aged greater than or equal to 50 years who have had a hysterectomy should be considered when individual patients are being counseled, screening guidelines are being formulated, and health care resources are being allocated. C1 Ctr Dis Control, Epidemiol Program Off, Div Appl Publ Hlth Training, Atlanta, GA 30333 USA. Med Coll Wisconsin, Dept Family & Community Med, Milwaukee, WI 53226 USA. Dane Cty Cytol Ctr, Madison, WI USA. RP Fox, J (reprint author), Phys Plus Insurance Corp, 340 W Morgantown Ave, Madison, WI 53703 USA. NR 20 TC 18 Z9 19 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD MAY PY 1999 VL 180 IS 5 BP 1104 EP 1109 DI 10.1016/S0002-9378(99)70601-0 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 201PB UT WOS:000080603000009 PM 10329862 ER PT J AU Semenza, JC McCullough, JE Flanders, WD McGeehin, MA Lumpkin, JR AF Semenza, JC McCullough, JE Flanders, WD McGeehin, MA Lumpkin, JR TI Excess hospital admissions during the July 1995 heat wave in Chicago SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE heat; heat exhaustion; patient admission; hospitals; urban ID HEALTHY ELDERLY MEN; BLOOD-FLOW; MORTALITY; AGE; THIRST; MORBIDITY; RECORDS; STRESS; INJURY; DEATHS AB Introduction: This study describes medical conditions treated in all 47 non-VA hospitals in Cook County, IL during the 1995 heat wave. We characterize the underlying diseases of the susceptible population, with the goal of tailoring prevention efforts. Methods: Primary and secondary discharge diagnoses made during the heat wave and comparison periods were obtained from computerized inpatient hospital discharge data to determine reasons for hospitalization, and comorbid conditions, respectively. Results: During the week of the heat wave, there were 1072 (11%) more hospital admissions than average for comparison weeks and 838 (35%) more than expected among patients aged 65 years and older. The majority of this excess (59%) were treatments for dehydration, heat stroke, and heat exhaustion; with the exception of acute renal failure no other primary discharge diagnoses were significantly elevated. In contrast, analysis of comorbid conditions revealed 23% (p = 0.019) excess admissions of underlying cardiovascular diseases, 30% (p = 0.033) of diabetes, 52% (p = 0.011) of renal diseases, and 20% (p = 0.027) of nervous system disorders. Patient admissions for emphysema (p = 0.007) and epilepsy (p 0.009) were also significantly elevated during the heat wave week. Conclusions: The majority of excess hospital admissions were due to dehydration, heat stroke, and heat exhaustion, among people with underlying medical conditions. Short-term public health interventions to reduce heat-related morbidity should be directed toward these individuals to assure access to air conditioning and adequate fluid intake. Long-term prevention efforts should aim to improve the general health condition of people at risk through, among other things, regular physician-approved exercise. (C) 1999 American Journal of Preventive Medicine. C1 Univ Calif Irvine, Dept Med, Irvine, CA 92697 USA. Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Epiemiol Program Off, Epidem Intelligence Serv, Atlanta, GA USA. Illinois Dept Publ Hlth, Springfield, IL 62761 USA. RP Semenza, JC (reprint author), Univ Calif Irvine, Dept Med, 224 Irvine Hall, Irvine, CA 92697 USA. NR 34 TC 234 Z9 244 U1 3 U2 25 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 269 EP 277 DI 10.1016/S0749-3797(99)00025-2 PG 9 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500001 PM 10493281 ER PT J AU Logan, P Sacks, JJ Branche, CM Ryan, GW Bender, P AF Logan, P Sacks, JJ Branche, CM Ryan, GW Bender, P TI Alcohol-influenced recreational boat operation in the United States, 1994 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE motor boats; alcohol; drowning; accidents; sports AB Background: There were 183 recreational boating fatalities in the United States in 1994. One contributor to this toll is alcohol-influenced operation of boats. Our study objective was to determine the prevalence of alcohol-influenced motor boat operation, and describe its relationship to demographic factors and other risk behaviors. Methods: In 1994, a randomly dialed national telephone survey contacted 5238 adult respondents who reported on their operation of motor boats, alcohol use, and other potential injury risk behaviors. Data were weighted to obtain national estimates and percentages. Results: Of 597 respondents who operated a motor boat in 1994, 31% (206 respondents) reported doing so at least once while alcohol-influenced. Alcohol-influenced operation of a motor boat was significantly more likely among males, individuals between 25 and 34 years of age, and those with greater than a college education. Alcohol-influenced motor boat operation was also more common among those who drove motor vehicles while alcohol-influenced, and those who drove a motor vehicle without using a seat belt. Conclusions: To decrease alcohol-influenced boating, new strategies should be developed. Strategies used to decrease drinking and driving motor vehicles may prove adaptable to preventing alcohol-influenced boating. More effective means of monitoring alcohol-influenced boating is needed. Alcohol use by passengers on boats should not be overlooked as a problem. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, US PHS, Dept Hlth & Human Serv, Atlanta, GA 30341 USA. RP Sacks, JJ (reprint author), Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, US PHS, Dept Hlth & Human Serv, 4770 Buford Highway,NE K-63, Atlanta, GA 30341 USA. NR 16 TC 18 Z9 19 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 278 EP 282 DI 10.1016/S0749-3797(99)00022-7 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500002 PM 10493282 ER PT J AU Dellinger, AM Bolen, J Sacks, JJ AF Dellinger, AM Bolen, J Sacks, JJ TI A comparison of driver- and passenger-based estimates of alcohol-impaired driving SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE alcoholic intoxication; motor vehicles; automobile driving; adult; behavior; United States ID DRINKING; RISK AB Introduction: Persons who drive after drinking or ride with drinking drivers are at increased risk of motor vehicle crash. Although alcohol is involved in 40% of fatal motor vehicle crashes yearly, there exist few systems to monitor alcohol-impaired driving. In this study we compare driver- and passenger-based estimates of the prevalence of alcohol-impaired driving. Design: A random-digit-dialing telephone survey of the United States. Participants were adults aged 18 or older who were English- or Spanish-speaking from 5238 households (response rate = 56.1%). Results: From the 4603 respondents who reported driving in the preceding 30 days, we estimate that there were 126 million drinking-driving episodes in the United States in 1994. From the 4380 passengers in the preceding 30 days, we estimate 191 million episodes. Three percent of respondents self-reported as drinking drivers (4.8% of males and 1.3% of females) and 4.9% as passengers of drinking drivers. Drinking drivers were more likely to be passengers of drinking drivers (44% versus 4% of nondrinking drivers). Drinking drivers were also more than twice as likely to report drinking daily, and only one half as likely to report always wearing their safety belts. Conclusions: Passengers who report riding with a drinking driver may provide an important estimate of the prevalence of drinking driving. Passengers of drinking drivers represent a high-risk group that is not considered in most prevention efforts. Because being a passenger of a drinking driver is not illegal, it may be an easier topic for clinicians to broach than drinking and driving. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Dellinger, AM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, 4770 Buford Highway NE,Mailstop K-63, Atlanta, GA 30341 USA. NR 22 TC 22 Z9 23 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 283 EP 288 DI 10.1016/S0749-3797(98)00094-4 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500003 PM 10493283 ER PT J AU Nelson, DE Powell, K Johnson, CJ Mercy, J Grant-Worley, JA AF Nelson, DE Powell, K Johnson, CJ Mercy, J Grant-Worley, JA TI Household firearm storage practices - Do responses differ by whether or not individuals ever use firearms? SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE firearms; health surveys; interviews; telephone; behavior (risk taking) ID GUN OWNERSHIP; HOME; HANDGUNS; EXPOSURE AB Introduction: The prevalence with which firearms are stored loaded or unlocked has been measured in previous surveys. Our purpose was to compare household firearm storage practices reported by firearm users and nonusers. Methods: We analyzed telephone survey data from the 1992 and 1993 Oregon Behavioral Risk Factor Surveillance System on 2454 randomly selected adults in households with firearms. We compared reported firearm storage practices among persons who ever used firearms with persons who had never used firearms by demographics and type of firearm. Results: Nonusers of firearms were much less likely than firearm users to report that household firearms were always or sometimes stored loaded [odds ratio (OR) = 0.45, 95% confidence interval (CI):0.36-0.54] or stored loaded and unlocked (OR = 0.46, 95% CI: 0.36-0.57), Except for persons aged IS to 34 years and persons in handgun-only households, differences in reported firearm storage practices between nonusers and users varied little by demographic characteristics or by type of firearm. Nonusers of household firearms may be unaware that firearms are stored loaded or stored loaded and unlocked in their homes. Conclusions: Surveys that do not consider firearm use status may underestimate household exposure to loaded firearms or to loaded and unlocked firearms. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Natl Ctr Injury Prevent & Control, Atlanta, GA 30341 USA. Idaho Dept Hlth & Welfare, Boise, ID USA. Oregon Hlth Div, Portland, OR USA. RP Nelson, DE (reprint author), Ctr Dis Control & Prevent, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Natl Ctr Injury Prevent & Control, 4770 Buford Highway NE,Mailstop K30, Atlanta, GA 30341 USA. NR 26 TC 8 Z9 8 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 298 EP 302 DI 10.1016/S0749-3797(98)00096-8 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500005 PM 10493285 ER PT J AU Harbage, B Dean, AG AF Harbage, B Dean, AG TI Distribution of Epi Info software - An evaluation using the Internet SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article DE software; epidemiology; diffusion of innovation; evaluation; Internet; market research; Epi Info ID PUBLIC-HEALTH AB Introduction: Epi Info and Epi Map are computer programs for word processing, database management, epidemiologic statistics, and mapping designed for public health professionals. The programs are in che public domain, and distribution outside the Centers for Disease Control and Prevention (CDC) has been through a variety of informal channels. Methods: Individuals and organizations known to have distributed Epi Info or Epi Map since 1987 provided information. Distributors included CDC, the World Health Organization (WHO), commercial vendors, translators, instructors in university and public health settings, and other public health professionals. Reports documented a minimum number of 145,320 copies distributed. Conclusions: Since 1994, the Internet has become a major means of propagation, accounting for 66% of che copies for which the method of distribution was known. The Internet also was a major information source for this study. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Div Publ Hlth Surveillance & Informat, Epidemiol Program Off, Atlanta, GA 30333 USA. RP Dean, AG (reprint author), Ctr Dis Control & Prevent, Div Publ Hlth Surveillance & Informat, Epidemiol Program Off, Mailstop C08, Atlanta, GA 30333 USA. NR 3 TC 7 Z9 8 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 314 EP 317 DI 10.1016/S0749-3797(98)00101-9 PG 4 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500008 PM 10493288 ER PT J AU Buffington, J Bellamy, PR Dannenberg, AL AF Buffington, J Bellamy, PR Dannenberg, AL TI An elective rotation in applied epidemiology with the Centers for Disease Control and Prevention (CDC), 1975-1997 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review DE education; medical; graduate; public health; practice; education; veterinary; epidemiology ID PUBLIC-HEALTH; UNITED-STATES; SCHOOL; EDUCATION; CHOLERA; SERVICE AB Introduction: To increase awareness of and interest in public health and epidemiology, CDC initiated an elective in epidemiology and public health for senior medical students in 1975 and for veterinary students in 1982. Methods: A review of CDC records to describe participation in the elective, to assess whether students subsequently enrolled in another CDC training program, the Epidemic Intelligence Service (EIS), and, if enrolled, employment status following EIS. A review of documentation of board certification in preventive medicine to determine how many participants later chose this specialty, one indicator of public health and prevention as a career choice. Results: From 1975 through 1997, 632 students participated in the elective. Of these, 438 (69%) were assigned to infectious disease areas, 95 (15%) to environmental health, 59 (9%) to chronic disease, and 40 (7%) to other areas. Students participated in at least 278 official investigations of important public health problems including infectious disease outbreaks, natural disasters, chronic disease problems and access to health care. Of 530 students who had completed the elective through June 1995, 91 (17%) were enrolled in EIS by July 1997. Of 83 completing EIS by July 1997, 65 (78%) had continued in public health careers: 35 with CDC; 17 with local or state health departments; 7 with other federal agencies; 4 in academic public health; and 2 in international health. Of those not enrolling in EIS, at least 5% were certified by the American Board of Preventive Medicine, compared with 34% of those completing EIS. Conclusion: An elective rotation in public health and applied epidemiology is valuable in introducing future physicians and veterinarians to the practice of public health, and can provide important role models for encouragement to pursue careers in public health. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Epidemiol Program Off, Div Appl Publ Hlth Training, Atlanta, GA 30333 USA. RP Bellamy, PR (reprint author), Ctr Dis Control & Prevent, Epidemiol Program Off, Div Appl Publ Hlth Training, Mailstop D-18,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 27 TC 11 Z9 11 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 335 EP 340 DI 10.1016/S0749-3797(99)00028-8 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500012 PM 10493292 ER PT J AU Buffington, J Lyerla, RL Thacker, SB AF Buffington, J Lyerla, RL Thacker, SB TI Nonmedical doctoral-level scientists in the Centers for Disease Control and Prevention's epidemic intelligence service, 1964-1997 SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review DE public health; practice; applied epidemiology; education; graduate AB Introduction: Although historically a training program in applied epidemiology for physicians, veterinarians, and dentists, CDC's Epidemic Intelligence Service (EIS) has been attracting an increasing number of other doctoral-level scientists with prior experience and training in advanced analytic methods. Methods: Using data from alumni records, we studied the participation of these nonmedical scientists in the EIS program and their subsequent employment. Results: 160 nonmedical doctoral level scientists enrolled in EIS from 1964 through 1997; 135 had completed EIS as of July 1997. Of 160 enrolled, 94 (59%) had an advanced degree in epidemiology; other degrees included demography, anthropology, behavioral sciences, statistics, and other health areas; 66% were women. Most (112; 70%) were assigned to work in noninfectious disease areas. After completion of EIS, 113 (84%) of 135 officers continued to work in public health activities: 75 (56%) remained employed at CDC; 17 (13%) in academic institutions; 14 (10%) in local or state health departments; 3 (2%) in international health agencies; 2 (1%) in other federal health agencies; and 2 (1%) in public health foundations. Compared with trainees recruited during 1964-1989, greater proportions of those recruited during 1990-1995 remained employed at CDC (44/74 [59%] versus 31/61 [51%]) or at state or local health departments (10 [14%] versus 4 [7%]). Those training during EIS at a state or Local health department (15/20,75%) or in occupational health (17/24, 71%) were more likely than those in other assignments to work outside CDC following EIS. Conclusion: There is increasing participation and collaboration of persons trained in nonmedical sciences with those trained in traditional medical areas in the EIS training program and in careers in public health at all levels: local, state, and federal. (C) 1999 American Journal of Preventive Medicine. C1 Ctr Dis Control & Prevent, Div Appl Publ Hlth Training, Epidemiol Program Off, Atlanta, GA 30333 USA. RP Buffington, J (reprint author), Ctr Dis Control & Prevent, Div Appl Publ Hlth Training, Epidemiol Program Off, Mailstop G-37,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 12 TC 6 Z9 6 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 341 EP 346 DI 10.1016/S0749-3797(99)00027-6 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500013 PM 10493293 ER PT J AU O'Brien, DG Yasnoff, WA AF O'Brien, DG Yasnoff, WA TI Privacy, confidentiality, and security in information systems of state health agencies SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review DE computer security; confidentiality; public health administration; telecommunications; information systems; computer AB Objectives: To assess the employment and status of privacy, confidentiality, security and fair information practices in electronic information systems of U.S. state health agencies. Methods: A survey instrument was developed and administered to key contacts within the state health agencies of each of the 50 U.S. states, Puerto Rico and the District of Columbia. Results: About a third of U.S. state health agencies have no written policies in place regarding privacy and confidentiality in electronic information systems. The doctrines of fair information practice often seemed to be ignored. One quarter of the agencies reported at least one security breach during the past two years, and 16% experienced a privacy and confidentiality related transgression. Most of the breaches were committed by personnel from within the agencies. Conclusions: These results raise questions about the integrity of existing privacy, confidentiality and security measures in the information systems of U.S. state health agencies. Recommendations include the development and vigorous enforcement of written privacy and confidentiality policies, increased personnel training, and expanded implementation of security measures such as encryption and system firewalls. A discussion of the current status of U.S. privacy, confidentiality and security issues is offered. (C) 1999 American Journal of Preventive Medicine. C1 Life Concerns Inc, Pacific Grove, CA USA. Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Atlanta, GA USA. RP O'Brien, DG (reprint author), 208 Carmel Ave, Pacific Grove, CA 93950 USA. NR 16 TC 14 Z9 14 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 351 EP 358 DI 10.1016/S0749-3797(99)00024-0 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500015 PM 10493295 ER PT J AU Kilbourne, EM AF Kilbourne, EM TI The spectrum of illness during heat waves SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Editorial Material C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. RP Kilbourne, EM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, 4770 Buford Highway F-28, Atlanta, GA 30341 USA. NR 6 TC 28 Z9 28 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 359 EP 360 PG 2 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500016 PM 10493296 ER PT J AU Riley, P Kaplan, JP AF Riley, P Kaplan, JP TI Prevention research centers: The academic and community partnership. (vol 16, pg 5, 1999) SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Correction C1 CDC, Prevent Res Ctr Program, Atlanta, GA 30341 USA. RP Riley, P (reprint author), CDC, Prevent Res Ctr Program, Mailstop E-30,4770 Buford Highway, Atlanta, GA 30341 USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAY PY 1999 VL 16 IS 4 BP 373 EP 373 PG 1 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 198MG UT WOS:000080427500021 ER PT J AU Yusuf, HR Rochat, RW Baughman, WS Gargiullo, PM Perkins, BA Brantley, MD Stephens, DS AF Yusuf, HR Rochat, RW Baughman, WS Gargiullo, PM Perkins, BA Brantley, MD Stephens, DS TI Maternal cigarette smoking and invasive meningococcal disease: A cohort study among young children in metropolitan Atlanta, 1989-1996 SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID LOS-ANGELES-COUNTY; NEISSERIA-MENINGITIDIS; BACTERIAL-MENINGITIS; TOBACCO-SMOKE; COMMUNICABLE DISEASES; PARENTAL SMOKING; UNITED-STATES; RISK-FACTORS; CARRIAGE; POPULATION AB Objectives. This study assessed the association between maternal cigarette smoking during pregnancy and the risk of invasive meningococcal disease during early childhood. Methods. Using a retrospective cohort stud design, cases from an active surveillance project monitoring all invasive meningococcal disease in the metropolitan Atlanta area from 1989 to 1995 were merged with linked birth and death certificate data files. Children who had not died or acquired meningococcal disease were assumed to be alive and free of the illness. The Cox proportional hazards analysis was used to assess the independent association between maternal smoking and meningococcal disease. Results. The crude rate of meningococcal disease was 5 times higher for children whose mothers smoked during pregnancy than for children whose mothers did not smoke (0.05% vs. 0.01%). Multivariate analysis revealed that maternal smoking (risk ratio [RR] = 2.9; 95% confidence interval [CI] = 1.5, 5.7) and a mother's having fewer than 12 years of education (RR = 2.1; 95% CI = 1.0 4.2) were independently associated with invasive meningococcal disease. Conclusions. Maternal smoking, a likely surrogate for tobacco smoke exposure following delivery, appears to be a modifiable risk factor for sporadic meningococcal disease in young children. C1 Georgia Dept Human Resources, Div Publ Hlth, Off Perinatal Epidemiol, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Reprod Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. Vet Affairs Med Ctr, Atlanta, GA 30033 USA. Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Atlanta, GA USA. RP Yusuf, HR (reprint author), Ctr Dis Control & Prevent, Natl Immunizat Program, Mailstop E-52,4770 Buford Hwy, Atlanta, GA 30341 USA. RI Stephens, David/A-8788-2012; Rochat, Roger/J-9802-2012 NR 51 TC 27 Z9 27 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAY PY 1999 VL 89 IS 5 BP 712 EP 717 DI 10.2105/AJPH.89.5.712 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189RL UT WOS:000079919600011 PM 10224983 ER PT J AU Coughlin, SS Katz, WH Mattison, DR AF Coughlin, SS Katz, WH Mattison, DR CA Assoc Sch Public Hlth Educ Comm TI Ethics instruction at schools of public health in the United States SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID EPIDEMIOLOGY; CURRICULA AB Objectives. A survey of US schools of public health was undertaken in 1996 and 1997 to obtain a general picture of public health ethics curricula. Methods. An explanatory letter with a list of questions for discussion was sent to the deans of the accredited US schools of public health. The deans were asked that at least 1 individual at their school who is most knowledgeable about ethics curricula review the list of questions and complete an ethics survey contact form. Results. Ethics instruction was required for all students at only 1 (4%) of the 24 schools surveyed, while 7 schools required ethics instruction for some students. Two of the schools had no ethics courses. Ethics instruction was required for all MPH students at 9 (38%) of the schools and for all doctoral students at 4 (17%) of the schools. Most of the schools (19 of 24, or 79%) offered short coursed, seminar series, or invited lectures on ethical topics, and 23 (96%) included lectures on ethics topics in other courses such as health law. Conclusions. Training programs at US schools of public health vary greatly in how much attention is given to ethics instruction. Model curricula in public health ethics should be developed to help fill this gap. C1 Tulane Univ, Sch Publ Hlth & Trop Med, Dept Biostat & Epidemiol, Program Publ Hlth Eth, New Orleans, LA USA. Assoc Sch Publ Hlth, Washington, DC USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. RP Coughlin, SS (reprint author), Ctr Dis Control & Prevent, Epidemiol & Hlth Serv Res Branch, Div Canc Prevent & Control, 4770 Buford Hwy,NE K-55, Atlanta, GA 30341 USA. RI Mattison, Donald/C-2015-2009; Mattison, Donald/L-4661-2013 OI Mattison, Donald/0000-0001-5623-0874 NR 13 TC 28 Z9 29 U1 0 U2 3 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAY PY 1999 VL 89 IS 5 BP 768 EP 770 DI 10.2105/AJPH.89.5.768 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189RL UT WOS:000079919600022 PM 10224994 ER PT J AU Novotny, TE Seward, J Sun, RK Acree, K AF Novotny, TE Seward, J Sun, RK Acree, K TI The "sausage factory" tour of the legislative process: An interactive orientation SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article C1 Ctr Dis Control & Prevent, Publ Hlth Practice Program Off, Atlanta, GA USA. Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA. Lawrence Livermore Natl Lab, Livermore, CA USA. Calif Dept Hlth Serv, Sacramento, CA USA. RP Novotny, TE (reprint author), World Bank, Human Dev Network, Room G-3075,1818 H St NW, Washington, DC 20433 USA. EM tnovotny@worldbank.org FU NHLBI NIH HHS [HR95-265P] NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAY PY 1999 VL 89 IS 5 BP 771 EP 773 DI 10.2105/AJPH.89.5.771 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189RL UT WOS:000079919600023 PM 10224995 ER PT J AU Buehler, JW AF Buehler, JW TI Abandoning race as a variable in public health research SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter C1 Georgia Div Publ Hlth, Perinatal Epidemiol Unit, Atlanta, GA 30303 USA. Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA USA. RP Buehler, JW (reprint author), Georgia Div Publ Hlth, Perinatal Epidemiol Unit, 2 Peachtree St NW,Suite 4-522 Annex, Atlanta, GA 30303 USA. NR 2 TC 9 Z9 9 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAY PY 1999 VL 89 IS 5 BP 783 EP 783 DI 10.2105/AJPH.89.5.783 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189RL UT WOS:000079919600027 PM 10224999 ER PT J AU Laserson, KF Wypij, D Petralanda, I Spielman, A Maguire, JH AF Laserson, KF Wypij, D Petralanda, I Spielman, A Maguire, JH TI Differential perpetuation of malaria species among Amazonian Yanomami Amerindians SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID PLASMODIUM-FALCIPARUM MALARIA; MEROZOITE SURFACE-ANTIGEN; TRANSMISSION DYNAMICS; ANTIBODIES; REGION AB To determine whether malaria perpetuates within isolated Amerindian villages in the Venezuelan Amazon, we surveyed malaria infection and disease among 1,311 Yanomami in three communities during a 16-month period. Plasmodium vivax was generally present in each of these small, isolated villages; asymptomatic infection was frequent, and clinical disease was most evident among children less than five years of age (odds ratio [OR] = 6.3, 95% confidence interval [CI] = 1.4-29.2) and among persons experiencing parasitemias greater than or equal to 1,000 parasites/mm(3) of blood (OR = 45.0, 95% CI = 5.5-370.7). Plasmodium falciparum, in contrast, was less prevalent, except during an abrupt outbreak in which 72 infections resulted in symptoms in all age groups and at all levels of parasitemia, and occasionally were life-threatening. The observed endemic pattern of P. vivax infection may derive from the capacity of this pathogen to relapse, while the epidemic pattern of P. falciparum infection may reflect occasional introductions of strains carried by immigrants or residents of distant villages and the subsequent disappearance of this non-relapsing pathogen. C1 Harvard Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02115 USA. Harvard Univ, Sch Publ Hlth, Dept Immunol & Infect Dis, Boston, MA 02115 USA. Asoc Civil Invest & Control Endemias Amazonicas, San Antonio AP83, Venezuela. RP Laserson, KF (reprint author), Ctr Dis Control & Prevent, Mailstop E-10,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 39 TC 14 Z9 14 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 USA SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD MAY PY 1999 VL 60 IS 5 BP 767 EP 773 PG 7 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 198TE UT WOS:000080439600010 PM 10344650 ER PT J AU Duewer, DL Kline, MC Sharpless, KE Thomas, JB Gary, KT AF Duewer, DL Kline, MC Sharpless, KE Thomas, JB Gary, KT TI Micronutrients measurement quality assurance program: Helping participants use interlaboratory comparison exercise results to improve their long-term measurement performance SO ANALYTICAL CHEMISTRY LA English DT Article ID NOMENCLATURE AB Over the past decade, the Micronutrients Measurement Quality Assurance Program (M(2)QAP) at the National Institute of Standards and Technology (NIST) has administered nearly 40 interlaboratory comparison exercises devoted to fat-soluble vitamin-related analytes in human serum, While M(2)QAP studies have been used to help certify reference materials and to document the performance of analytical systems, the primary focus of the M(2)QAP has been, and remains, the improvement of amongparticipant measurement comparability for target analytes. Recent analysis of historical measurement performance indicated the most efficient mechanism for further improving measurement comparability among participants is the improvement of long-term (months to years) comparability within each laboratory. The summary reports for the M(2)QAP studies are being redesigned to provide more chemist-friendly analyses of participant performance, dissecting systematic and random components of measurement incomparability as functions of analyte level and time. This report documents the semantic and graphical tools developed to help interlaboratory-comparison-exercise participants interpret their own measurement performance. C1 Natl Inst Stand & Technol, Chem Sci & Technol Lab, Gaithersburg, MD 20899 USA. Ctr Dis Control & Prevent, Nutr Biochem Branch, Atlanta, GA 30341 USA. RP Duewer, DL (reprint author), Natl Inst Stand & Technol, Chem Sci & Technol Lab, Gaithersburg, MD 20899 USA. RI Duewer, David/B-7410-2008; OI Sharpless, Katherine/0000-0001-6569-198X NR 20 TC 14 Z9 14 U1 2 U2 4 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0003-2700 J9 ANAL CHEM JI Anal. Chem. PD MAY 1 PY 1999 VL 71 IS 9 BP 1870 EP 1878 DI 10.1021/ac981074k PG 9 WC Chemistry, Analytical SC Chemistry GA 192QP UT WOS:000080090700045 PM 10330911 ER PT J AU Talan, DA Moran, GJ Pinner, RW AF Talan, DA Moran, GJ Pinner, RW TI Updated rabies postexposure prophylaxis guidelines (Reprinted from MMWR, vol 48, pg 1, 1999) SO ANNALS OF EMERGENCY MEDICINE LA English DT Reprint ID GUILLAIN-BARRE-SYNDROME; DIPLOID CELL STRAIN; UNITED-STATES; BETA-PROPIOLACTONE; VACCINE; EXPOSURE; SURVEILLANCE; IMMUNIZATION; CULTURE; IMMUNOGENICITY C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Talan, DA (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 76 TC 1 Z9 1 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD MAY PY 1999 VL 33 IS 5 BP 590 EP 597 PG 8 WC Emergency Medicine SC Emergency Medicine GA 194PQ UT WOS:000080203100016 ER PT J AU Breslow, RA Wideroff, L Graubard, BI Erwin, D Reichman, ME Ziegler, RG Ballard-Barbash, R AF Breslow, RA Wideroff, L Graubard, BI Erwin, D Reichman, ME Ziegler, RG Ballard-Barbash, R TI Alcohol and prostate cancer in the NHANES I epidemiologic follow-up study SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE alcohol; prostate cancer; Cohort study ID RISK-FACTORS; SAMPLING DESIGN; UNITED-STATES; MEN; CONSUMPTION; DIET; POPULATION; SMOKING; NUTRITION; ETHANOL AB PURPOSE: We prospectively investigated the association between alcohol consumption and prostate cancer In the Epidemiologic Followup Study (NHEFS) of the first National Health and Nutrition Examination Survey (NHANES I). METHODS: There were two cohorts: 1) Cohort I, followed from baseline (1971-15) through 1992, included 5766 men ages 25-74 years (median follow-up = 17 years); and 2) Cohort II, followed from the first follow-up round for Cohort I (1982-84) through 1992, included the 3868 men in Cohort I free of prostate cancer in 1982-84 (median follow-up = 9 years). Alcohol consumption was assessed at baseline as usual consumption, and at follow-up as usual consumption and as distant past consumption at. the ages of 25, 35, 45, and 55. RESULTS: There were 252 incident cases of prostate cancer. Consistent with most previous studies, we found no significant associations between usual total alcohol consumption and prostate cancer in Cohorts I or II If, = non significant (NS)I, except for a significant inverse association at the heaviest level of drinking in Cohort II [relative risk (RR) = 0.23, 95% confidence interval (CI) = 0.06-0.95]. Further study of heavy drinkers in Cohort II revealed significant inverse associations between distant past heavy drinking (defined as > 25 drinks/week)and prostate cancer at age 25 (RR = 0.20, 95% CI = 0.06-0.63), age 35 (RR = 0.30, 95% CI = 0.12-0.77), and age 45(RR = 0.39, 95% CI = 0.17-0.93), but not at: age 55 (RR = 0.43, 95% CI = 0.17-1.10). CONCLUSIONS: These results suggest that it may be important to consider distant past alcohol consumption in etiologic studies of prostate cancer. However, our results were based on small numbers of cases who were heavy drinkers and require replication. C1 NCI, Appl Res Branch, Div Canc Prevent & Control, Bethesda, MD 20892 USA. NCI, Div Canc Epidemiol & Genet, Biostat Branch, Bethesda, MD 20892 USA. Informat Management Serv, Rockville, MD USA. ROW Associates, Rockville, MD USA. RP Breslow, RA (reprint author), Ctr Dis Control & Prevent, 4770 Buford Hwy,MS k-55, Atlanta, GA 30341 USA. RI Hernandez, Jessica/G-6527-2011 NR 70 TC 35 Z9 36 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD MAY PY 1999 VL 9 IS 4 BP 254 EP 261 DI 10.1016/S1047-2797(98)00071-4 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 192CX UT WOS:000080061600005 PM 10332931 ER PT J AU Guillette, LJ Brock, JW Rooney, AA Woodward, AR AF Guillette, LJ Brock, JW Rooney, AA Woodward, AR TI Serum concentrations of various environmental contaminants and their relationship to sex steroid concentrations and phallus size in juvenile American alligators SO ARCHIVES OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY LA English DT Article ID GREAT-LAKES; POLYCHLORINATED-BIPHENYLS; CHEMICALS; MORTALITY; FLORIDA; MISSISSIPPIENSIS; WILDLIFE; RESIDUES; FISH; EGGS AB Recent studies have reported a number of abnormalities in the hatchling and juvenile alligators of Lake Apopka, FL (USA). These abnormalities include modifications of plasma concentrations of sex steroids in males and females as well as abnormalities in gonadal morphology, gonadal enzyme activity, and steroidogenesis. Embryonic exposure to environmental contaminants in the eggs has been hypothesized to be the causal agent for these changes. However, posthatchling exposure can also contribute to changes in reproductive and endocrine functioning. We have detected serum concentrations of 16 of 18 organochlorine pesticides or metabolites (OCs) and 23 of 28 congener-specific polychlorinated biphenyls (PCBs) examined in juvenile alligators from Lake Apopka, Orange Lake, and Lake Woodruff National Wildlife Refuge. Lake Apopka juveniles had significantly elevated serum concentrations of p,p'-DDE, dieldrin, endrin, mirex, oxychlordane, Sigma DDTs, and Sigma PCBs compared to juveniles from the other lakes. Further, we observed no correlations between serum contaminant concentrations and sex steroid concentrations (estradiol-17 beta and testosterone). However, serum testosterone was significantly lower in males from Lake Apopka and Orange Lake compared to Lake Woodruff NWR. We did not observe relationships between phallus size or other body parameters and serum contaminant levels. Phallus size was smaller in males from Lake Apopka even after adjustment for body size. We suggest that the observations previously reported for juvenile alligators-and observed again in this study-are apparently not associated with the current serum levels of the environmental contaminants we measured, but could be due to exposures during embryonic development to these or other pollutants. Future studies must determine if a causal relationship exists between the contaminants found in alligator eggs and abnormalities observed in the hatchlings and persisting in juveniles. C1 Univ Florida, Dept Zool, Gainesville, FL 32611 USA. CDC, Natl Ctr Environm Hlth, Div Environm Hlth Lab Sci, Atlanta, GA 30341 USA. Florida Game & Fresh Water Fish Commiss, Wildlife Res Lab, Gainesville, FL 32601 USA. RP Guillette, LJ (reprint author), Univ Florida, Dept Zool, 223 Bartram Hall, Gainesville, FL 32611 USA. NR 41 TC 129 Z9 136 U1 1 U2 11 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0090-4341 J9 ARCH ENVIRON CON TOX JI Arch. Environ. Contam. Toxicol. PD MAY PY 1999 VL 36 IS 4 BP 447 EP 455 PG 9 WC Environmental Sciences; Toxicology SC Environmental Sciences & Ecology; Toxicology GA 189XL UT WOS:000079931400011 PM 10227864 ER PT J AU Behets, FMT Brathwaite, AR Hylton-Kong, T Chen, CY Hoffman, I Weiss, JB Morse, SA Dallabetta, G Cohen, MS Figueroa, JP AF Behets, FMT Brathwaite, AR Hylton-Kong, T Chen, CY Hoffman, I Weiss, JB Morse, SA Dallabetta, G Cohen, MS Figueroa, JP TI Genital ulcers: Etiology, clinical diagnosis, and associated human immunodeficiency virus infection in Kingston, Jamaica SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID SEXUALLY-TRANSMITTED DISEASE; SOUTH-AFRICA; PREVALENCE; HERPES; DURBAN; SEX AB Individuals presenting consecutively with genital ulcers in Kingston, Jamaica, underwent serological testing for human immunodeficiency virus (HIV) infection, chlamydial infection, and syphilis. Ulcer material was analyzed by multiplex polymerase chain reaction (M-PCR) analysis. DNA ti om herpes simplex virus (HSV), Haemophilus ducreyi, and Treponema pallidum was detected ia 158 (52.0%), 72 (23.7%), and 31 (10.2%) of 304 ulcer specimens. Of the 304 subjects, 67 (22%) were HIV-seropositive and 64 (21%) were T. pallidum-seroreactive. Granuloma inguinale was clinically diagnosed in nine (13.4%) of 67 ulcers negative by M-PCR analysis and in 12 (5.1%) of 237 ulcers positive by M-PCR analysis (P = .03). Lymphogranuloma venereum was clinically diagnosed in eight patients. Compared with M-PCR analysis, the sensitivity and specificity of a clinical diagnosis of syphilis, herpes, and chancroid were 67.7%, 53.8%, and 75% and 91.2%, 83.6%, and 75.4%, respectively, Reactive syphilis serology was 74% sensitive and 85% specific compared with M-PCR analysis. Reported contact with a prostitute in the preceding 3 months was associated with chancroid (P = .009), reactive syphilis serology (P = .011), and HIV infection (P = .007). The relatively poor accuracy of clinical and locally available laboratory diagnoses pleads for syndromic management of genital ulcers in Jamaica. Prevention efforts should be intensified. C1 Univ N Carolina, Dept Med, Chapel Hill, NC USA. Yale Univ, Sch Publ Hlth, New Haven, CT USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Roche Mol Syst, Alameda, CA USA. Family Hlth Int, AIDS Control & Prevent Project, Arlington, VA USA. Minist Hlth, Epidemiol Unit, Kingston, Jamaica. RP Behets, FMT (reprint author), 75 Cottage St, New Haven, CT 06511 USA. FU NIDA NIH HHS [DA09531-01A2] NR 20 TC 42 Z9 43 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1086 EP 1090 DI 10.1086/514751 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800021 PM 10452639 ER PT J AU Harrison, LH Halsey, NA McKee, KT Peters, CJ Oro, JGB Briggiler, AM Feuillade, MR Maiztegui, JI AF Harrison, LH Halsey, NA McKee, KT Peters, CJ Oro, JGB Briggiler, AM Feuillade, MR Maiztegui, JI TI Clinical case definitions for Argentine hemorrhagic fever SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID JUNIN VIRUS ACTIVITY; EFFICACY; VACCINE AB Argentine hemorrhagic fever (AHF) is a potentially lethal infection in Argentina. The case-fatality ratio is >15%, but treatment reduces the mortality rate to <1%. Diagnosis is based on clinical and laboratory criteria, but no case definition has been validated. A chart review was conducted for patients hospitalized with suspected AHF. Individuals with a fourfold rise in antibody titer were classified as cases. The combination of a platelet count of <100,000/mm(3) and a white blood cell (WBC) count of <2,500/mm(3) had a sensitivity and specificity of 87% and 88%, respectively, thus suggesting that the use of these criteria in a cane definition would be helpful for epidemiological studies of AHF. The combination of a platelet count of <100,000/mm(3) and a WBC count of <4,000/mm(3) had a sensitivity of 100% and a specificity of 71%; the use of these criteria in a case definition should be helpful for screening patients for therapy with immune plasma in the region where AHF is endemic. C1 Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15261 USA. Salk Inst, Govt Serv Div, N Swiftwater, PA USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD USA. Womack Army Med Ctr, Prevent Med Serv, Ft Bragg, NC USA. Ctr Dis Control & Prevent, Special Pathogens Branch, Div Viral Dis, Atlanta, GA USA. Inst Nacl Estud Virosis Hemorragicas, Inst Nacl Enfermedades Virales Humanas Julio I Ma, Pergamino, Argentina. RP Harrison, LH (reprint author), Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, 521 Parran Hall,130 DeSoto St, Pittsburgh, PA 15261 USA. NR 21 TC 43 Z9 45 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1091 EP 1094 DI 10.1086/514749 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800022 PM 10452640 ER PT J AU Dworkin, MS Sullivan, PS Buskin, SE Harrington, RD Olliffe, J MacArthur, RD Lopez, CE AF Dworkin, MS Sullivan, PS Buskin, SE Harrington, RD Olliffe, J MacArthur, RD Lopez, CE TI Bordetella bronchiseptica infection in human immunodeficiency virus-infected patients SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 12th International Conference on AIDS CY JUN, 1998 CL GENEVA, SWITZERLAND ID AIDS PATIENT; PNEUMONIA; BACTEREMIA; BRONCHITIS; LEUKEMIA; RABBITS; CATS; PIGS AB Bordetella bronchiseptica is a pleomorphic gram-negative coccobacillus that commonly causes respiratory tract infections in dogs. We identified nine human immunodeficiency virus (HIV)infected persons with culture-confirmed B. bronchiseptica infections (eight respiratory tract and one disseminated infection). The respiratory illnesses ranged in severity from mild upper respiratory tract infection to pneumonia. All nine patients had had at least one AIDS-defining condition before the B. bronchiseptica infection. Two patients had household contact with dogs before their illnesses, and one had household contact with cats. Infection due to B. bronchiseptica is uncommon in HIV-infected persons. Additional data are needed to fully define the spectrum of disease due to B. bronchiseptica infections and to evaluate the possibility that this infection may be acquired from pets. Treatment of B. bronchiseptica infection should be tailored to the patient and should be based on the results of susceptibility testing. C1 Ctr Dis Control & Prevent, Natl Ctr HIV STD & TB Prevent, Div HIV AIDS Prevent Surveillance & Epidemiol, Atlanta, GA USA. Seattle King Cty Dept Publ Hlth, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. Wayne State Univ, Detroit, MI USA. Atlanta Infect Dis Grp, Atlanta, GA USA. RP Dworkin, MS (reprint author), Ctr Dis Control & Prevent, Div HIV AIDS Surveillance & Epidemiol, Mailstop E-47, Atlanta, GA 30333 USA. RI Sullivan, Patrick/A-9436-2009; OI Sullivan, Patrick/0000-0002-7728-0587 NR 39 TC 55 Z9 58 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1095 EP 1099 DI 10.1086/514761 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800023 PM 10452641 ER PT J AU Fridkin, SK Edwards, JR Pichette, SC Pryor, ER McGowan, JE Tenover, FC Culver, DH Gaynes, RP AF Fridkin, SK Edwards, JR Pichette, SC Pryor, ER McGowan, JE Tenover, FC Culver, DH Gaynes, RP TI Determinants of vancomycin use in adult intensive care units in 41 United States hospitals SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID RESISTANT STAPHYLOCOCCUS-AUREUS; UNIVERSITY MEDICAL-CENTER; ANTIMICROBIAL-RESISTANCE; NOSOCOMIAL INFECTIONS; KLEBSIELLA-PNEUMONIAE; EPIDEMIOLOGY; ENTEROCOCCI; GUIDELINES; STRATEGIES; PREVENTION AB We analyzed data from a prospective observational cohort study that included 108 adult intensive care units (ICUs) in 41 United States hospitals. Use of vancomycin (defined daily doses per 1,000 patient-days), nosocomial infection rates, and proportion of all Staphylococcus aureus isolates resistant to methicillin (MRSA rate) were recorded from January 1996 through November 1997, The median rate of vancomycin use was lowest in coronary care ICUs and highest in general surgical ICUs, Prior approval before use of vancomycin was required in only 26 (24%) of the 108 ICUs. In a multivariate linear regression model, rates of MRSA, central line-associated bloodstream infection, and the type of ICU were independent predictors of vancomycin use. None of the vancomycin control practices was associated with lower rates of vancomycin use; however, it is important to recognize that this database was not designed to measure rates of inappropriate use. Vancomycin use is heavily determined by rates of endemic MRSA and central line-associated bloodstream infection. Efforts to reduce these rates through infection control activities should be included in hospitals' efforts to reduce vancomycin use. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA USA. RP Fridkin, SK (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, MS E-55,1600 Clifton Rd, Atlanta, GA 30333 USA. RI mcgowan jr, john/G-5404-2011 NR 44 TC 44 Z9 45 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1119 EP 1125 DI 10.1086/514752 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800027 PM 10452645 ER PT J AU McMahon, BJ Parkinson, AJ Rudolph, K Davidson, M Grabman, J AF McMahon, BJ Parkinson, AJ Rudolph, K Davidson, M Grabman, J TI Sepsis due to Streptococcus pneumoniae in a patient with alcoholism who received pneumococcal vaccine SO CLINICAL INFECTIOUS DISEASES LA English DT Article C1 Ctr Dis Control & Prevent, Arctic Invest Program, Natl Ctr Infect Dis, Anchorage, AK 99508 USA. US Publ Hlth Serv, Dept Internal Med, Alaska Nat Ctr, Indian Hlth Serv,Dept Hlth & Human Serv, Anchorage, AK USA. RP McMahon, BJ (reprint author), Ctr Dis Control & Prevent, Arctic Invest Program, Natl Ctr Infect Dis, 4055 Tudor Ctr Dr, Anchorage, AK 99508 USA. NR 8 TC 4 Z9 4 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1162 EP 1163 DI 10.1086/517764 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800037 PM 10452655 ER PT J AU Curlin, ME Barat, LM Walsh, DK Granger, DL AF Curlin, ME Barat, LM Walsh, DK Granger, DL TI Noncardiogenic pulmonary edema during vivax malaria SO CLINICAL INFECTIOUS DISEASES LA English DT Article C1 Univ Med Ctr, Salt Lake City, UT USA. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA USA. St Agnes Hosp, Div Infect Dis, Baltimore, MD USA. RP Granger, DL (reprint author), Room 4B333-SOM,50 N Med Dr, Salt Lake City, UT 84132 USA. NR 6 TC 20 Z9 23 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 SOUTH WOODLAWN AVE, CHICAGO, IL 60637-1603 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAY PY 1999 VL 28 IS 5 BP 1166 EP 1167 DI 10.1086/517767 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190HB UT WOS:000079955800040 PM 10452658 ER PT J AU Richards, MJ Edwards, JR Culver, DH Gaynes, RP AF Richards, MJ Edwards, JR Culver, DH Gaynes, RP CA Natl Nosocomial Infect Surveillance System TI Nosocomial infections in medical intensive care units in the United States SO CRITICAL CARE MEDICINE LA English DT Article DE epidemiology; cross-infection; risk factors; bacteremia; pneumonia; urinary tract infections; microbiology; bacteriology; fungal infections ID SURVEILLANCE-SYSTEM; EPIDEMIOLOGY AB Objective: To describe the epidemiology of nosocomial infections in medical intensive care units (ICUs) in the United States. Design: Analysis of ICU surveillance data collected through the National Nosocomial infections Surveillance (NNIS) System between 1992 and 1997. Setting: Medical ICUs in the United States. Patients: A total of 181,993 patients. Measurements and Main Results: Nosocomial infections were analyzed by infection site and pathogen distribution. Urinary tract infections were most frequent (31%), followed by pneumonia (27%) and primary bloodstream infections (19%). Eighty-seven percent of primary bloodstream infections were associated with central lines, 86% of nosocomial pneumonia was associated with mechanical ventilation, and 95% of urinary tract infections were associated with urinary catheters. Coagulase-negative staphylococci (36%) were the most common bloodstream infection isolates, followed by enterococci (16%) and Staphylococcus aureus (13%). Twelve percent of bloodstream isolates were fungi. The most frequent isolates from pneumonia were Gram negative aerobic organisms (64%). Pseudomonas aeruginosa (21%) was the most frequently isolated of these. S. aureus (20%) was isolated with similar frequency. Candida albicans was the most common single pathogen isolated from urine and made up just over half of the fungal isolates. Fungal urinary infections were associated with asymptomatic funguria rather than symptomatic urinary tract infections (p < .0001). Certain pathogens were associated with device use: coagulase-negative staphylococci with central lines, P. aeruginosa and Acinetobacter species with ventilators, and fungal infections with urinary catheters. Patient nosocomial infection rates for the major sites correlated strongly with device use. Device exposure was controlled for by calculating device associated infection rates for bloodstream infections, pneumonia, and urinary tract infections by dividing the number of device associated infections by the number of days of device use. There was no association between these device associated infection rates and number of hospital beds, number of ICU beds, or length of stay. There is a considerable variation within the distribution of each of these infection rates. Conclusions: The distribution of sites of infection in medical ICUs differed from that previously reported in NNIS ICU surveillance studies, largely as a result of anticipated low rates of surgical site infections. Primary bloodstream infections, pneumonia, and urinary tract infections associated with invasive devices made up the great majority of nosocomial infections. Coagulase negative staphylococci were more frequently associated with primary bloodstream infections than reported from NNIS ICUs of all types in the 1980s, and enterococci were a more frequent isolate from bloodstream infections than S. aureus. Fungal urinary tract infections, often asymptomatic and associated with catheter use, were considerably more frequent than previously reported. Invasive device associated infections were associated with specific pathogens. Although device-associated site-specific infection rates are currently our most useful rates for performing comparisons between ICUs, the considerable variation in these rates between ICUs indicates the need for further risk adjustment. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Gaynes, RP (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Mail Stop E55,1600 Clifton Rd NE, Atlanta, GA 30333 USA. NR 22 TC 847 Z9 905 U1 3 U2 40 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0090-3493 J9 CRIT CARE MED JI Crit. Care Med. PD MAY PY 1999 VL 27 IS 5 BP 887 EP 892 DI 10.1097/00003246-199905000-00020 PG 6 WC Critical Care Medicine SC General & Internal Medicine GA 201QM UT WOS:000080606600017 PM 10362409 ER PT J AU Bernard, AM Anderson, L Cook, CB Phillips, LS AF Bernard, AM Anderson, L Cook, CB Phillips, LS TI What do internal medicine residents need to enhance their diabetes care? SO DIABETES CARE LA English DT Article ID URBAN AFRICAN-AMERICANS; HEALTH; MANAGEMENT; QUALITY; NEPHROPATHY; MELLITUS; DISEASE; THERAPY; PROGRAM; SYSTEM AB OBJECTIVE - To identify areas that should be targeted for improvement in care, we examined internal medicine resident practice patterns and beliefs regarding diabetes in a large urban hospital outpatient clinic. RESEARCH DESIGN AND METHODS - Internal medicine residents were surveyed to assess the frequency at which they performed key diabetes quality of care indicators. Responses were compared with recorded performance derived from chart and laboratory database reviews. Resident attitudes about diabetes were determined using the Diabetes Attitude Survey for Practitioners. Finally, an eight-item scale was used to assess barriers to diabetes care. RESULTS - Both self-described and recorded performance of recommended diabetes services fell short of national recommendations. For yearly eye examinations and lipid screening, recorded performance levels were similar to trainees' reports. However, documented inquiries about patient self-monitoring of blood glucose, performance of foot examinations, and urine protein screening were lower than trainees' reports. Some 49% of the residents selected a target HbA(1c) of 6.6-7.5% as an attainable goal, yet half of the patients using oral agents or insulin had HbA(1c) values >8.0%. No differences in self-described or recorded performance were found by year of training. Most residents did not perceive themselves to need additional training related to diabetes care, and residents were generally neutral about patient autonomy. Patient nonadherence and time constraints within the clinic were most often cited as barriers to care. CONCLUSIONS - The study identifies several areas that require improvement in resident care of diabetes in the ambulatory setting. Because experience during training contributes to future practice patterns, developing a program that teaches trainees how to implement diabetes practice guidelines and methods to achieve optimal glycemic control may be key to future improvements in the quality of diabetes care. C1 Emory Univ, Sch Med, Dept Med, Div Endocrinol & Metab,Diabet Unit, Atlanta, GA 30303 USA. Emory Univ, Sch Med, Dept Med, Div Gen Med, Atlanta, GA 30303 USA. Ctr Dis Control & Prevent, Div Adult & Community Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA. RP Cook, CB (reprint author), Emory Univ, Sch Med, Dept Med, Div Endocrinol & Metab,Diabet Unit, 69 Butler St SE, Atlanta, GA 30303 USA. FU AHRQ HHS [HS-09722]; NIDDK NIH HHS [DK-48124] NR 34 TC 36 Z9 36 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD MAY PY 1999 VL 22 IS 5 BP 661 EP 666 DI 10.2337/diacare.22.5.661 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 192WP UT WOS:000080102900002 PM 10332662 ER PT J AU Kieffer, EC Martin, JA Herman, WH AF Kieffer, EC Martin, JA Herman, WH TI Impact of maternal nativity on the prevalence of diabetes during pregnancy among US ethnic groups SO DIABETES CARE LA English DT Article ID MEXICAN-AMERICANS; SOCIOECONOMIC-STATUS; GLUCOSE-TOLERANCE; GLOBAL BURDEN; RISK-FACTORS; MELLITUS; OBESITY; WOMEN; COMPLICATIONS; ACCULTURATION AB OBJECTIVE - This study examines the impact of maternal nativity (birthplace) on the overall prevalence of diabetes during pregnancy and among 15 racial and ethnic groups in the U.S. RESEARCH DESIGN AND METHODS - Birth certificate data for all resident single live births in the U.S. from 1994 to 1996 were used to calculate reported diabetes prevalence during pregnancy and to assess the impact of maternal birthplace outside of the 50 states and Washington, DC, on the risk of diabetes before and after adjustment for differences in maternal age, other sociodemographic characteristics, and late or no initiation of prenatal care overall and for each racial and ethnic group. RESULTS - Mothers born outside of the U.S. are significantly more likely to have diabetes during pregnancy. The impact of maternal nativity on diabetes prevalence is largely explained by the older childbearing age of immigrant mothers. However, adjusted diabetes risk remains elevated for Asian-Indian, non-Hispanic black, Filipino, Puerto Rican, and Central and South American mothers who were born outside the U.S. Conversely, birthplace outside the U.S. significantly reduces diabetes risk for Japanese, Mexican, and Native American women. CONCLUSIONS - Identification, treatment, and follow-up of immigrant mothers with diabetes during pregnancy may require special attention to language and sociocultural barriers to effective care. Systematic surveillance of the prevalence and impact of diabetes during pregnancy for immigrant and nonimmigrant women, particularly in racial and ethnic minority groups, and more detailed studies on the impact of acculturation on diabetes may increase understanding of the epidemiology of diabetes during pregnancy in our increasingly diverse society. C1 Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, Ann Arbor, MI 48109 USA. Univ Michigan, Sch Med, Ann Arbor, MI USA. Ctr Dis Control & Prevent, Natl Ctr Hlth Stat, Hyattsville, MD 20782 USA. RP Kieffer, EC (reprint author), Univ Michigan, Sch Publ Hlth, Dept Hlth Behav & Hlth Educ, 1420 Washington Hts, Ann Arbor, MI 48109 USA. NR 39 TC 35 Z9 35 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD MAY PY 1999 VL 22 IS 5 BP 729 EP 735 DI 10.2337/diacare.22.5.729 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 192WP UT WOS:000080102900013 PM 10332673 ER PT J AU Liburd, LC Anderson, LA Edgar, T Jack, L AF Liburd, LC Anderson, LA Edgar, T Jack, L TI Body size and body shape: Perceptions of black women with diabetes SO DIABETES EDUCATOR LA English DT Article ID FAT DISTRIBUTION; MODERATE EXERCISE; AFRICAN-AMERICAN; OBESITY; ATTITUDES; BEHAVIORS; MELLITUS; IMAGE AB PURPOSE this qualitative study was conducted to explore perceptions of body size and shape in a group of black women with Type 2 diabetes. METHODS Thirty-three black women with Type 2 diabetes participated in one of three focus groups to discuss perceptions about body size and body shape, Transcriptions of the discussion were analyzed for themes of participants perceptions about their bodies, their ideas about body size and body shape, and personal and environmental influences on their preferences about size and shape. RESULTS Participants preferred a middle-to-small body size but indicated that a middle-to-large body size was healthier. They also said that a large body sire did result in some untoward social consequences. Participants preferred a pear-shaped body (a figure without abdominal adiposity). The three major influences on body image perceptions were children, parents, and the media. CONCLUSIONS With these findings in mind diabetes education programs that are geared for black women may benefit from the inclusion of Key family members. Additionally, the importance of body image perceptions should be recognized in the design and implementation of weight-related diabetes education programs. C1 Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Liburd, LC (reprint author), Ctr Dis Control & Prevent, Div Diabet Translat, Natl Ctr Chron Dis Prevent & Hlth Promot, MS-K-10, Atlanta, GA 30341 USA. EM LCL1@cdc.gov NR 22 TC 20 Z9 21 U1 1 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD MAY-JUN PY 1999 VL 25 IS 3 BP 382 EP 388 DI 10.1177/014572179902500309 PG 7 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 203CA UT WOS:000080688900008 PM 10531858 ER PT J AU Meltzer, MI Dennis, DT Orloski, KA AF Meltzer, MI Dennis, DT Orloski, KA TI The cost effectiveness of vaccinating against Lyme disease SO EMERGING INFECTIOUS DISEASES LA English DT Article ID SURFACE PROTEIN-A; BORRELIA-BURGDORFERI; TICK BITES; IMMUNOGENICITY; DOXYCYCLINE; POPULATION; COMMUNITY; EPIDEMIC; MIGRANS; SAFETY AB To determine the cost effectiveness of vaccinating against Lyme disease, we used a decision tree to examine the impact on society of six key components. The main measure of outcome was the cost per case averted. Assuming a 0.80 probability of diagnosing and treating early Lyme disease, a 0.005 probability of contracting Lyme disease, and a vaccination cost of $50 per year, the mean cost of vaccination per case averted was $4,466. When we increased the probability of contracting Lyme disease to 0.03 and the cost of vaccination to $100 per year, the mean net savings per case averted was $3,377. Since few communities have average annual incidences of Lyme disease >0.005, economic benefits will be greatest when vaccination is used on the basis of individual risk, specifically, in persons whose probability of contracting Lyme disease is greater than or equal to 0.01. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Meltzer, MI (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, 1600 Clifton Rd,Mailstop C12, Atlanta, GA 30333 USA. NR 50 TC 51 Z9 51 U1 1 U2 1 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 321 EP 328 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600002 PM 10341168 ER PT J AU Dobos, KM Quinn, FD Ashford, DA Horsburgh, CR King, CH AF Dobos, KM Quinn, FD Ashford, DA Horsburgh, CR King, CH TI Emergence of a unique group of necrotizing mycobacterial diseases SO EMERGING INFECTIOUS DISEASES LA English DT Article ID BURULI ULCER; MARINUM INFECTION; SKIN INFECTION; NONTUBERCULOUS MYCOBACTERIA; EMERGING PATHOGEN; HIV-INFECTION; HAEMOPHILUM; EPIDEMIOLOGY; PATIENT; TOXIN AB Although most diseases due to pathogenic mycobacteria are caused by Mycobacterium tuberculosis, several other mycobacterial diseases-caused by M. ulcerans (Buruli ulcer), M. marinum, and M. haemophilum-have begun to emerge. We review the emergence of diseases caused by these three pathogens in the United States and around the world in the last decade. We examine the pathophysiologic similarities of the diseases (all three cause necrotizing skin lesions) and common reservoirs of infection (stagnant or slow-flowing water). Examination of the histologic and pathogenic characteristics of these mycobacteria suggests differences in the modes of transmission and pathogenesis, though no singular mechanism for either characteristic has been definitively described for any of these mycobacteria. C1 Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA 30303 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP King, CH (reprint author), Emory Univ, Sch Med, Dept Med, Div Infect Dis, 69 Butler St SE, Atlanta, GA 30303 USA. RI Dobos, Karen/D-1170-2017 OI Dobos, Karen/0000-0001-7115-8524 NR 64 TC 58 Z9 59 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 367 EP 378 PG 12 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600007 PM 10341173 ER PT J AU Wyatt, JD Barker, WH Bennett, NM Hanlon, CA AF Wyatt, JD Barker, WH Bennett, NM Hanlon, CA TI Human rabies postexposure prophylaxis during a raccoon rabies epizootic in New York, 1993 and 1994 SO EMERGING INFECTIOUS DISEASES LA English DT Article ID EPIDEMIOLOGY; STATES AB We describe the epidemiology of human rabies postexposure prophylaxis (PEP) in four upstate New York counties during the 1st and 2nd year of a raccoon rabies epizootic. We obtained data from records of 1,173 persons whose rabies PEP was reported to local health departments in 1993 and 1994. Mean annual PEP incidence rates were highest in rural counties, in summer, and in patients 10 to 14 and 35 to 44 years of age. PEP given after bites was primarily associated with unvaccinated dogs and cats, but most (70%) was not attributable to bites. Although pet vaccination and stray animal control, which target direct exposure, remain the cornerstones of human rabies prevention, the risk for rabies by the nonbite route (e.g., raccoon saliva on pet dogs' and cats' fur) should also be considered. C1 Univ Rochester, Sch Med & Dent, Rochester, NY 14642 USA. Monroe Cty Dept Hlth, Rochester, NY USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Wyatt, JD (reprint author), Univ Rochester, Sch Med & Dent, Box 674, Rochester, NY 14642 USA. NR 19 TC 18 Z9 19 U1 0 U2 1 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 415 EP 423 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600012 PM 10341178 ER PT J AU Watanabe, Y Ozasa, K Mermin, JH Griffin, PM Masuda, K Imashuku, S Sawada, T AF Watanabe, Y Ozasa, K Mermin, JH Griffin, PM Masuda, K Imashuku, S Sawada, T TI Factory outbreak of Escherichia coli O157 : H7 infection in Japan SO EMERGING INFECTIOUS DISEASES LA English DT Article ID HEMOLYTIC-UREMIC-SYNDROME; HEMORRHAGIC COLITIS; DIARRHEA; SPROUTS AB To determine the cause of a July 1996 outbreak of Escherichia coli O157:H7 among factory workers in Kyoto, Japan, we conducted cohort and case-control studies. Eating radish sprout salad during lunch at the factory cafeteria had been linked to illness. The sprouts were traced to four growers in Japan; one had been associated with an outbreak of E. coli O157:H7 among 6,000 schoolchildren in Sakai earlier in July. C1 Kyoto Prefectural Univ Med, Dept Social Med & Cultural Sci, Res Inst Neurol Dis & Geriatr, Kamigyo Ku, Kyoto 6028566, Japan. Ctr Dis Control & Prevent, Atlanta, GA USA. Kyoto City Govt, Publ Hlth Bur, Kyoto, Japan. Kyoto City Inst Hlth & Environm Sci, Kyoto, Japan. RP Watanabe, Y (reprint author), Kyoto Prefectural Univ Med, Dept Social Med & Cultural Sci, Res Inst Neurol Dis & Geriatr, Kamigyo Ku, Kyoto 6028566, Japan. RI Mermin, Jonathan/J-9847-2012 NR 20 TC 75 Z9 76 U1 2 U2 10 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 424 EP 428 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600013 PM 10341179 ER PT J AU Pape, WJ Fitzsimmons, TD Hoffman, RE AF Pape, WJ Fitzsimmons, TD Hoffman, RE TI Risk for rabies transmission from encounters with bats, Colorado, 1977-1996 SO EMERGING INFECTIOUS DISEASES LA English DT Article AB To assess the risk for rabies transmission to humans by bats, we analyzed the prevalence of rabies in bats that encountered humans from 1977 to 1996 and characterized the bat-human encounters. Rabies was diagnosed in 685 (15%) of 4,470 bats tested. The prevalence of rabies in bats that bit humans was 2.1 times higher than in bats that did not bite humans. At least a third of the encounters were preventable. C1 Colorado Dept Publ Hlth & Environm, Denver, CO USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Pape, WJ (reprint author), 4300 Cherry Creek S, Denver, CO 80246 USA. NR 17 TC 37 Z9 37 U1 0 U2 3 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 433 EP 437 PG 5 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600015 PM 10341181 ER PT J AU Pieniazek, NJ Bornay-Llinares, FJ Slemenda, SB da Silva, AJ Moura, INS Arrowood, MJ Ditrich, O Addiss, DG AF Pieniazek, NJ Bornay-Llinares, FJ Slemenda, SB da Silva, AJ Moura, INS Arrowood, MJ Ditrich, O Addiss, DG TI New Cryptosporidium genotypes in HIV-infected persons SO EMERGING INFECTIOUS DISEASES LA English DT Article ID POLYMERASE CHAIN-REACTION; GENETIC-HETEROGENEITY; PCR DETECTION; C-WRAIRI; PARVUM; DNA; DIFFERENTIATION; SEQUENCE; OOCYSTS; POLYMORPHISM AB Using DNA sequencing and phylogenetic analysis, we identified four distinct Cryptosporidium genotypes in HIV-infected patients: genotype 1 (human), genotype 2 (bovine) Cryptosporidium parvum, a genotype identical to C. felis, and one identical to a Cryptosporidium sp. isolate from a dog. This is the first identification of human infection with the latter two genotypes. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA 30341 USA. Inst Parasitol AS CR, Ceske Budejovice, Czech Republic. RP Pieniazek, NJ (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, 4770 Buford Highway NE,Mail Stop F13, Atlanta, GA 30341 USA. NR 36 TC 154 Z9 169 U1 0 U2 1 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 444 EP 449 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600018 PM 10341184 ER PT J AU Flores, I Pieniazek, D Moran, N Soler, A Rodriguez, N Alegria, M Vera, M Janini, LM Bandea, CI Ramos, A Rayfield, M Yamamura, Y AF Flores, I Pieniazek, D Moran, N Soler, A Rodriguez, N Alegria, M Vera, M Janini, LM Bandea, CI Ramos, A Rayfield, M Yamamura, Y TI HIV-1 subtype F in single and dual infections in Puerto Rico: A potential sentinel site for monitoring novel genetic HIV variants in north America SO EMERGING INFECTIOUS DISEASES LA English DT Letter C1 Ponce Sch Med, Ponce, PR USA. Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Univ Puerto Rico, San Juan, PR 00936 USA. RP Flores, I (reprint author), Ponce Sch Med, Ponce, PR USA. FU NCRR NIH HHS [G12 RR003050, G12RR-03050] NR 8 TC 14 Z9 15 U1 0 U2 2 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 USA SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD MAY-JUN PY 1999 VL 5 IS 3 BP 481 EP 483 PG 3 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 205NN UT WOS:000080827600028 PM 10341345 ER PT J AU Shults, RA Arndt, V Olshan, AF Martin, CF Royce, RA AF Shults, RA Arndt, V Olshan, AF Martin, CF Royce, RA TI Effects of short interpregnancy intervals on small-for-gestational age and preterm births SO EPIDEMIOLOGY LA English DT Article DE birth intervals; low-birth weight infant; premature infant; small-for-gestational age infant ID WEIGHT; RISK; PREGNANCY; DELIVERY; WOMEN AB We examined the effects of short interpregnancy intervals on small-for-gestational age and preterm births in a biracial population using North Carolina birth certificate data from 1988 to 1994. We defined small-for-gestational age birth as being below the 10th percentile on a race-, sex, and parity specific growth curve after a gestation of 37-42 weeks. We defined preterm birth as a gestation of less than 37 weeks. We analyzed birth records from all eligible singleton births to black or white women ages 15-45 years after an interpregnancy interval of 0-3 months (N = 11,451) and a random sample of singleton births after an interval of 4-24 months (N = 23,118). We defined interpregnancy interval exposure categories as 0-3, 4-12, and 13-24 months. The multivariate adjusted odds ratio for small-for-gestational age births after interpregnancy intervals of 0-3 months compared with 13-24 month intervals was 1.6 (95% confidence interval = 1.4-1.8). nle odds ratio for preterm birth after interpregnancy intervals of 0-3 montlls was 1.2 (95% confidence interval = 1.1-1.3). Odds ratios did not: vary substantially by race for either outcome. C1 Univ N Carolina, Sch Publ Hlth, Dept Epidemiol, Chapel Hill, NC USA. RP Shults, RA (reprint author), Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, 4770 Buford Highway NE,MS K63, Atlanta, GA 30341 USA. RI Royce, Rachel/A-7964-2012; OI Arndt, Volker/0000-0001-9320-8684 NR 21 TC 34 Z9 35 U1 0 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD MAY PY 1999 VL 10 IS 3 BP 250 EP 254 DI 10.1097/00001648-199905000-00010 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189EM UT WOS:000079891400010 PM 10230833 ER PT J AU Hoppin, JA Tolbert, PE Flanders, WD Zhang, RH Daniels, DS Ragsdale, BD Brann, EA AF Hoppin, JA Tolbert, PE Flanders, WD Zhang, RH Daniels, DS Ragsdale, BD Brann, EA TI Occupational risk factors for sarcoma subtypes SO EPIDEMIOLOGY LA English DT Article DE soft tissue sarcoma; skeletal sarcoma; occupational exposures; herbicides; chlorophenol; woodworking ID SOFT-TISSUE SARCOMA; OIL REFINERY WORKERS; MORTALITY FOLLOW-UP; CANCER MORTALITY; CHLOROPHENOL EXPOSURE; COHORT; 2,3,7,8-TETRACHLORODIBENZO-PARA-DIOXIN; HERBICIDES; INDUSTRY; UNION AB Herbicides, chlorophenols, and other occupational exposures are suspected risk factors for soft-tissue sarcoma, but the epidemiologic evidence is inconsistent. Given that soft tissue sarcomas represent a heterogeneous mix of cancer subtypes and that these subtypes have different disease patterns by race, sex, and age at diagnosis, studying all soft tissue sarcomas combined may mask subtype-specific associations. Using the Selected Cancers Study, a large population-based case-control study of sarcoma conducted among U.S. men aged 30 to 60 in 1984 to 1988, we explored the occupational risk factors for soft-tissue sarcoma subtypes and skeletal sarcoma. The analysis included 251 living sarcoma cases (48 dermatofibrosarcoma protuberans, 32 malignant fibrohistiocytic sarcoma, 67 leiomyosarcoma, 53 liposarcoma, and 51 skeletal sarcoma) and 1908 living controls. Exact conditional logistic regression models suggested patterns of subtype specificity for occupational exposures. Self-reported herbicide use was associated with malignant fibrohistiocytic sarcoma (OR = 2.9, 95% CI = 1.1-7.3). We found elevated risks for chlorophenol exposure and cutting oil exposure and malignant fibrohistiocytic sarcoma and leiomyosarcoma. We found no occupational risk factor for liposarcoma. Polytomous regression models identified different odds ratios across subtypes for plywood exposure and exposure to wood and saw dust. Although exploratory, this analysis suggests that occupational risk factors for sarcoma are not uniform across subtypes. C1 Emory Univ, Rollins Sch Publ Hlth, Dept Environm & Occupat Hlth, Atlanta, GA 30322 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA. Emory Univ, Rollins Sch Publ Hlth, Dept Biostat, Atlanta, GA 30322 USA. Arizona State Univ, Dept Anthropol, Tempe, AZ 85287 USA. Ctr Dis Control & Prevent, Atlanta, GA USA. RP Hoppin, JA (reprint author), NIEHS, Epidemiol Branch, MDA3-05,POB 12233, Res Triangle Pk, NC 27709 USA. RI Tolbert, Paige/A-5676-2015 FU NCI NIH HHS [1R29CA63622-01A1] NR 34 TC 23 Z9 23 U1 2 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD MAY PY 1999 VL 10 IS 3 BP 300 EP 306 DI 10.1097/00001648-199905000-00019 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189EM UT WOS:000079891400019 PM 10230842 ER PT J AU Will, JC Vinicor, F Calle, EE AF Will, JC Vinicor, F Calle, EE TI Is diabetes mellitus associated with prostate cancer incidence and survival? SO EPIDEMIOLOGY LA English DT Article DE prostatic neoplasms; confounding factors; diabetes mellitus; effect modifiers; survival; incidence ID RISK; MORTALITY; MEN; GLUCOSE; DEATH AB Results of two recent prospective incidence studies have suggested that certain subgroups of men with diabetes mellitus map be protected from developing prostate cancer. Two earlier studies, however, concluded that diabetes increased the risk of mortality from prostate cancer. With hundreds of thousands of male respondents, the 1959-1972 Cancer Prevention Study provided a unique opportunity to explore whether men with diabetes were more likely to develop prostate cancer during a 13-year follow up period than were men without diabetes. After adjusting fur factors associated with prostate cancer in previous studies, we found little association between diabetes at baseline and prostate cancer incidence [incidence density ratio (IDR) = 1.05; 95% confidence interval (CI) = 0.81-1.36]. Men who had diabetes mellitus for 5 or more years, however, had a higher incidence of prostate cancer than did men without diabetes (IDR = 1.56; 95% CI = 1.02-2.38). Among all study participants who were diagnosed with prostate canter, men with diabetes were only slightly more likely to die from prostate cancer than were men without diabetes (IDR = 1.11; 95% CI = 0.76-1.62). C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. Amer Canc Soc, Atlanta, GA 30329 USA. RP Will, JC (reprint author), Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, 4770 Buford Highway NE,Mailstop K-26, Atlanta, GA 30341 USA. NR 26 TC 67 Z9 68 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD MAY PY 1999 VL 10 IS 3 BP 313 EP 318 DI 10.1097/00001648-199905000-00021 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 189EM UT WOS:000079891400021 PM 10230844 ER PT J AU Whitaker, DJ Miller, KS May, DC Levin, ML AF Whitaker, DJ Miller, KS May, DC Levin, ML TI Teenage partners' communication about sexual risk and condom use: The importance of parent-teenager discussions SO FAMILY PLANNING PERSPECTIVES LA English DT Article ID INCARCERATED ADOLESCENTS; FAMILY COMMUNICATION; BEHAVIOR; AIDS; PREDICTORS; STUDENTS AB Context: Teenagers' communication with their partners about sex and their use of condoms may be influenced by the discussions teenagers have with their parents about sex. However, little is known about the process of parent-teenager communication on this topic Understanding both what parents discuss with their children and how they discuss it may lead to a greater understanding of teenagers' sexual behavior. Methods: interviews were conducted with 372 sexually active black and Hispanic youth aged 14-17 from Alabama, New York and Puerto Rico. Regression analyses were used to examine parent-teenager discussions about sexuality and about sexual risk, and parental communication skills as predictors of teenagers' discussions about sexual risk with a partner and teenagers' condom use. Results: Parent-teenager discussions about sexuality and sexual risk were associated with an increased likelihood of teenager-partner discussions about sexual risk and of teenagers' condom use, but only if parents were open, skilled and comfortable in having those discussions. Teenagers' communication with their partner about sexual risk also was associated with greater condom use, but the relationship; between parent-teenager communication and teenagers' condom use was independent of this association. Conclusions: The influence on teenagers of parent-teenager discussions about sexuality and sexual risk depends on both what parents say and how they say it Programs that foster parent-teenager communication about sexuality and sexual risk must emphasize both of these aspects. C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Univ Mississippi, Dept Sociol Anthropol & Social Work, University, MS 38677 USA. Indiana Univ Purdue Univ, Sch Publ & Environm Affairs, Ft Wayne, IN 46805 USA. RP Whitaker, DJ (reprint author), Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RI Whitaker, Daniel/C-1956-2009 NR 28 TC 148 Z9 149 U1 0 U2 9 PU ALAN GUTTMACHER INST PI NEW YORK PA 120 WALL STREET, NEW YORK, NY 10005 USA SN 0014-7354 J9 FAM PLANN PERSPECT JI Fam. Plann. Perspect. PD MAY-JUN PY 1999 VL 31 IS 3 BP 117 EP 121 DI 10.2307/2991693 PG 5 WC Demography; Family Studies SC Demography; Family Studies GA 205TU UT WOS:000080837300010 PM 10379427 ER PT J AU Dietz, PM Adams, MM Spitz, AM Morris, L Johnson, CH AF Dietz, PM Adams, MM Spitz, AM Morris, L Johnson, CH CA PRAMS Working Grp TI Live births resulting from unintended pregnancies: Is there variation among states? SO FAMILY PLANNING PERSPECTIVES LA English DT Article ID UNITED-STATES; SERVICES AB Context: States need data on live births resulting from unintended pregnancies in order to assess the need for family planning services; however, many states do not collect such data. Some states may use extrapolated rates from other states. Methods: Pregnancy Risk Assessment Monitoring System (PRAMS) data were assessed to explore the feasibility of extrapolating data on the percentage of live births resulting from unintended pregnancies from states that collect these data to states that do not. Data on women who had live births between 1993 and 1995 were examined for eight states: Alabama, Florida, Georgia, Michigan, New York (excluding New York City), Oklahoma, South Carolina and West Virginia. Logistic regression was used to determine state variation in the odds of delivering a live birth resulting from an unintendedpregnancy after adjustment for maternal race, marital status, age, education, previous live birth and participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Results: The percentage of live births resulting from unintended pregnancy ranged from 33% in New York to 49%:, in Alabama, Georgia and South Carolina. Compared with women in Alabama, women in Oklahoma were more likely to deliver a live birth resulting from an unintended pregnancy (odds ratio of 1.2, confidence interval of 1.1-1.3) and women in New York State were less likely (odds ratio of 0.7, confidence interval of 0.6-0.8) to have such a birth. However, unmarried white women in New York had lower odds of having a live birth resulting from an unintended pregnancy and married black women in Michigan had higher odds of having a live birth resulting from unintendedpregnancy than their counterparts in Alabama. Although the percentages varied, in all eight states women who were black, were unmarried, were younger than 20 years of age, had less than 12 years of education or had more than one child had higher percentages of live births resulting from unintended pregnancy than women with other demographic characteristics. Conclusions: Data on which women have the greatest risk of delivering a live birth resulting from an unintended pregnancy may be extrapolated from one state to another, but the rate of such births may overestimate or underestimate the problem from one state to another. C1 Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30333 USA. RP Dietz, PM (reprint author), Ctr Dis Control & Prevent, Div Reprod Hlth, Atlanta, GA 30333 USA. NR 16 TC 8 Z9 8 U1 0 U2 0 PU ALAN GUTTMACHER INST PI NEW YORK PA 120 WALL STREET, NEW YORK, NY 10005 USA SN 0014-7354 J9 FAM PLANN PERSPECT JI Fam. Plann. Perspect. PD MAY-JUN PY 1999 VL 31 IS 3 BP 132 EP 136 DI 10.2307/2991696 PG 5 WC Demography; Family Studies SC Demography; Family Studies GA 205TU UT WOS:000080837300013 PM 10379430 ER PT J AU Marcus, M Kiely, J Parker, J Marcus, M McGeehin, M Jackson, R Sinks, T AF Marcus, M Kiely, J Parker, J Marcus, M McGeehin, M Jackson, R Sinks, T TI Anything other than by chance? Reply SO FERTILITY AND STERILITY LA English DT Letter ID RATIO C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. RP Marcus, M (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA 30333 USA. NR 3 TC 3 Z9 3 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 0015-0282 J9 FERTIL STERIL JI Fertil. Steril. PD MAY PY 1999 VL 71 IS 5 BP 969 EP 970 PG 2 WC Obstetrics & Gynecology; Reproductive Biology SC Obstetrics & Gynecology; Reproductive Biology GA 189KX UT WOS:000079904600038 ER PT J AU Ikegami, T Kimata, K Hosoya, K Tanaka, N Oida, T Smith, CJ Moffett, DB Grainger, J Patterson, DG AF Ikegami, T Kimata, K Hosoya, K Tanaka, N Oida, T Smith, CJ Moffett, DB Grainger, J Patterson, DG TI Isolation of polychlorodibenzo-p-dioxins and polychlorobiphenyls upon deproteinization of a serum sample by HPLC with restricted-access reversed-phase packing materials SO HRC-JOURNAL OF HIGH RESOLUTION CHROMATOGRAPHY LA English DT Article DE deproteinization; polychlorobiphenyls; polychlorodibenzo-p-dioxins; restricted-access reversed-phase packings; sample preparation ID PERFORMANCE LIQUID-CHROMATOGRAPHY; HYDROPHOBIC ENVIRONMENTAL CONTAMINANTS; STATIONARY PHASES; POLYCHLORINATED-BIPHENYLS; ELECTRON-ACCEPTOR; SEPARATION; SILICA; SELECTIVITY; RETENTION; FRACTIONATION C1 Kyoto Inst Technol, Dept Polymer Sci & Engn, Sakyo Ku, Kyoto 606, Japan. Kyoto Inst Technol, Dept Chem & Mat Technol, Sakyo Ku, Kyoto 606, Japan. Ctr Dis Control & Prevent, Atlanta, GA 30341 USA. RP Tanaka, N (reprint author), Kyoto Inst Technol, Dept Polymer Sci & Engn, Sakyo Ku, Kyoto 606, Japan. NR 23 TC 0 Z9 0 U1 3 U2 4 PU WILEY-V C H VERLAG GMBH PI BERLIN PA MUHLENSTRASSE 33-34, D-13187 BERLIN, GERMANY SN 0935-6304 J9 HRC-J HIGH RES CHROM JI HRC-J. High Resolut. Chromatogr. PD MAY PY 1999 VL 22 IS 5 BP 287 EP 293 PG 7 WC Chemistry, Analytical SC Chemistry GA 192DY UT WOS:000080064100009 ER PT J AU Shevchenko, DV Sellati, TJ Cox, DL Shevchenko, OV Robinson, EJ Radolf, JD AF Shevchenko, DV Sellati, TJ Cox, DL Shevchenko, OV Robinson, EJ Radolf, JD TI Membrane topology and cellular location of the Treponema pallidum glycerophosphodiester phosphodiesterase (GlpQ) ortholog SO INFECTION AND IMMUNITY LA English DT Article ID SEXUALLY-TRANSMITTED DISEASES; BORRELIA-BURGDORFERI; SUBSP PALLIDUM; OUTER-MEMBRANE; HAEMOPHILUS-INFLUENZAE; SURFACE-PROTEIN; SYPHILIS SPIROCHETE; SECONDARY-STRUCTURE; LIPID MODIFICATION; GLOBULAR-PROTEINS AB Recent reports that isolated Treponema pallidum outer membranes contain an ortholog for glycerophosphodiester phosphodiesterase (GlpQ) (D. V. Shevchenko, D. R. Akins, E. J. Robinson, M. Li. O. V. Shevchenko, and J, D, Radolf, Infect. Immun, 65:4179-4189, 1997) and that this protein is a potential opsonic target for T. pallidum (C. E. Stebeck, J. M. Shaffer, T. W. Arroll, S. A. Lukehart, and W. C. Van Voorhis, FEMS Microbiol, Lett, 154:303-310, 1997) prompted a more detailed investigation of its physicochemical properties and cellular location. [C-14]palmitate radiolabeling studies of a GlpQ-alkaline phosphatase fusion expressed in Escherichia coli confirmed the prediction from DNA sequencing that the protein is lipid modified. Studies using Triton X-114 phase partitioning revealed that the protein's amphiphilicity is due to lipid modification and that a substantial portion of the polypeptide is associated with the T. pallidum peptidoglycan sacculus, Three different approaches, i.e., (i) proteinase K treatment of intact treponemes, (ii) indirect immunofluorescence analysis of treponemes encapsulated in agarose beads, and (iii) opsonophagocytosis of treponemes incubated with antiserum against recombinant GlpQ by rabbit peritoneal marrophages, confirmed that GlpQ is entirely subsurface in T. pallidum. Moreover, rabbits hyperimmunized with GlpQ were not protected against intradermal challenge with virulent treponemes, Circular dichroism spectroscopy confirmed that the recombinant form of the polypeptide lacked discernible evidence of denaturation, Finally, GlpQ was not radiolabeled when T. pallidum outer membranes were incubated with 3-(trifluoromethyl)-3-(m-[I-125]iodophenyl)-diazarene, a photoactivatable, lipophilic probe which promiscuously labels both proteins and lipids within phospholipid bilayers, Taken as a whole, these studies indicate that the T. pallidum GlpQ ortholog: is a periplasmic protein associated predominantly with the spirochete's peptidoglycan-cytoplasmic membrane complex. C1 Univ Texas, SW Med Ctr, Dept Internal Med, Dallas, TX 75235 USA. Univ Texas, SW Med Ctr, Dept Microbiol, Dallas, TX 75235 USA. Ctr Dis Control & Prevent, Div STD Lab Res, Atlanta, GA 30333 USA. RP Radolf, JD (reprint author), Univ Connecticut, Ctr Hlth, Ctr Microbial Pathogenesis, 263 Farmington Ave, Farmington, CT 06030 USA. EM JRadolf@up.uchl.edu FU NIAID NIH HHS [AI-09973, AI-26756, AI-38894, F32 AI009973, R01 AI026756, R01 AI038894, R37 AI026756] NR 65 TC 29 Z9 30 U1 0 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0019-9567 EI 1098-5522 J9 INFECT IMMUN JI Infect. Immun. PD MAY PY 1999 VL 67 IS 5 BP 2266 EP 2276 PG 11 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 189MQ UT WOS:000079909300030 PM 10225883 ER PT J AU Kim, JO Romero-Steiner, S Sorensen, UBS Blom, J Carvalho, M Barnard, S Carlone, G Weiser, JN AF Kim, JO Romero-Steiner, S Sorensen, UBS Blom, J Carvalho, M Barnard, S Carlone, G Weiser, JN TI Relationship between cell surface carbohydrates and intrastrain variation on opsonophagocytosis of Streptococcus pneumoniae SO INFECTION AND IMMUNITY LA English DT Article ID C-REACTIVE-PROTEIN; PHASE VARIATION; NASOPHARYNGEAL COLONIZATION; CAPSULAR POLYSACCHARIDE; COLONIAL MORPHOLOGY; TEICHOIC-ACID; IMMUNOGENICITY; COMPLEMENT; ADHERENCE; BINDING AB Streptococcus pneumoniae undergoes spontaneous phase variation between a transparent and an opaque colony phenotype, the latter being more virulent in a murine model of sepsis, Opaque pneumococci have previously been shown to express lower amounts of C polysaccharide (cell wall teichoic acid) and in this study were shown to have a higher content of capsular polysaccharide by immunoelectron microscopy, This report then examined the relationship between expression of these two cell surface carbohydrate structures and their relative contribution to the increased virulence of opaque variants. Comparison of genetically related strains showed that the differential content of capsular polysaccharide did not affect the amount of teichoic acid as measured by a capture enzyme-linked immunosorbent assay (ELISA), In contrast, when the teichoic acid structure was altered by replacing choline in the growth medium with structural analogs, the quantity of capsular polysaccharide as measured by a capture ELISA was decreased, demonstrating a linkage in the expression of the two surface carbohydrate structures. A standardized assay was used to assess the relative contribution of cell surface carbohydrates to opsonophagocytosis. The opaque variants required 1.2- to 30-fold more immune human serum to achieve 50% opsonophagocytic killing than did related transparent variants (types 6B and 9V), The opsonophagocytic titer was proportional to the quantity of capsular polysaccharide rather than teichoic acid. The major factor in binding of the opsonin, C-reactive protein (CRP), was also the amount of capsular polysaccharide rather than the teichoic acid ligand. Only for the transparent variant (type 6B), which bound more CRP, was there enhanced opsonophagocytic killing in the presence of this serum protein. Increased expression of capsular polysaccharide, therefore, appeared to be the major factor in the decreased opsonophagocytic killing of opaque pneumococci. C1 Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Microbiol, Philadelphia, PA 19104 USA. Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USA. Childrens Hosp Philadelphia, Dept Microbiol, Philadelphia, PA 19104 USA. Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Div Bacterial & Mycot Dis, Atlanta, GA 30333 USA. Aarhus Univ, Dept Med Microbiol & Immunol, DK-8000 Aarhus, Denmark. Statens Serum Inst, Dept Mol Cell Biol, DK-2300 Copenhagen S, Denmark. RP Weiser, JN (reprint author), Univ Penn, Sch Med, Dept Pediat, 301B Johnson Pavilion, Philadelphia, PA 19104 USA. OI Romero-Steiner, Sandra/0000-0003-4128-7768 FU NIAID NIH HHS [R01 AI038446, AI38446, AI07278-13, T32 AI007278] NR 24 TC 93 Z9 95 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD MAY PY 1999 VL 67 IS 5 BP 2327 EP 2333 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA 189MQ UT WOS:000079909300038 PM 10225891 ER PT J AU Emori, TG Gaynes, RP AF Emori, TG Gaynes, RP TI Being wired for a year - Reply SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Letter C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Emori, TG (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAY PY 1999 VL 20 IS 5 BP 299 EP 300 PG 2 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 197EG UT WOS:000080351200002 ER PT J AU Marx, A Shay, DK Noel, JS Brage, C Bresee, JS Lipsky, S Monroe, SS Ando, T Humphrey, CD Alexander, ER Glass, RI AF Marx, A Shay, DK Noel, JS Brage, C Bresee, JS Lipsky, S Monroe, SS Ando, T Humphrey, CD Alexander, ER Glass, RI TI An outbreak of acute gastroenteritis in a geriatric long-term-care facility: Combined application of epidemiological and molecular diagnostic methods SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the Infectious-Diseases-Society-of-America CY SEP 18-20, 1996 CL NEW ORLEANS, LOUISIANA SP Infectious Dis Soc Amer ID SNOW MOUNTAIN AGENT; NORWALK-LIKE VIRUS; ACUTE NONBACTERIAL GASTROENTERITIS; IMMUNE ELECTRON-MICROSCOPY; ROUND-STRUCTURED VIRUS; VIRAL GASTROENTERITIS; HOSPITAL OUTBREAK; NURSING-HOME; CRUISE SHIP; TRANSMISSION AB OBJECTIVE: To assess possible transmission modes of, and risk factors for, gastroenteritis associated with Norwalk-like viruses (NLVs) in a geriatric long-term-care facility. METHODS: During a prolonged outbreak of acute gastroenteritis, epidemiological data on illness among residents and employees ere collected in conjunction with stool, vomitus, and environmental specimens for viral testing. NLVs were identified by electron microscopy in stool and vomitus specimens, and further characterized by reverse-transcriptase polymerase chain reaction and nucleotide sequencing. Potential risk factors were examined through medical-record review, personal interview, and a self-administered questionnaire sent to all employees. RESULTS: During the outbreak period, 52 (57%) of 91 residents and 34 (35%) of 90 employees developed acute gastroenteritis. Four case-residents were hospitalized; three residents died at the facility shortly after onset of illness. A point source was not identified; no association between food or water consumption and gastroenteritis was identified. A single NLV strain genetically related to Toronto virus was the only pathogen identified. Residents were at significantly higher risk of gastroenteritis if they were physically debilitated (relative risk. [RR], 3.5; 95% confidence interval [CI95], 1.0 12.9), as were employees exposed to residents with acute gastroenteritis (RR, 2.6; CI95, 1.1-6.5) or ill household members (RR, 2.3; CI95, 1.4-3.6). Adherence to infection control measures among the nursing staff may have reduced the risk of gastroenteritis, but the reduction did not reach statistical significance. CONCLUSIONS: In the absence of evidence for foodborne or waterborne transmission, NLVs likely spread among residents and employees of a long-term-care facility through person-to-person or airborne droplet transmission. Rapid notification of local health officials, collection of clinical specimens, and institution of infection control measures are necessary if viral gastroenteritis transmission is to be limited in institutional settings. C1 Ctr Dis Control & Prevent, Viral Gastroenteritis Unit, Resp & Enter Viruses Branch, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Atlanta, GA 30333 USA. Univ Washington, Dept Pediat, Seattle, WA 98195 USA. Seattle King Cty Dept Publ Hlth, Seattle, WA USA. Sun Healthcare Grp, Albuquerque, NM USA. RP Glass, RI (reprint author), Ctr Dis Control & Prevent, Viral Gastroenteritis Unit, Resp & Enter Viruses Branch, 1600 Clifton Rd, Atlanta, GA 30333 USA. OI Monroe, Stephan/0000-0002-5424-716X; Shay, David/0000-0001-9619-4820 NR 35 TC 34 Z9 34 U1 0 U2 6 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAY PY 1999 VL 20 IS 5 BP 306 EP 311 DI 10.1086/501622 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 197EG UT WOS:000080351200010 PM 10349945 ER PT J AU Manangan, LP Collazo, ER Tokars, J Paul, S Jarvis, WR AF Manangan, LP Collazo, ER Tokars, J Paul, S Jarvis, WR TI Trends in compliance with the guidelines for preventing the transimission of Mycobacterium tuberculosis among New Jersey hospitals, 1989 to 1996 SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID HEALTH-CARE WORKERS; NOSOCOMIAL TRANSMISSION AB OBJECTIVE: To determine trends in compliance with the guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities among New Jersey hospitals from 1989 through 1996. DESIGN: A voluntary questionnaire was sent to all 96 New Jersey hospitals in 1992. The 53 that responded were resurveyed in 1996. RESULTS: Of the 96 hospitals surveyed in 1992, 53 (55%) returned a completed questionnaire; 33 (64%) were community, nonteaching hospitals. In 1991, patients with tuberculosis (TB) were admitted at 38 (72%) of 53 hospitals, and from 1989 through 1991, patients with multidrug-resistant (MDR) TB were admitted at 15 (29%) of 52 hospitals. Twenty-nine (57%) of 51 reported having rooms meeting the Centers for Disease Control and Prevention (CDC) criteria for acid-fast bacilli (AFB) isolation. A nonfitted surgical mask was used as a respiratory protective device by healthcare workers (HCWs) at 28 (55%) of 51 hospitals. Attending physicians were included in tuberculin skin-testing (TST) programs at 5 (11%) of 45 hospitals. In the 1996 resurvey, 48 (94%) of 53 surveyed hospitals returned a completed questionnaire; 34 (81%) of 42 had TB patient admissions, and 4 (9%) of 43 had MDR TB patient admissions in 1996. Forty-five (96%) of 47 reported having rooms that met CDC criteria for AFB isolation. N95 respiratory devices were used by HCWs at 45 (94%) of 48 hospitals. Attending physicians were included in the TST programs at 22 (54%) of 41 hospitals. CONCLUSION: New Jersey hospitals have made improvements in availability of AFB isolation rooms, use of proper respiratory protective devices, and expansion of TST programs for HCWs from 1989 through 1996. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. New Jersey Dept Hlth & Senior Serv, Trenton, NJ USA. RP Manangan, LP (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, Natl Ctr Infect Dis, Mailstop E-69,1600 Clifton Rd, Atlanta, GA 30333 USA. NR 18 TC 2 Z9 2 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAY PY 1999 VL 20 IS 5 BP 337 EP 340 DI 10.1086/501627 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 197EG UT WOS:000080351200015 PM 10349950 ER PT J AU Kamau, L Mukabana, WR Hawley, WA Lehmann, T Irungu, LW Orago, AAS Collins, FH AF Kamau, L Mukabana, WR Hawley, WA Lehmann, T Irungu, LW Orago, AAS Collins, FH TI Analysis of genetic variability in Anopheles arabiensis and Anopheles gambiae using microsatellite loci SO INSECT MOLECULAR BIOLOGY LA English DT Article DE Anopheles arabiensis; Anopheles gambiae; genetic variability; microsatellite loci; population genetics ID CHROMOSOMAL INVERSION POLYMORPHISM; SHORT TANDEM REPEATS; WESTERN KENYA; F-STATISTICS; COMPLEX; MALARIA; DIFFERENTIATION; POPULATION; RESISTANCE; AFRICA AB We analysed genetic variability in Anopheles arabiensis and Anopheles gambiae populations using microsatellite loci to determine whether the Rift Valley restricts the flow of genes. Deviations from Hardy-Weinberg expectations were significant, and were most likely to be due to the high frequency of null alleles observed. An, arabiensis populations occurring between 40 and 700 km apart across the Eastern arm of the Rift Valley were not differentiated (pair-wise F-ST range: 0.0033-0.0265, P > 0.05). Neither were An. gambiae populations from Asembo Bay and Ghana (F-ST: 0.0063, P > 0.05) despite a geographical separation of about 5000 km, In contrast, significant differentiation was observed between An. gambiae populations from Asembo Bay and Kilifi (about 700 km apart; F-ST = 0.1249, P < 0.01), suggesting the presence of a barrier to gene flow. C1 Kenya Med Res Inst, Nairobi, Kenya. Univ Nairobi, Dept Zool, Nairobi, Kenya. Ctr Dis Control & Prevent, Div Parasit Dis, Atlanta, GA USA. Kenyatta Univ, Dept Zool, Nairobi, Kenya. Univ Notre Dame, Dept Biol Sci, Notre Dame, IN 46556 USA. RP Irungu, LW (reprint author), POB 18240, Nairobi, Kenya. NR 49 TC 45 Z9 51 U1 0 U2 12 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD OX2 0NE, OXON, ENGLAND SN 0962-1075 J9 INSECT MOL BIOL JI Insect Mol. Biol. PD MAY PY 1999 VL 8 IS 2 BP 287 EP 297 DI 10.1046/j.1365-2583.1999.820287.x PG 11 WC Biochemistry & Molecular Biology; Entomology SC Biochemistry & Molecular Biology; Entomology GA 201ZZ UT WOS:000080628800015 PM 10380112 ER PT J AU Dietz, W AF Dietz, W TI How to tackle the problem early? The role of education in the prevention of obesity SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article; Proceedings Paper CT 8th International Congress of Obesity Satellite Symposium CY AUG 29, 1998 CL PARIS, FRANCE DE obesity; education; prevention; children; adolescents AB The major issues that confront the clinician in relation to childhood obesity are identifying children at risk, deciding the goal and focus of therapy, and determining how to maintain weight loss. The severity of obesity and the age at which it is present appear to be significant determinants of whether childhood obesity will persist into adulthood. At any age, severe obesity is more likely to persist, and obesity present in adolescents is much more likely to persist than obesity in young children. If a child has obese parents, the risk that their obesity will persist to adulthood increases, though the magnitude of that risk varies with the age of the child. The goals of therapy depend on the child's age and the severity of obesity-related complications. Assessment of the family's readiness to change represents the first focus of therapy. A reduction in time spent watching television, coupled with family involvement and a diet that aims to reduce or eliminate high caloric density foods is the best approach in most cases. Children or adolescents who have an emergent complication of obesity are candidates for aggressive weight reduction such as the protein modified fast. More aggressive therapies, such as drug therapy or gastric bypass surgery, must be considered as experimental in children and adolescents. C1 CDC, Div Nutr & Phys Act, Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA 30341 USA. RP Dietz, W (reprint author), CDC, Div Nutr & Phys Act, Ctr Chron Dis Prevent & Hlth Promot, Mail Stop K24,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 6 TC 13 Z9 13 U1 0 U2 3 PU STOCKTON PRESS PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE RG21 6XS, HAMPSHIRE, ENGLAND SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD MAY PY 1999 VL 23 SU 4 BP S7 EP S9 DI 10.1038/sj.ijo.0800913 PG 3 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA 198CN UT WOS:000080404500003 PM 10385273 ER PT J AU Do, AN Limpakarnjarat, K Uthaivoravit, W Zuber, PLF Korattana, S Binkin, N Mastro, TD Jarvis, WR AF Do, AN Limpakarnjarat, K Uthaivoravit, W Zuber, PLF Korattana, S Binkin, N Mastro, TD Jarvis, WR TI Increased risk of Mycobacterium tuberculosis infection related to the occupational exposures of health care workers in Chiang Rai, Thailand SO INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE LA English DT Article DE health care workers; tuberculin skin testing; Thailand ID OUTBREAK; TRANSMISSION; MORBIDITY AB SETTING: Chiang Rai, the northernmost province of Thailand. OBJECTIVE: To evaluate the occupational risk for tuberculous infection of health care workers (HCWs) and the utility of tuberculin skin test (TST) in a developing country setting. DESIGN: A cross-sectional TST survey, including a risk assessment questionnaire, of Chiang Rai Hospital HCWs. RESULTS: Of 911 HCWs tested, 623 (68%) had indurations of greater than or equal to 10 mm and 322 (35%) indurations of greater than or equal to 15 mm. Factors most predictive for TST positivity, using either cut-off, were employment >1 year, frequent direct patient contact, and male sex. Moreover, having a bacillus Calmette-Guerin (BCG) scar was predictive of a greater than or equal to 10 mm, but not a greater than or equal to 15 mm, reaction. CONCLUSIONS: Chiang Rai Hospital HCWs had an increased risk for Mycobacterium tuberculosis infection, which was significantly associated with occupational exposure. Where BCG coverage is high, a TST cut-off of greater than or equal to 15 mm may correlate better with M. tuberculosis infection than does a cut-off of greater than or equal to 10 mm. Effective, affordable infection control measures are needed for health care facilities in developing countries such as Thailand, where HCWs may be at increased risk for M. tuberculosis infection from occupational exposures. C1 Ctr Dis Control & Prevent, Hosp Infect Program, Atlanta, GA 30333 USA. HIV AIDS Collaborat, Nonthaburi, Thailand. Chiang Rai Hosp, Chiang Mai, Thailand. RP Jarvis, WR (reprint author), Ctr Dis Control & Prevent, Hosp Infect Program, 1600 Clifton Rd,MS E-69, Atlanta, GA 30333 USA. NR 20 TC 40 Z9 40 U1 0 U2 0 PU INT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D) PI PARIS PA 68 BOULEVARD SAINT-MICHEL,, 75006 PARIS, FRANCE SN 1027-3719 J9 INT J TUBERC LUNG D JI Int. J. Tuberc. Lung Dis. PD MAY PY 1999 VL 3 IS 5 BP 377 EP 381 PG 5 WC Infectious Diseases; Respiratory System SC Infectious Diseases; Respiratory System GA 194VP UT WOS:000080215200005 PM 10331725 ER PT J AU Simon, TR Crosby, AE Dahlberg, LL AF Simon, TR Crosby, AE Dahlberg, LL TI Students who carry weapons to high school - Comparison with other weapon-carriers SO JOURNAL OF ADOLESCENT HEALTH LA English DT Article DE weapon; violence; school; substance use; fighting; victimization; gender differences ID AFRICAN-AMERICAN; UNITED-STATES; HEALTH-RISK; DRUG-USE; ADOLESCENTS; BEHAVIORS; VIOLENCE; HANDGUNS; YOUTH AB Purpose: To determine if those who have recently carried a weapon on school grounds differ from those who carry weapons elsewhere. We hypothesized that involvement in other problem behaviors and exposure to school crime and violence would be associated with risk for weapon carrying on school grounds. Methods: The data for this study were from the 1995 Youth Risk Behavior Survey of 10,904 high school students. Logistic regression analysis was used to examine risk for weapon carrying on school grounds. Results: Among the students who carried a weapon, 48% carried a weapon on school grounds. Female gender, lower parental education levels, substance use on school grounds, involvement in physical fights, exposure to school crime and violence, frequency of weapon-carrying, and gun carrying distinguished students who carried weapons on school grounds from those who carried weapons off school grounds. Conclusions: The results suggest that weapon-carrying on school grounds is associated with individual and school-related characteristics. Efforts to reduce weapon-carrying on school grounds might focus on reduction of students' actual and perceived vulnerability to victimization, as well as by helping students understand that other problem behaviors increase their risk for violence. (C) Society for Adolescent Medicine, 1999. C1 Natl Ctr Injury Prevent & Control, CDC, Atlanta, GA 30341 USA. RP Simon, TR (reprint author), Natl Ctr Injury Prevent & Control, CDC, Mailstop K-60,4770 Buford Highway, Atlanta, GA 30341 USA. NR 26 TC 49 Z9 49 U1 2 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1054-139X J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD MAY PY 1999 VL 24 IS 5 BP 340 EP 348 DI 10.1016/S1054-139X(98)00121-9 PG 9 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA 192AY UT WOS:000080056400007 PM 10331840 ER PT J AU Chabra, A Chavez, GF Harris, ES Shah, R AF Chabra, A Chavez, GF Harris, ES Shah, R TI Hospitalization for mental illness in adolescents - Risk groups and impact on the health care system SO JOURNAL OF ADOLESCENT HEALTH LA English DT Article DE adolescence; hospitalization; mental disorders; adolescent psychiatry; cost; ethnic differences; gender difference ID PSYCHIATRIC-DISORDERS; CONDUCT DISORDER; SERVICES; CHILDREN; DIAGNOSIS; INPATIENT; PATTERNS; RACE AB Purpose: To determine the extent and cost of hospitalizations for mental illness among adolescents and to identify differences in acute care hospital use by gender and between racial/ethnic groups. Methods: Analysis of discharge data for adolescents, 10 to 19 years of age (n = 27,595), with a principal diagnosis of mental illness from acute care hospitals in California in 1994. Relative risks (RRs) were calculated by race/ethnicity and gender and stratified by race/ethnicity and payment source. Results: Mental illness accounted for 14.8% of hospitalizations in this age group; the mean length of stay was 10.9 days. Total charges exceeded $300 million. Overall, adolescent boys had a slightly lower risk of hospitalization for mental illness than did adolescent girls (RR = 0.90, 95% confidence interval [CI] = 0.87, 0.92) but a higher risk for certain diagnoses. Overall, nonwhite adolescents had a lower risk of hospitalization for mental illness than did white adolescents: African-Americans (RR = 0.77, 95% CI = 0.74, 0.81), Latinos (RR = 0.35 95% CI = 0.31, 0.33), and Asians/others (RR = 0.27, 95% CI = 0.26, 0.29). These differences remained significant after stratification by payment source. Conclusions: The risk of hospitalization for mental illness among adolescents varies by specific mental illness and by rate/ethnicity. In light of the significant human and financial costs associated with hospitalization for mental illness, further research into the determinants of illness and the options for care is warranted. (C) Society for Adolescent Medicine, 1999. C1 Calif State Dept Hlth Serv, Maternal & Child Hlth Branch, Sacramento, CA 95814 USA. Ctr Dis Control & Prevent, Natl Ctr Chron Dis Prevent & Hlth Promot, Div Reprod Hlth, Pregnancy & Infant Hlth Branch, Atlanta, GA USA. Univ Calif Davis, Div Child Adolescent & Family Psychiat, Dept Psychiat, Sacramento, CA 95817 USA. RP Chabra, A (reprint author), Calif Dept Hlth Serv, Maternal & Child Hlth Branch, 2151 Berkeley Way,Annex 4,Room 200, Berkeley, CA 94704 USA. NR 32 TC 12 Z9 12 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 USA SN 1054-139X J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD MAY PY 1999 VL 24 IS 5 BP 349 EP 356 DI 10.1016/S1054-139X(98)00116-5 PG 8 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA 192AY UT WOS:000080056400008 PM 10331841 ER PT J AU Hamilton, RG Biagini, RE Krieg, EF AF Hamilton, RG Biagini, RE Krieg, EF CA Multictr Latex Skin Testing Study Task Force TI Diagnostic performance of Food and Drug Administration - cleared serologic assays for natural rubber latex-specific IgE antibody SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Article DE natural rubber latex; IgE anti-latex; diagnosis; serologic testing; human ID HISTAMINE-RELEASE; AMMONIATED LATEX; ALLERGY; PREVALENCE; EXTRACTS; PROTEINS AB Background: In the absence of Food and Drug Administration-approved natural rubber latex skin testing reagents, latex-specific IgE antibody immunoassays are used in the diagnosis of latex allergy. Comparative diagnostic performance of these tests has not been definitively determined. Objective: We sought to study the predictive value of available Food and Drug Administration (510K)-cleared latex-specific IgE antibody immunoassays in the diagnosis of latex allergy. Methods: Subjects (n = 312) were classified as having a positive (n = 117) or a negative (n = 195) latex allergy history (Hx) or having a positive (n = 131) or a negative (n = 181) puncture skin test (PST) response (Greer reagent). The 14 subjects with a negative Hx and a positive PST response had negative responses to glove provocation testing and thus were considered sensitized but asymptomatic. Sera from 22 subjects were split to evaluate intra-assay variation. All 334 coded sera were analyzed for latex-specific IgE antibodies in the Diagnostic Products Corporation microplate AlaSTAT, Hycor HY-TEC EIA System, and Pharmacia-UpJohn CAP System. Variance and diagnostic performance parameters of each test were computed with 95% confidence intervals in relation to the subjects' Hx and PST status. Results: Intra-assay concordance of split sera results was 96.0% for all 3 assays, with coefficients of variation of less than 25% and between-assay coefficients of variation of less than 21%. The diagnostic performance of the CAP and AlaSTAT assays were equivalent in comparison with PST results: sensitivity, CAP 76.3% and ALASTAT 73.3% and specificity, CAP 96.7% and AlaSTAT 97.2% (P = NS). The HY-TEC assay was more sensitive (91.6%) and less specific (73.3%) than the CAP and AlaSTAT assays (P < .001). From 9% to 25% of the sera were discordant, being positive in at least 1, but not all 3, assays. Conclusion: The CAP and AlaSTAT assays produce 24% and 27% of false-negative results, respectively, whereas the HY-TEC produces 27% of false-positive results when compared with the PST. C1 Johns Hopkins Univ, Sch Med, Johns Hopkins Asthma & Allergy Ctr, Div Clin Immunol & Allergy, Baltimore, MD 21224 USA. NIOSH, Div Biomed & Behav Sci, Dept Hlth & Human Serv, Publ Hlth Serv,Ctr Dis Control & Prevent, Cincinnati, OH USA. RP Hamilton, RG (reprint author), Johns Hopkins Univ, Sch Med, Johns Hopkins Asthma & Allergy Ctr, Div Clin Immunol & Allergy, Room 1A20,5501 Hopkins Bayview Circle, Baltimore, MD 21224 USA. NR 27 TC 73 Z9 76 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD MAY PY 1999 VL 103 IS 5 BP 925 EP 930 DI 10.1016/S0091-6749(99)70440-9 PN 1 PG 6 WC Allergy; Immunology SC Allergy; Immunology GA 199FP UT WOS:000080470200031 PM 10329830 ER PT J AU Peng, SL Whitaker, JS AF Peng, SL Whitaker, JS TI Mechanisms determining the atmospheric response to midlatitude SST anomalies SO JOURNAL OF CLIMATE LA English DT Article ID SEA-SURFACE TEMPERATURE; DECADAL CLIMATE VARIABILITY; GENERAL-CIRCULATION MODEL; NORTH PACIFIC; ATLANTIC; OCEAN; FREQUENCY; GCM; DEPENDENCE; DYNAMICS AB Previous GCM experiments demonstrated that a model atmosphere produces two different responses to a midlatitude warm SST anomaly over the Pacific under perpetual January and February conditions. To elucidate the mechanisms responsible for the different GCM responses and their dependence on the background How, experiments with two idealized models are conducted. Experiments with a linear baroclinic model reveal that the GCM responses at equilibrium are primarily maintained by the anomalous eddy forcing. The anomalous Bow induced directly by an idealized initial heat source exhibits little sensitivity to the background How. Eddy feedbacks on the heating-induced anomalous flow are examined using a linear storm track model. The anomalous eddy Forcing produced by the storm track model is sensitive to the basic state. The eddy forcing in January acts to shift the heating-induced upper-level ridge toward the northeast of the Gulf of Alaska, while in February it acts to reinforce the ridge. This suggests that the differences in the GCM; responses are primarily associated with differences in the response of synoptic eddies to the presence of an anomalous ridge at the end of the Pacific storm track. The idealized model experiments are also performed with the observed winter mean flow. The eddy feedbacks depend on the position of the heating relative to the storm track. With the heating centered over the western Pacific the eddy-driven anomalous flow reinforces the ridge over the Pacific, similar to that in GCM February, but much stronger. No such reinforcement by the transients is found with the heating shifted over the eastern Pacific. These results suggest that SST anomalies over the western Pacific perhaps play a more active role in midlatitude atmosphere-ocean interactions. C1 NOAA, CIRES, CDC, R,E,CDI, Boulder, CO 80303 USA. RP Peng, SL (reprint author), NOAA, CIRES, CDC, R,E,CDI, 325 Broadway, Boulder, CO 80303 USA. NR 26 TC 170 Z9 177 U1 2 U2 11 PU AMER METEOROLOGICAL SOC PI BOSTON PA 45 BEACON ST, BOSTON, MA 02108-3693 USA SN 0894-8755 J9 J CLIMATE JI J. Clim. PD MAY PY 1999 VL 12 IS 5 BP 1393 EP 1408 DI 10.1175/1520-0442(1999)012<1393:MDTART>2.0.CO;2 PN 2 PG 16 WC Meteorology & Atmospheric Sciences SC Meteorology & Atmospheric Sciences GA 193PR UT WOS:000080145700004 ER PT J AU Rosen, CJ Kiel, DP Langlois, JA Visser, M AF Rosen, CJ Kiel, DP Langlois, JA Visser, M TI Association between insulin-like growth factor (IGF-I) and bone mineral density: Further evidence linking IGF-I to breast cancer risk - Authors' response SO JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM LA English DT Letter C1 St Joseph Hosp, Maine Ctr Osteoporosis Res & Educ, Bangor, ME 04401 USA. Harvard Univ, Sch Med, Hebrew Rehabil Ctr Aged, Res & Training Inst, Boston, MA USA. Harvard Univ, Sch Med, Div Aging, Boston, MA USA. Natl Ctr Injury Prevent & Control, Atlanta, GA USA. EMGO Inst, Amsterdam, Netherlands. RP Rosen, CJ (reprint author), St Joseph Hosp, Maine Ctr Osteoporosis Res & Educ, 360 Broadway, Bangor, ME 04401 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0021-972X EI 1945-7197 J9 J CLIN ENDOCR METAB JI J. Clin. Endocrinol. Metab. PD MAY PY 1999 VL 84 IS 5 BP 1761 EP 1761 DI 10.1210/jc.84.5.1761 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 193MZ UT WOS:000080141600053 ER PT J AU Oberste, MS Maher, K Kilpatrick, DR Flemister, MR Brown, BA Pallansch, MA AF Oberste, MS Maher, K Kilpatrick, DR Flemister, MR Brown, BA Pallansch, MA TI Typing of human enteroviruses by partial sequencing of VP1 SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID MOLECULAR EPIDEMIOLOGY; DEOXYINOSINE RESIDUES; CODON DEGENERACY; MIXED-BASE; IDENTIFICATION; POLIOVIRUSES; VIRUS; PICORNAVIRUSES; OUTBREAKS; POSITIONS AB Human enteroviruses (family Picornaviridae) are the major cause of aseptic meningitis and also cause a wide range of other acute illnesses, including neonatal sepsis-like disease, acute flaccid paralysis, and acute hemorrhagic conjunctivitis. The neutralization assay is usually used for enterovirus typing, but it is labor-intensive and time-consuming and standardized antisera are in Limited supply, We hare developed a molecular typing system based on reverse transcription-PCR and nucleotide sequencing of the 3' half of the genomic region encoding VP1. The standard PCR primers amplify approximately 450 bp of VP1 for most known human enterovirus serotypes. The serotype of an "unknown" may be inferred by comparison of the partial VPI sequence to those in a database containing VP1 sequences for the prototype strains of all 66 human enterovirus serotypes. Fifty-one clinical isolates of known serotypes from the years 1991 to 1998 were amplified and sequenced, and the antigenic and molecular typing results agreed for all isolates. With one exception, the nucleotide sequences of homologous strains were at least 75% identical to one another (>88% amino acid identity). Strains with homologous serotypes were easily discriminated from those with heterologous serotypes by using these criteria for identification. This method can greatly reduce the time required to type an enterovirus isolate and can be used to type isolates that are difficult or impossible to type with standard immunological reagents. The technique may. also be useful for the rapid determination of whether viruses isolated during an outbreak are epidemiologically related. C1 Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis, Atlanta, GA 30333 USA. RP Oberste, MS (reprint author), Ctr Dis Control & Prevent, Natl Ctr Infect Dis, Resp & Enter Viruses Branch, Div Viral & Rickettsial Dis, 1600 Clifton Rd NE,Mailstop G-17, Atlanta, GA 30333 USA. NR 29 TC 347 Z9 388 U1 1 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAY PY 1999 VL 37 IS 5 BP 1288 EP 1293 PG 6 WC Microbiology SC Microbiology GA 187NG UT WOS:000079792400010 PM 10203472 ER PT J AU Pellett, PE Spira, TJ Bagasra, O Boshoff, C Corey, L de Lellis, L Huang, ML Lin, JC Matthews, S Monini, P Rimessi, P Sosa, C Wood, C Stewart, JA AF Pellett, PE Spira, TJ Bagasra, O Boshoff, C Corey, L de Lellis, L Huang, ML Lin, JC Matthews, S Monini, P Rimessi, P Sosa, C Wood, C Stewart, JA TI Multicenter comparison of PCR assays for detection of human herpesvirus 8 DNA in semen SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID VIRUS-INFECTED MEN; KAPOSIS-SARCOMA; NEGATIVE INDIVIDUALS; HOMOSEXUAL MEN; SEQUENCES; PROSTATE; AIDS; HUMAN-HERPESVIRUS-8; ABSENCE; BLOOD AB Reported prevalences of human herpesvirus 8 (HHV-8) (Kaposi's sarcoma-associated herpesvirus) in semen hare ranged widely. This is possibly due to differences in assay sensitivity, geographic or population-based differences in the true presence of the virus in semen, and PCR contamination, This study assessed interlaboratory sensitivity and reproducibility in the analysis of blinded experimental panels, each consisting of 48 specimens and being composed of semen specimens from different healthy artificial-insemination donors (n = 30) and human immunodeficiency virus (HIV)-infected patients (n = 7) plus positive (n = 4) and negative (n = 7) controls. The experimental panels analyzed in each laboratory were identical except for being independently coded. Of 10 experiments done in five laboratories, 5 experiments from three laboratories had evidence of PCR contamination; all instances of contamination were in the contest of nested PCR procedures. In the experiments with no false-positive results, HHV-8 DNA was detected in three (8%) of the 37 semen specimens (two from artificial-insemination donors and one from an HIV-positive patient) but in only 3 (1.6%) of the 184 PCRs in which these specimens were analyzed. This suggests that HHV-8 DNA is present in semen at concentrations that can be too low to allow its consistent detection. This study emphasizes the importance of performing blinded, multi-institution experiments to provide a coherent basis for comparing results and to motivate standardization of methods. C1 Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. Thomas Jefferson Univ, Philadelphia, PA 19107 USA. Canc Res Inst, Chester Beatty Labs, London, England. Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA. Univ Ferrara, Inst Microbiol, I-44100 Ferrara, Italy. Univ Nebraska, Lincoln, NE 68583 USA. RP Pellett, PE (reprint author), Ctr Dis Control & Prevent, 1600 Clifton Rd,g18, Atlanta, GA 30333 USA. RI Monini, Paolo/K-1429-2016 OI Monini, Paolo/0000-0002-4941-6854 NR 25 TC 51 Z9 53 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAY PY 1999 VL 37 IS 5 BP 1298 EP 1301 PG 4 WC Microbiology SC Microbiology GA 187NG UT WOS:000079792400012 PM 10203474 ER PT J AU Murphy, G Belda, FJ Pau, CP Clewley, JP Parry, JV AF Murphy, G Belda, FJ Pau, CP Clewley, JP Parry, JV TI Discrimination of subtype B and non-subtype B strains of human immunodeficiency virus type 1 by serotyping: Correlation with genotyping SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; HIV-1 GROUP-O; HETERODUPLEX MOBILITY ASSAY; ANTIBODY-BINDING; V3 LOOP; SENSITIVITY; INFECTIONS; DIVERSITY; SEQUENCES; THAILAND AB The ability of a peptide-based serotyping assay to differentiate human immunodeficiency virus (HIV) type 1 (HIV-1) subtype B infections from non-subtype B infections was investigated with 166 anti-HIV-1- and HIV RNA-positive (by PCR) serum or plasma specimens. The specimens were divided genetically into those infected with subtype B and non-subtype B by application of a screening heteroduplex mobility assay (HMA) that used plasmids for subtypes A and B alone. Specimens that were not clearly infected with HIV-1 subtype B by HMA or for which the two methods had discordant results in distinguishing those infected with subtype B from those infected with non-subtype B were then investigated with a full I HMA plasmid panel and, For selected specimens, env sequencing. For the 141 genotyped and serotypically reactive specimens, the correlation between genotyping and serotyping (all subtypes) was 69%. Of the 67 specimens that reacted monotypically as serotype BI 64 were shown to be infected with genotype B (positive predictive value, 96%). Of the 82 specimens that contained genotype B nucleic acid, 64 reacted monotypically as serotype B (sensitivity 78%), and 4 specimens reacted with a single non-subtype B peptide; the viruses in 14 specimens could not be assigned a serotype. Initial screening results had indicated that 12 samples had results discordant between restricted HMA and serotyping. The V3 loop amino acids of the infecting HIV strains from the se, en specimens with discordant serology results were analyzed. For five specimens discordance occurred when the amino acid sequence of the infecting vints closely resembled those of more than one consensus peptide antigen or when the observed V3 crown motif of the strain was atypical for the genetic subtype present. For the other two specimens no explanation for the discordance,vas identified. Five specimens gave unclear or discordant results in the initial HMA screen, but the results were resolved when the full plasmid panel was used. Serotyping, although of limited sensitivity, distinguishes between subtype B and non-subtype B infections with a high degree of specificity. However, it poorly differentiates the major non-subtype B subtypes, particularly; subtypes A and C, When HIV-1 subtype B predominates, serological typing and,or subtype-restricted HMA screening usefully distinguishes between subtype B and non-subtype B infections. C1 Cent Publ Hlth Lab, Hepatitis & Retrovirus Lab, PHLS Virus Reference Div, London NW9 5HT, England. Ctr Dis Control & Prevent, Div Aids, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. Ctr Dis Control & Prevent, STD & TB Lab, Natl Ctr Infect Dis, Atlanta, GA 30333 USA. RP Parry, JV (reprint author), Cent Publ Hlth Lab, Hepatitis & Retrovirus Lab, PHLS Virus Reference Div, 61 Colindale Ave, London NW9 5HT, England. NR 24 TC 30 Z9 31 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAY PY 1999 VL 37 IS 5 BP 1356 EP 1360 PG 5 WC Microbiology SC Microbiology GA 187NG UT WOS:000079792400024 PM 10203486 ER PT J AU Holmberg, M MgGill, S Ehrenborg, C Wesslen, L Hjelm, E Darelid, J Blad, L Engstrand, L Regnery, R Friman, G AF Holmberg, M MgGill, S Ehrenborg, C Wesslen, L Hjelm, E Darelid, J Blad, L Engstrand, L Regnery, R Friman, G TI Evaluation of human seroreactivity to Bartonella species in Sweden SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID SEROLOGICAL CROSS-REACTIONS; SP-NOV; QUINTANA; ENDOCARDITIS; HENSELAE; PATIENT AB Among the species that compose the expanding genus Bartonella, thus far only B. henselae and B. quintana have reportedly been isolated from humans in Europe. To evaluate the prevalence of Bartonella infection in Sweden,we conducted a retrospective serological examination of 126 human serum samples. These samples were analyzed for antibodies to B. henselae, B. quintana, and B. elizabethae, Serum samples from 100 blood donors, who spanned the ages of 20 to 60 and had no apparent clinical signs of illness, were also studied as a control group. An immunoglobulin G indirect fluorescence antibody assay revealed 4 and 8.3% Bartonella positivity rates for the blood donor and patient group, respectively, when a cutoff titer of greater than or equal to 64 was chosen. Among the blood donors, four were seropositive to B, elizabethae; one of these also had concordant positive titer to B. henselae, In the patient group, 14 serum samples were positive against Bartonella spp, These serum specimens represented nine patients. In three of these seropositive patients, paired serum samples displayed a fourfold increase in antibody titer to at least one of the three antigens, These three patients are discussed. In this report we also present a case study of a 60-year-old Swedish male with fatal myocarditis, Postmortem serological analysis revealed a high titer against B. elizabethae, PCR and nucleotide sequencing of the myocardial tissue from this patient, and of Liver tissue from one of the other three patients, showed sequences similar to B. quintana, The age, geographical origin, animal contacts, and serological response pattern to the different Bartonella antigens differed among the four patients. This study substantiates the presence of Bartonella spp, in Sweden, documents the seroreactivity to three Bartonella antigens in Swedish patients, and reports the first two cases of B. quintana-like infections in Sweden. C1 Univ Uppsala Hosp, Infect Dis Sect, Dept Med Sci, S-75185 Uppsala, Sweden. Univ Uppsala Hosp, Dept Med Sci, Sect Clin Bacteriol, S-75185 Uppsala, Sweden. Cty Hosp, Dept Infect Dis, Jonkoping, Sweden. Cty Hosp, Dept Infect Dis, Gavle, Sweden. US Dept HHS, Publ Hlth Serv, Ctr Dis Control & Prevent, Atlanta, GA USA. RP Holmberg, M (reprint author), Univ Uppsala Hosp, Infect Dis Sect, Dept Med Sci, S-75185 Uppsala, Sweden. NR 12 TC 27 Z9 28 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAY PY 1999 VL 37 IS 5 BP 1381 EP 1384 PG 4 WC Microbiology SC Microbiology GA 187NG UT WOS:000079792400029 PM 10203491 ER EF