FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Gold, BD Khanna, B Huang, LM Lee, CY Banatvala, N AF Gold, BD Khanna, B Huang, LM Lee, CY Banatvala, N TI Helicobacter pylori acquisition in infancy after decline of maternal passive immunity SO PEDIATRIC RESEARCH LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; CAMPYLOBACTER-PYLORI; ANTIBODY-RESPONSE; GASTRIC-MUCOSA; INFECTION; CHILDREN; DIAGNOSIS; RISK; INFLAMMATION; ASSOCIATION AB We evaluated the natural history of Helicobacter pylori infection and the host immune response in 80 infants, and determined seroprevalence of H. pylori infection in their Taiwanese mothers. Decline in passively transferred maternal anti-H. pylori IgG antibodies and subsequent H. pylori infection was assessed in infants over 14 mo. A sensitive and specific, 96-well microtiter ELISA for the detection of H. pylori IgG antibodies was used to evaluate maternal serum (single specimen) and their infants (birth, 1, 2, 3, 6, 12, and 14 mo). Sera were also evaluated by ELISA for the presence of anti-H. pylori IgM antibodies in the infants. Maternal H. pylori IgG seroprevalence was 62.5% [50/80; 95% confidence intervals (CI), 51-73%]. All infants born to the 50 seropositive mothers passively acquired maternal H. pylori IgG. Transplacentally transferred maternal anti-H. pylori IgG lasted until about the 3rd mo of life, and disappeared in nearly ail the infants by 6 mo of age. Seven and one-half percent of infants (6/80; 95% CI, 3-16%) acquired H. pylori infection; two were born to H. pylori-negative mothers. Among the six IgG seropositive infants, an IgM response specific for H. pylori antigens was detected and appeared to precede the rise in IgG in five. We conclude that maternal passive transfer of IgG antibodies occurs in the infant and disappears by 6 mo of age. H. pylori infection is acquired in infancy in this population: IgM antibodies against H. pylori are detectable, seem short-lived, and appear to precede IgG antibody development. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA. NATL TAIWAN UNIV HOSP,DEPT PEDIAT,TAIPEI 10016,TAIWAN. ST BARTHOLOMEWS HOSP,DEPT EPIDEMIOL & MED STAT,LONDON,ENGLAND. ROYAL LONDON SCH MED & DENT,LONDON,ENGLAND. RP Gold, BD (reprint author), EMORY UNIV,SCH MED,DEPT PEDIAT,DIV PEDIAT GASTROENTEROL & NUTR,2040 RIDGEWOOD DR NE,ATLANTA,GA 30322, USA. OI LEE, CHIN-YUN/0000-0002-3938-377X; Huang, Li-Min/0000-0002-9291-260X NR 43 TC 62 Z9 65 U1 0 U2 1 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD MAY PY 1997 VL 41 IS 5 BP 641 EP 646 DI 10.1203/00006450-199705000-00007 PG 6 WC Pediatrics SC Pediatrics GA WV663 UT WOS:A1997WV66300007 PM 9128285 ER PT J AU Brown, CM Anderson, HA Etzel, RA AF Brown, CM Anderson, HA Etzel, RA TI Asthma - The State's challenge SO PUBLIC HEALTH REPORTS LA English DT Article ID CHILDHOOD ASTHMA; RISK-FACTORS; CHILDREN; EXACERBATIONS; POLLUTION; SEVERITY; EXPOSURE; PROFILE AB AT THE NATIONAL LEVEL, asthma is increasingly being recognized as an important public health problem, Because of the significant role of environmental exposure in asthma morbidity, public health agencies have a critical role to play in the surveillance and prevention of the disease, In April 1996, the Council of State and Territorial Epidemiologists, with assistance from the Centers for Disease Control and Prevention, surveyed state and territorial public health departments to determine the status of their asthma surveillance and intervention programs. Of the 51 health departments that responded, only eight reported that they had implemented an asthma control program within the previous 10 years, Reasons cited for not having programs included lack of funds, shortage of personnel, and asthma not being a priority, Most states were unable to assess the burden of asthma because they lack data or face barriers to using existing data. Removing barriers to the use of data is a first step toward defining the scope of the asthma problem. C1 CTR DIS CONTROL & PREVENT,DIV ENVIRONM HAZARDS & HLTH EFFECTS,NATL CTR ENVIRONM HLTH,ATLANTA,GA. COUNCIL STATE & TERR EPIDEMIOLOGISTS,ATLANTA,GA. NR 31 TC 16 Z9 16 U1 0 U2 0 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPT OF DOCUMENTS, WASHINGTON, DC 20402-9325 SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAY-JUN PY 1997 VL 112 IS 3 BP 198 EP 205 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WZ466 UT WOS:A1997WZ46600029 PM 9160053 ER PT J AU Howell, MR Kassler, WJ Haddix, A AF Howell, MR Kassler, WJ Haddix, A TI Partner notification to prevent pelvic inflammatory disease in women - Cost-effectiveness of two strategies SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID CHLAMYDIA-TRACHOMATIS INFECTIONS; TRANSMISSION; GONORRHEA; RISK; MEN AB Background and Objectives: Partner notification is an important strategy for prevention of Chlamydia trachomatis infection and pelvic inflammatory disease (PID), PID can be prevented by early diagnosis and treatment of the female sex partners of men infected with C. trachomatis (strategy 1) and by preventing reinfection in women through diagnosis and treatment of their male sex partners (strategy 2), Study Design: Using a decision model, the cost-effectiveness of strategies 1 and 2 was compared to no partner notification, Outcomes were measured by cases of PID prevented and net costs expended from a health care system perspective, Results: In a hypothetical cohort of 1,000 male and 1,000 female index patients, strategy 1 prevented 64 and strategy 2 prevented 20 cases of PID, Strategy 1 saved $247,000 and strategy 2 saved $33,000 over no partner notification, Sensitivity analysis showed that strategy 1 was cost-effective across a wide range of assumptions, Strategy 2 was cost-effective at baseline, but its cost-saving ability was subject to changes in the model, Conclusion: Partner notification of both male and female index patients is a cost-effective public health strategy for prevention of PID, In most settings, both strategies can and should be implemented. C1 CTR DIS CONTROL,NATL CTR PREVENT SERV,DIV STD PREVENT,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR PREVENT SERV,EPIDEMIOL PROGRAM OFF,PREVENT EFFECTIVENESS ACT,ATLANTA,GA. RP Howell, MR (reprint author), JOHNS HOPKINS UNIV,SCH MED,DIV INFECT DIS,1159 ROSS RES BLDG,720 RUTLAND AVE,BALTIMORE,MD 21205, USA. NR 26 TC 36 Z9 37 U1 2 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD MAY PY 1997 VL 24 IS 5 BP 287 EP 292 DI 10.1097/00007435-199705000-00010 PG 6 WC Infectious Diseases SC Infectious Diseases GA WY432 UT WOS:A1997WY43200010 PM 9153739 ER PT J AU Ku, L Sonenstein, FL Turner, CF Aral, SO Black, CM AF Ku, L Sonenstein, FL Turner, CF Aral, SO Black, CM TI The promise of integrated representative surveys about sexually transmitted diseases and behavior SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID LIGASE CHAIN-REACTION; UNITED-STATES; CHLAMYDIA-TRACHOMATIS; CONDOM USE; ADOLESCENT MALES; RISK-FACTORS; MEN; INFECTIONS; PREVALENCE; URINE AB Background: It has been difficult to conduct representative surveys measuring both sexually transmitted disease prevalence and behavioral data, This article reviews the literature, describes a recent pretest of the feasibility of integrated surveys, and discusses the potential implications, Methods: Several national surveys are reviewed, including the National Health and Nutrition Examination Surveys, National Health and Social Life Survey, and National Survey of Adolescent Males, The 1994 pretest of the National Survey of Adolescent Males collected urine specimens of male respondents, which were tested for Chlamydia trachomatis using ligase and polymerase chain reaction tests, Results: There have not been any prior national surveys that collect clinical measures of STD infection and detailed behavioral data, In the pretest, 85% of the eligible interview respondents provided a urine specimen, Of those tested, 6% were positive for C. trachomatis. Conclusions: Combining behavioral surveys with collection of urine specimens for STD testing in representative samples is feasible, However, STD testing adds new operational and ethical challenges to the conduct of household surveys. C1 RES TRIANGLE INST,ROCKVILLE,MD. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Ku, L (reprint author), URBAN INST,2100 M ST NW,WASHINGTON,DC 20037, USA. OI Ku, Leighton/0000-0002-6154-9289 NR 47 TC 20 Z9 20 U1 1 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD MAY PY 1997 VL 24 IS 5 BP 299 EP 309 DI 10.1097/00007435-199705000-00012 PG 11 WC Infectious Diseases SC Infectious Diseases GA WY432 UT WOS:A1997WY43200012 PM 9153741 ER PT J AU Chapman, DP Giles, WH AF Chapman, DP Giles, WH TI Pharmacologic and dietary therapies in epilepsy: Conventional treatments and recent advances SO SOUTHERN MEDICAL JOURNAL LA English DT Article ID NEWLY-DIAGNOSED EPILEPSY; QUALITY-OF-LIFE; CONTROLLED-RELEASE CARBAMAZEPINE; PARTIAL-ONSET SEIZURES; DOUBLE-BLIND; SODIUM VALPROATE; LONG-TERM; FELBAMATE MONOTHERAPY; PSYCHOMOTOR FUNCTIONS; REFRACTORY EPILEPSY AB A number of treatment options are currently available for the medical management of epilepsy. Conventional antiepileptic drugs (AEDs) include phenytoin, carbamazepine, valproic acid, ethosuximide, barbiturates, and benzodiazepines. Although these drugs control seizures, they may also cause blood dyscrasias, sedation, and cognitive impairment. Felbamate, gabapentin, lamotrigine, and vigabatrin are new AEDs believed to cause fewer side effects than conventional medications. Felbamate, however, has been linked with substantially increased incidence of aplastic anemia, and the other new AEDs have been studied for relatively short periods of time. Ketogenic diets, comprised of foods high in fat and low in protein and carbohydrate content, have been reported to improve seizure control. However, these diets are widely acknowledged to be unpalatable, making sustained compliance with dietary restrictions difficult. To promote long-term control of seizures, physicians must consider the side effects of therapeutic interventions for epilepsy, as well as their anticonvulsant efficacy. RP Chapman, DP (reprint author), CTR DIS CONTROL & PREVENT,AGING STUDIES BRANCH,4770 BUFORD HWY NE,MAINSTOP K-51,ATLANTA,GA 30341, USA. NR 95 TC 5 Z9 5 U1 1 U2 2 PU SOUTHERN MEDICAL ASSN PI BIRMINGHAM PA 35 LAKESHORE DR PO BOX 190088, BIRMINGHAM, AL 35219 SN 0038-4348 J9 SOUTHERN MED J JI South.Med.J. PD MAY PY 1997 VL 90 IS 5 BP 471 EP 480 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA WZ806 UT WOS:A1997WZ80600001 PM 9160061 ER PT J AU Hooper, WC Phillips, DJ Evatt, BL AF Hooper, WC Phillips, DJ Evatt, BL TI Endothelial cell protein S synthesis is upregulated by the complex of IL-6 and soluble IL-6 receptor SO THROMBOSIS AND HAEMOSTASIS LA English DT Article ID TUMOR-NECROSIS-FACTOR; INTERLEUKIN-6 RECEPTOR; SIGNAL TRANSDUCER; CYTOKINE REGULATION; ESCHERICHIA-COLI; GENE-EXPRESSION; GP130; COAGULATION; TRIGGERS; PATHWAY AB We have recently demonstrated that the proinflammatory cytokine, interleukin-6 (IL-6), could upregulate the production of protein S in the human hepatoma cell line, HepG-2, but not in endothelial cells. In this study, we have demonstrated that the combination of exogenous IL-6 and soluble IL-6 receptor (sIL-6R) could significantly upregulate protein S production in both primary human umbilical vein endothelial cells (HUVEC) and in the immortalized human microvascular endothelial cell line, HMEC-1. The IL-6/sIL-6R complex was also able to rapidly induce tyrosine phosphorylation of the IL-6 transducer, gp 130. Neutralizing antibodies directed against either IL-6 or gp130 blocked protein S upregulation by the IL-6/sIL-6R complex. It was also observed that exogenous sIL-6R could also upregulate protein S by forming a complex with IL-6 constitutively produced by the endothelial cell. Two other cytokines which also utilize the gp130 receptor, oncostatin M (OSM) and leukemia inhibitory factor (LIF), were also able to upregulate endothelial cell protein S. This study demonstrates a mechanism that allows endothelial cells to respond to IL-6 and also illustrates the potential importance of circulating soluble receptors in the regulation of the anticoagulation pathway. RP Hooper, WC (reprint author), CTR DIS CONTROL,NATL CTR INFECT DIS,HEMATOL DIS BRANCH,DIV HIV AIDS,MS-D02,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 42 TC 18 Z9 19 U1 0 U2 0 PU F K SCHATTAUER VERLAG GMBH PI STUTTGART PA P O BOX 10 45 45, LENZHALDE 3, D-70040 STUTTGART, GERMANY SN 0340-6245 J9 THROMB HAEMOSTASIS JI Thromb. Haemost. PD MAY PY 1997 VL 77 IS 5 BP 1014 EP 1019 PG 6 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA WZ706 UT WOS:A1997WZ70600039 PM 9184420 ER PT J AU Crudder, S Huszti, H Parsons, J Parish, K Jarvis, D LloydSchulz, S Gage, B AF Crudder, S Huszti, H Parsons, J Parish, K Jarvis, D LloydSchulz, S Gage, B TI Stage-based HIV risk reduction behavioral interventions in adults with hemophilia. SO TRANSFUSION LA English DT Meeting Abstract C1 HEMOPHILIA FDN MICHIGAN,DETROIT,MI. CHILDRENS HOSP,OKLAHOMA CITY,OK. JERSEY CITY STATE COLL,JERSEY CITY,NJ. HUNTINGTON HOSP,PASADENA,CA. CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 SN 0041-1132 J9 TRANSFUSION JI Transfusion PD MAY PY 1997 VL 37 IS 5 BP 535 EP 536 PG 2 WC Hematology SC Hematology GA WY256 UT WOS:A1997WY25600021 ER PT J AU Soucie, JM Evatt, B AF Soucie, JM Evatt, B TI Factors associated with hospitalization for infection or bleeding among persons with hemophilia in the United States. SO TRANSFUSION LA English DT Meeting Abstract C1 CDC,HEMATOL DIS BRANCH,ATLANTA,GA 30333. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 SN 0041-1132 J9 TRANSFUSION JI Transfusion PD MAY PY 1997 VL 37 IS 5 BP 536 EP 537 PG 2 WC Hematology SC Hematology GA WY256 UT WOS:A1997WY25600023 ER PT J AU Belliot, G Laveran, H Monroe, SS AF Belliot, G Laveran, H Monroe, SS TI Capsid protein composition of reference strains and wild isolates of human astroviruses SO VIRUS RESEARCH LA English DT Article DE capsid protein; human astroviruses; gastroenteritis ID RNA SEQUENCE; GASTROENTERITIS; DIARRHEA; OUTBREAK; VIRUSES; SEROTYPES; SIGNAL; REGION AB Astroviruses are small RNA viruses that are frequently associated with gastroenteritis in humans and animals. Despite much work on the genetic analysis of astrovirus strains, little progress has been made in the characterization of the proteins composing mature virions. We have analyzed the capsid protein composition of the reference strains and several wild isolates of human astroviruses using high-resolution polyacrylamide gradient gels. For reference strains of the seven serotypes analyzed, a consistent pattern of three infection-specific proteins-designated P1, P2, and P3-was generally observed. The strains could be divided into two groups, based upon the reactivity of these proteins in immune precipitation assays that used homologous rabbit serum. One group included reference types 1-4 for which all three proteins were precipitated by homologous rabbit sera; for the other group, types 5-7, only proteins P2 and P3 were precipitated. When wild isolates from around the world were compared to the reference strains, a correlation between genetic type and the pattern of protein sizes and immune reactivity was observed for strains of the common types (1-4). Strains of types 2 and 4 consistently exhibited P3 proteins larger than those of types 1 and 3. Unusual patterns of proteins or immune reactivity were detected in strains of types 5-7, indicating that there may be incomplete processing of the capsid precursor during growth in cell culture. (C) 1997 Elsevier Science B.V. C1 FAC MED,SERV HYG HOSP,CLERMONT FERRAN,FRANCE. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30333. OI Monroe, Stephan/0000-0002-5424-716X NR 26 TC 19 Z9 19 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-1702 J9 VIRUS RES JI Virus Res. PD MAY PY 1997 VL 49 IS 1 BP 49 EP 57 DI 10.1016/S0168-1702(97)01457-3 PG 9 WC Virology SC Virology GA XC443 UT WOS:A1997XC44300006 PM 9178496 ER PT J AU Huang, C Thompson, WH Karabatsos, N Grady, L Campbell, WP AF Huang, C Thompson, WH Karabatsos, N Grady, L Campbell, WP TI Evidence that fatal human infections with La Crosse virus may be associated with a narrow range of genotypes SO VIRUS RESEARCH LA English DT Article DE La Crosse virus; mosquito isolates; genotype; RNA ID VIRAL-RNA SEGMENT; CALIFORNIA SEROGROUP VIRUSES; SNOWSHOE HARE BUNYAVIRUS; LACROSSE VIRUS; MESSENGER-RNA; PROTEIN; GENOME; IDENTIFICATION; VIRULENCE; SEQUENCE AB La Crosse (LAC) virus belongs to the California (CAL) serogroup of the genus Bunyavirus lu, family Bunyaviridae. It is considered one of the most important mosquito-borne pathogens in North America, especially in the upper Mid-West, where it is associated with encephalitis during the time of year when mosquitoes are active. Infections occur most frequently in children and young adults and, while most cases are resolved after a period of intense illness, a small fraction (< 1%) are fatal. At present there have only been three isolates of LAC virus from humans, all made from brain tissue postmortem. The cases yielding viruses are separated chronologically by 33 years and geographically from Minnesota/Wisconsin (1960, 1978) to Missouri (1993). The M RNA sequence of the first two isolates was previously reported. The present study extends the observations to the isolate from the 1993 case and includes several mosquito isolates as well. A comparison of the M RNAs of these viruses shows that for the human isolates both nucleotide sequence and the deduced amino-acid sequence of the encoded proteins are highly conserved, showing a maximum variation of only 0.91% and 0.69%, respectively. This high degree of conservation over time and space leads to the hypothesis that human infections with this particular genotype of LAC virus are those most likely to have a fatal outcome. It is also shown that a virus with this genotype could be found circulating in mosquitoes in an area more or less intermediate between the locations of the first and second fatal cases. (C) 1997 Elsevier Science B.V. C1 CTR DIS CONTROL & PREVENT,FT COLLINS,CO 80522. RP Huang, C (reprint author), NEW YORK STATE DEPT HLTH,WADSWORTH CTR,POB 509,ALBANY,NY 12201, USA. NR 23 TC 18 Z9 18 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-1702 J9 VIRUS RES JI Virus Res. PD MAY PY 1997 VL 48 IS 2 BP 143 EP 148 DI 10.1016/S0168-1702(97)01437-8 PG 6 WC Virology SC Virology GA XA565 UT WOS:A1997XA56500004 PM 9175252 ER PT J AU Sheikh, NM Philen, RM Love, LA AF Sheikh, NM Philen, RM Love, LA TI Chaparral-associated hepatotoxicity SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID COMFREY HERB TEA; VENO-OCCLUSIVE DISEASE; NORDIHYDROGUAIARETIC ACID; GRANULOMATOUS HEPATITIS; LARREA-TRIDENTATA; ARACHIDONIC-ACID; LIVER-DAMAGE; SUPPLEMENTS; INGESTION; MEDICATION AB Background: Personal health care practices that may include the use of dietary supplements are common in the United States. Products marketed as dietary supplements are diverse and may include botanicals, vitamins, and/or minerals. Chaparral (Larrea tridentata) is a botanical dietary supplement made from a desert shrub and used for its antioxidant properties. Several reports of chaparral-associated hepatitis have been published since 1990, but a complete picture of the clinical presentation is still unclear. Materials and Methods: We reviewed the 18 case reports of adverse events associated with the ingestion of chaparral reported to the Food and Drug Administration between 1992 and 1994. These reports were from health care professionals, state health departments, and individual consumers. Results: Of 18 reports of illnesses associated with the ingestion of chaparral, there was evidence of hepatotoxicity in 13 cases. Clinical presentation, characterized as jaundice with a marked increase in serum liver chemistry values, occurred 3 to 52 weeks after the ingestion of chaparral, and it resolved 1 to 17 weeks after most individuals stopped their intake of chaparral. The predominant pattern of liver injury was characterized as toxic or drug-induced cholestatic hepatitis; in 4 individuals, there was progression to cirrhosis; and in 2 individuals, there was acute fulminant liver failure that required liver transplants. Conclusions: These data indicate that the use of chaparral may be associated with acute to chronic irreversible liver damage with fulminant hepatic failure, and they underscore the potential for certain dietary supplement ingredients to cause toxic effects on the liver. Health professionals should be encouraged to inquire routinely about the use of dietary supplements and other products, to be alert to potential adverse effects that may be associated with these products, and, finally, to report any serious adverse events associated with these products through the MEDWatch Program of the Food and Drug Administration. C1 US FDA,CTR FOOD SAFETY & APPL NUTR,OFF SPECIAL NUTR,CLIN RES & REVIEW STAFF,WASHINGTON,DC 20204. CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV ENVIRONM HAZARDS & HLTH EFFECTS,ATLANTA,GA. NR 38 TC 104 Z9 106 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD APR 28 PY 1997 VL 157 IS 8 BP 913 EP 919 DI 10.1001/archinte.157.8.913 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA WV850 UT WOS:A1997WV85000010 PM 9129552 ER PT J AU Giri, A Slattery, JP Heneine, W Gessain, A Rivadeneira, E Desrosiers, RC Rosen, L Anthony, R Pamungkas, J Iskandriati, D Richards, AL Herve, V McClure, H OBrien, SJ Franchini, G AF Giri, A Slattery, JP Heneine, W Gessain, A Rivadeneira, E Desrosiers, RC Rosen, L Anthony, R Pamungkas, J Iskandriati, D Richards, AL Herve, V McClure, H OBrien, SJ Franchini, G TI The tax gene sequences form two divergent monophyletic lineages corresponding to types I and II of simian and human T-Cell leukemia lymphotropic viruses SO VIROLOGY LA English DT Article ID COMPLETE NUCLEOTIDE-SEQUENCE; TROPICAL SPASTIC PARAPARESIS; HTLV-II; LYMPHOMA VIRUS; STLV-I; PHYLOGENETIC ANALYSES; HUMAN-POPULATIONS; BLOOD-DONORS; DRUG-ABUSERS; ANTIBODIES AB Evolutionary associations of human and simian T-cell leukemia/lymphotropic viruses I and II (HTLV-I/II and STLV-I/II) are inferred from phylogenetic analysis of lax gene sequences. Samples studied consisted of a geographically diverse assemblage of viral strains obtained from 10 human subjects and 20 individuals representing 12 species of nonhuman primates. Sequence analyses identified distinct substitutions, which distinguished between viral types I and II, irrespective of host species. Phylogenetic reconstruction of nucleotide sequences strongly supported two major evolutionary groups corresponding to viral types I and II. With the type I lineage, clusters were composed of strains from multiple host species. A genetically diverse, monophyletic lineage consisting of eight new viral strains from several species of Asian macaques was identified. The second lineage consisted of a monophyletic assemblage of HTLV-II/STLV-II strains from Africa and the New World, including an isolate from a pygmy chimp (Pan paniscus) as an early divergence within the lineage. High levels of genetic variation among strains from Asian STLV-I macaque suggest the virus arose in Asia. Evidence of the origin of the type II virus is less clear, but diversity among HTLV-II variants from a single isolated population of Mbati villagers is suggestive but not proof of an African origin. (C) 1997 Academic Press. C1 NCI,BASIC RES LAB,NIH,BETHESDA,MD 20892. NCI,LAB GENOM DIVERS,FREDERICK CANC RES & DEV CTR,FREDERICK,MD 21702. CTR DIS CONTROL & PREVENT,RETROVIRUS DIS BRANCH,DIV VIRAL & RICKETTSIAL DIS,CTR INFECT DIS,ATLANTA,GA 30333. INST PASTEUR,UNITE EPIDEMIOL VIRUS ONCOGENES,F-75724 PARIS 15,FRANCE. INST PASTEUR,SERV INFORMAT SCI,F-75724 PARIS 15,FRANCE. HARVARD UNIV,SCH MED,DIV MICROBIOL,SOUTHBOROUGH,MA 01772. UNIV HAWAII,PACIFIC BIOMED RES CTR,HONOLULU,HI 96816. AMER UNIV CARIBBEAN,BELIZE CITY,BELIZE. BOGOR AGR UNIC,PRIMATE RES CTR,BOGOR,INDONESIA. INST PASTEUR,BANGUI,CENT AFR REPUBL. YERKES REG PRIMATE RES CTR,ATLANTA,GA 30322. USN,MED RES UNIT N2,APO,AP 96520. NR 58 TC 13 Z9 13 U1 0 U2 0 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0042-6822 J9 VIROLOGY JI Virology PD APR 28 PY 1997 VL 231 IS 1 BP 96 EP 104 DI 10.1006/viro.1997.8511 PG 9 WC Virology SC Virology GA WW957 UT WOS:A1997WW95700012 PM 9143307 ER PT J AU Howanitz, PJ Tetrault, GA Steindel, SJ AF Howanitz, PJ Tetrault, GA Steindel, SJ TI Clinical laboratory quality control: A costly process now out of control SO CLINICA CHIMICA ACTA LA English DT Article DE quality control; laboratory costs; timeliness; quality costs; quality improvement; laboratory management ID CONTROL-SYSTEMS; CHEMISTRY; PRECISION; CRITERIA; GOALS AB We studied laboratory internal quality control (QC) processes using the College of American Pathologists Q-Probes program. Over 500 institutions participated, providing practices based on approximately 710 000 cholesterol, 880 000 calcium, 400 000 digoxin, and 1 180 000 hemoglobin QC results. The costs of QC included participant median control sample rates comprising 9.1, 9.4, 37.0, and 6.8% for the four analytes respectively, repeat patient test rates of 0.36% for hemoglobin to 0.65% for digoxin, and median delays in reporting results when QC exceptions occurred of 15.8 min for calcium to 24.7 min for hemoglobin. Quality control practices were complex and highly variable among participants and frequently differed from internal laboratory protocols and from long-established quality guidelines, We conclude that QC is costly, and laboratorians frequently do not follow established QC practices, in part because they are complex. To improve compliance, we believe QC practices must be simplified. (C) 1997 Elsevier Science B.V. C1 N SHORE UNIV HOSP,MANHASSET,NY. CTR DIS CONTROL & PREVENT,ATLANTA,GA. UNIV NEBRASKA,MED CTR,OMAHA,NE. RP Howanitz, PJ (reprint author), UNIV CALIF LOS ANGELES,DEPT PATHOL & LAB MED,10833 LECONTE AVE,LOS ANGELES,CA 90095, USA. NR 25 TC 19 Z9 22 U1 0 U2 4 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 APR 25 PY 1997 VL 260 IS 2 BP 163 EP 174 DI 10.1016/S0009-8981(96)06494-7 PG 12 WC Medical Laboratory Technology SC Medical Laboratory Technology GA WZ180 UT WOS:A1997WZ18000006 PM 9177911 ER PT J AU Clark, E Chia, J Waterman, S Soll, D AF Clark, E Chia, J Waterman, S Soll, D TI Candida albicans endocarditis with a contaminated aortic valve allograft - California, 1996 (Reprinted from MMWR, vol 46, pg 261-263, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CALIF DEPT HLTH SERV,SACRAMENTO,CA 95814. UNIV IOWA,IOWA CITY,IA 52242. CDC,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333. RP Clark, E (reprint author), TORRANCE MEM MED CTR,TORRANCE,CA 90505, USA. NR 1 TC 5 Z9 5 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 23 PY 1997 VL 277 IS 16 BP 1271 EP 1272 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WU135 UT WOS:A1997WU13500010 ER PT J AU Rodriguez, A Westbo, S Adam, B Langkop, C Francis, BJ AF Rodriguez, A Westbo, S Adam, B Langkop, C Francis, BJ TI Outbreak of aseptic meningitis - Whiteside County, Illinois, 1995 (Reprinted from MMWR, vol 46, pg 221-224, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CGH MED CTR,STERLING,IL. ILLINOIS DEPT PUBL HLTH,SPRINGFIELD,IL 62761. CDC,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV REPROD HLTH,PROGRAM SERV,ATLANTA,GA 30333. CDC,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV REPROD HLTH,DEV BRANCH,ATLANTA,GA 30333. CDC,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,RESP & ENTEROVIRUSES BRANCH,ATLANTA,GA 30333. RP Rodriguez, A (reprint author), WHITESIDE CTY HLTH DEPT,MORRISON,IL 61270, USA. NR 6 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 23 PY 1997 VL 277 IS 16 BP 1272 EP 1273 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WU135 UT WOS:A1997WU13500011 ER PT J AU Brewer, RD Siegel, PZ Mokdad, AH Serdula, M Liu, SM Sleet, D AF Brewer, RD Siegel, PZ Mokdad, AH Serdula, M Liu, SM Sleet, D TI Alcohol-impaired driving: The family's tragedy and the public's health - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 HARVARD UNIV,SCH PUBL HLTH,BOSTON,MA 02115. SAN DIEGO STATE UNIV,SAN DIEGO,CA 92182. RP Brewer, RD (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 23 PY 1997 VL 277 IS 16 BP 1280 EP 1280 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WU135 UT WOS:A1997WU13500024 ER PT J AU Zheng, LB Cornel, AJ Wang, R Erfle, H Voss, H Ansorge, W Kafatos, FC Collins, FH AF Zheng, LB Cornel, AJ Wang, R Erfle, H Voss, H Ansorge, W Kafatos, FC Collins, FH TI Quantitative trait loci for refractoriness of Anopheles gambiae to Plasmodium cynomolgi B SO SCIENCE LA English DT Article ID MALARIA VECTOR; AEDES-AEGYPTI; SUSCEPTIBILITY; ASSOCIATION; GALLINACEUM; MOSQUITO; MAP AB The severity of the malaria pandemic in the tropics is aggravated by the ongoing spread of parasite resistance to antimalarial drugs and mosquito resistance to insecticides. A strain of Anopheles gambiae, normally a major vector for human malaria in Africa, can encapsulate and kill the malaria parasites within a melanin-rich capsule in the mosquito midgut. Genetic mapping revealed one major and two minor quantitative trait loci (QTLs) for this encapsulation reaction. Understanding such antiparasite mechanisms in mosquitoes may lead to new strategies for malaria control. C1 EUROPEAN MOL BIOL LAB,D-69117 HEIDELBERG,GERMANY. CTR DIS CONTROL & PREVENT,CHAMBLEE,GA 30341. OI Wang-Sattler, Rui/0000-0002-8794-8229 NR 25 TC 155 Z9 164 U1 0 U2 5 PU AMER ASSOC ADVANCEMENT SCIENCE PI WASHINGTON PA 1200 NEW YORK AVE, NW, WASHINGTON, DC 20005 SN 0036-8075 J9 SCIENCE JI Science PD APR 18 PY 1997 VL 276 IS 5311 BP 425 EP 428 DI 10.1126/science.276.5311.425 PG 4 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA WU477 UT WOS:A1997WU47700043 PM 9103203 ER PT J AU Kelly, J AF Kelly, J TI Sports-related recurrent brain injuries - United States (Reprinted from MMWR, vol 46, pg 224-227, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID HEAD TRAUMA; CONCUSSION C1 AMER ACAD NEUROL,QUAL STAND SUBCOMM & TASK FORCE PREVENT NEUROL,MINNEAPOLIS,MN. CDC,DIV ACUTE CARE REHABIL RES & DISABIL PREVENT,ATLANTA,GA 30333. CDC,DIV UNINTENT INJURY PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA 30333. RP Kelly, J (reprint author), REHABIL INST CHICAGO,BRAIN INJURY PROGRAM,CHICAGO,IL 60611, USA. NR 11 TC 19 Z9 20 U1 1 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 1997 VL 277 IS 15 BP 1190 EP 1191 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WT403 UT WOS:A1997WT40300009 ER PT J AU Dawson, M Johnson, PT Feldman, L Glover, R Koehler, J Blake, P Toomey, KE AF Dawson, M Johnson, PT Feldman, L Glover, R Koehler, J Blake, P Toomey, KE TI Probable locally acquired mosquito-transmitted Plasmodium vivax infection - Georgia, 1996 (Reprinted from MMWR, vol 46, pg 264-267, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID MALARIA C1 GEORGIA DEPT HUMAN RESOURCES,EPIDEMIOL & PREVENT BR,DIV PUBL HLTH,ATLANTA,GA 30334. CDC,MALARIA SECT,EPIDEMIOL BRANCH,DIV PARASIT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP Dawson, M (reprint author), TIFT GEN HOSP,TIFTON,GA 31794, USA. NR 10 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 1997 VL 277 IS 15 BP 1191 EP 1193 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA WT403 UT WOS:A1997WT40300010 ER PT J AU Feldkamp, M Jones, KL Ornoy, A Pastuszak, A Rosenwasser, TS Schick, B Bar, J AF Feldkamp, M Jones, KL Ornoy, A Pastuszak, A Rosenwasser, TS Schick, B Bar, J TI Postmarketing surveillance for angiotensin-converting enzyme inhibitor use during the first trimester of pregnancy - United States, Canada, and Israel, 1987-1995 (Reprinted from MMWR, vol 46, pg 240-242, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CALIF TERATOGEN INFORMAT SERV,SAN DIEGO,CA. ISRAEL TERATOL INFORMAT SERV,JERUSALEM,ISRAEL. MOTHERISK PROGRAM,TORONTO,ON,CANADA. MASSACHUSETTS TERATOGEN INFORMAT SERV,BOSTON,MA. PREGNANCY HEALTHLINE,PHILADELPHIA,PA. BEILINSON TERATOL INFORMAT SERV,PETAH TIQWA,ISRAEL. CDC,BIRTH DEFECTS & GENET DIS BR,DIV BERTH DEFECTS & DEV DISABIL,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333. RP Feldkamp, M (reprint author), PREGNANCY RISKLINE,SALT LAKE CITY,UT, USA. NR 8 TC 22 Z9 22 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 1997 VL 277 IS 15 BP 1193 EP 1194 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WT403 UT WOS:A1997WT40300011 ER PT J AU Calvert, GM Steenland, K Palu, S AF Calvert, GM Steenland, K Palu, S TI End-stage renal disease among silica-exposed gold miners - A new method for assessing incidence among epidemiologic cohorts SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID LUNG-CANCER MORTALITY; GRANITE WORKERS; NEPHROPATHY; MERCURY; GLOMERULONEPHRITIS; NEPHROTOXICITY; FAILURE AB Objective.-To examine the association between silica exposure and end-stage renal disease (ESRD). Design.-Retrospective cohort study. Participants.-A cohort of 2412 white male gold miners was studied. Eligible gold miners worked underground for at least 1 year between 1940 and 1965 in a South Dakota gold mine and were alive on January 1, 1977. Of primary interest was exposure to silica. Methods.-The ESRD Program Management and Medical Information System (PMMIS) was used to identify members of the gold mine cohort who had treated ESRD and to create a US rate file for treated ESRD. The ESRD incidence among the gold miners was compared with that in the US population. Results.-Based on the 11 cohort members identified with treated ESRD, the risk for ESRD in the cohort was elevated (standardized incidence ratio [SIR], 1.37; 95% confidence interval [CI], 0.68-2.46). The risk was greatest for nonsystemic ESRD (ESRD caused by glomerulonephritis or interstitial nephritis) for which the SIR was 4.22 (95% CI, 1.54-9.19), increasing to 7.70 (95% CI, 1.59-22.48) among workers with 10 or more years of employment underground. Conclusions.-To our knowledge this is the first epidemiologic study to examine ESRD incidence in an occupational cohort. This study provides evidence that silica exposure is associated with an increased risk for ESRD, especially ESRD caused by glomerulonephritis. This study also demonstrates the usefulness of the ESRD PMMIS to assess ESRD risk among cohorts exposed to potential nephrotoxins. RP Calvert, GM (reprint author), CTR DIS CONTROL & PREVENT,NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDIES,CINCINNATI,OH 45226, USA. NR 37 TC 44 Z9 44 U1 1 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 16 PY 1997 VL 277 IS 15 BP 1219 EP 1223 DI 10.1001/jama.277.15.1219 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WT403 UT WOS:A1997WT40300033 PM 9103346 ER PT J AU Neal, JJ Fleming, PL Green, TA Ward, JW AF Neal, JJ Fleming, PL Green, TA Ward, JW TI Trends in heterosexually acquired AIDS in the United States, 1988 through 1995 SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE acquired immunodeficiency syndrome; human immunodeficiency virus infection trends; surveillance; exposure categories; heterosexuals ID CRACK COCAINE USE; IMMUNODEFICIENCY-VIRUS INFECTION; HIV-INFECTION; MALE TRANSMISSION; RISK-FACTORS; DISEASE; MEN; SEROCONVERSION; SYPHILIS; THAILAND AB We used national AIDS surveillance data to characterize trends in the numbers and proportions of heterosexually acquired AIDS cases diagnosed from January 1988 through December 1995 among adults and adolescents. We adjusted for expansion of the 1993 AIDS surveillance case definition and for delays in reporting, and we redistributed cases initially reported without risk. The chi-square test for linear trend was used to analyze trends at the p < 0.01 level by half-year of diagnosis and by sex, age, race or ethnicity, geographic region of residence at diagnosis, and partner's HIV exposure risk. From 1988 through 1995, heterosexual contact accounted for 10% of all AIDS cases. Heterosexual contact increased the most rapidly of all HIV exposure modes, with increases found among men and women in all age groups; among blacks, white, and Hispanics; and among persons living in all geographic regions of the country. Blacks and Hispanics accounted for 75% of all persons reported with AIDS attributed to heterosexual contact. Although heterosexual contact with an injection drug user (IDU) accounted for most cases until 1993, cases increased most rapidly among persons reporting heterosexual contact with an HIV-infected partner whose risk was not specified. Findings suggest continued growth of the heterosexual AIDS epidemic. Because of the disproportionate and increasing number of heterosexually acquired AIDS cases among blacks and Hispanics, black and Hispanic communities at risk for HIV infection should be considered a high priority for prevention and education programs specifically targeting heterosexually active adolescents and adults. Epidemiologic and behavioral research and prevention program evaluation are urgent public health priorities to better control and prevent the further spread of HIV among heterosexually active adults and adolescents. C1 CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. CTR DIS CONTROL & PREVENT,DIV AIDS STD & TB LAB RES,NATL CTR INFECT DIS,ATLANTA,GA. RP Neal, JJ (reprint author), COUNCIL STATE & TETTITORIAL EPIDEMIOLOGISTS,2872 WOODCOCK BLVD,SUITE 303,ATLANTA,GA 30341, USA. NR 48 TC 46 Z9 46 U1 1 U2 3 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 15 PY 1997 VL 14 IS 5 BP 465 EP 474 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XC491 UT WOS:A1997XC49100011 PM 9170422 ER PT J AU Lal, RB Pardi, D Switzer, W Segurado, A Black, F AF Lal, RB Pardi, D Switzer, W Segurado, A Black, F TI Immune reactivity of HTLV-IIa-infected Kayapo indians with HTLV-IIb extended tax epitope SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Letter ID VIRUS TYPE-II; LEUKEMIA-LYMPHOMA VIRUS; IDENTIFICATION C1 YALE UNIV,SCH MED,DEPT PUBL HLTH,NEW HAVEN,CT 06520. RP Lal, RB (reprint author), CTR DIS CONTROL & PREVENT,RETROVIRUS DIS BRANCH,ATLANTA,GA 30333, USA. RI Segurado, Aluisio/K-2229-2012 OI Segurado, Aluisio/0000-0002-6311-8036 NR 10 TC 2 Z9 4 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 15 PY 1997 VL 14 IS 5 BP 476 EP 477 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XC491 UT WOS:A1997XC49100013 PM 9170424 ER PT J AU Montesano, MA Freeman, GL Secor, WE Colley, DG AF Montesano, MA Freeman, GL Secor, WE Colley, DG TI Immunoregulatory idiotypes stimulate T helper 1 cytokine responses in experimental Schistosoma mansoni infections SO JOURNAL OF IMMUNOLOGY LA English DT Article ID DIFFERENT CLINICAL FORMS; GRANULOMA-FORMATION; IMMUNE-RESPONSES; IFN-GAMMA; INTERFERON-GAMMA; ANTIBODY; MICE; ANTIGEN; IL-4; RESPONSIVENESS AB Inbred male CBA/J mice with chronic Schistosoma mansoni infections develop two distinct syndromes. Hypersplenomegaly syndrome (HSS) demonstrates pathologic similarities to the hepatosplenic form of chronic human schistosomiasis, and moderate splenomegaly syndrome (MSS) resembles the asymptomatic intestinal form. Immunoaffinity-purified Abs against S. mansoni soluble egg Ags (SEA) from infected patients' sera differ idiotypically according to the donor's clinical form of the disease. We now show that immunoaffinity-purified anti-SEA Abs (Id) from MSS or HSS mice parallel idiotypic preparations of the analogous human clinical form by their differential ability to stimulate the proliferation of anti-Id T cells. MSS Id preparations stimulate spleen cells from either MSS or HSS animals. In contrast, HSS Id does not stimulate spleen cells from either group. In an anti-SEA ELISA, MSS and HSS Id preparations contained comparable levels of IgM and IgG1. However, the MSS Id preparation had higher levels of SEA-specific IgG2a and IgG2b than did HSS Id. The Ig isotypes of these Id preparations suggested differences in cytokine expression patterns. Studies of the cytokine profiles of the spleen cells responding to anti-SEA Id preparations demonstrated that while Id preparations from acutely infected mice stimulate IL-4 and IL-10 production, Id preparations from chronic MSS mice stimulate IFN-gamma production. HSS Id did not stimulate the production of any of these cytokines. The possibility that distinct immunoregulatory environments may contribute to the development of MSS and HSS correlates with earlier hypotheses that hepatosplenic pathology results at least in part from a lack of development or expression of appropriate regulatory Ids. C1 CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30341. FED UNIV JUIZ DE FORA,JUIZ DE FORA,BRAZIL. FU NIAID NIH HHS [AI11289] NR 36 TC 24 Z9 24 U1 0 U2 0 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD APR 15 PY 1997 VL 158 IS 8 BP 3800 EP 3804 PG 5 WC Immunology SC Immunology GA WT196 UT WOS:A1997WT19600033 PM 9103446 ER PT J AU Satten, GA AF Satten, GA TI Steady-state calculation of the risk of HIV infection from transfusion of screened blood from repeat donors SO MATHEMATICAL BIOSCIENCES LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; ANTIBODY; TRANSMISSION; SEROCONVERSION; TIME AB All blood donations in the United States are screened for human immunodeficiency virus (HIV), the virus that causes AIDS; in spite of this, potentially infectious donations are still made by donors who are infectious but have not yet developed detectable HIV antibodies. A steady-state model for blood donations is used to calculate the expected number of potentially infectious blood donations made by repeat blood donors in a specified time interval. The expected number of potentially infectious donations made by each infectious blood donor who subsequently becomes HIV positive is calculated, and estimators of this quantity are presented. The relative risks due to donations from repeat and first-time donors is discussed. Estimates of the proportion of all blood donations made at 19 American Red Cross regional blood centers that are potentially infectious are presented. Published 1997 by Elsevier Science, Inc. RP Satten, GA (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT SURVEILLANCE & EPIDEMIOL E48,ATLANTA,GA 30333, USA. NR 14 TC 14 Z9 14 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 0025-5564 J9 MATH BIOSCI JI Math. Biosci. PD APR 15 PY 1997 VL 141 IS 2 BP 101 EP 113 DI 10.1016/S0025-5564(96)00185-X PG 13 WC Biology; Mathematical & Computational Biology SC Life Sciences & Biomedicine - Other Topics; Mathematical & Computational Biology GA WP661 UT WOS:A1997WP66100002 PM 9103828 ER PT J AU Tenover, FC AF Tenover, FC TI Hot papers - Clinical microbiology - Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: Criteria for bacterial strain typing by F.C. Tenover, R.D. Arbeit, R.V. Goering, P.A. Mickelsen, B.E. Murray, D.H. Persing, B. Swaminathan - Comments SO SCIENTIST LA English DT Editorial Material AB Centers for Disease Control and Prevention researcher Fred C. Tenover discusses has criteria to unify microbial databases derived from pulsed-field gel electrophoresis. RP Tenover, FC (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 1 TC 0 Z9 0 U1 0 U2 2 PU SCIENTIST INC PI PHILADELPHIA PA 3600 MARKET ST SUITE 450, PHILADELPHIA, PA 19104 SN 0890-3670 J9 SCIENTIST JI Scientist PD APR 14 PY 1997 VL 11 IS 8 BP 11 EP 11 PG 1 WC Information Science & Library Science; Multidisciplinary Sciences SC Information Science & Library Science; Science & Technology - Other Topics GA WX946 UT WOS:A1997WX94600009 ER PT J AU Kinney, RM Butrapet, S Chang, GJJ Tsuchiya, KR Roehrig, JT Bhamarapravati, N Gubler, DJ AF Kinney, RM Butrapet, S Chang, GJJ Tsuchiya, KR Roehrig, JT Bhamarapravati, N Gubler, DJ TI Construction of infectious cDNA clones for dengue 2 virus: Strain 16681 and its attenuated vaccine derivative, strain PDK-53 SO VIROLOGY LA English DT Article ID YELLOW-FEVER VIRUS; RNA-STIMULATED NTPASE; 5' NONCODING REGION; MONOCLONAL-ANTIBODIES; NUCLEOTIDE-SEQUENCE; STRUCTURAL PROTEINS; PUTATIVE HELICASES; HEMORRHAGIC FEVER; FLAVIVIRUSES; GENOME AB We identified nine nucleotide differences between the genomes of dengue-2 (DEN-2) 16681 virus and its vaccine derivative, strain PDK-53. These included a C-to-T (16681-to-PDK-53) mutation at nucleotide position 57 of the 5'-untranslated region, three silent mutations, and substitutions prM-29 Asp to Val, NS1-53 Gly to Asp, NS2A-181 Leu to Phe, NS3-250 Glu to Val, and NS4A-75 Gly to Afa. Unpassaged PDK-53 vaccine contained two genetic Variants as a result of partial mutation at NS3-250. We constructed infectious cDNA clones for 16681 virus and each of the two PDK-53 variants. DEN-2 16681 clone-derived viruses were identical to the 16681 virus in plaque size and replication in LLC-MK2 cells, replication in C6/36 cells, E and prM epitopes, and neurovirulence for suckling mice. PDK-53 virus and both clone-derived PDK-53 variants were attenuated in mice. However, the Variant containing NS3-250-Glu was less temperature sensitive and replicated better in C6/36 cells than did PDK-53 virus. The variant containing NS3-250-Val had smaller, more diffuse plaques, decreased replication, and increased temperature sensitivity in LLC-MK2 cells relative to PDK-53 virus. Both PDK-53 virus and the NS3-250-Val variant replicated poorly in C6/36 cells relative to 16681 virus. Unpassaged PDK-53 Vaccine virus and the Virus passaged once in LLC-MK2 cells had genomes of identical sequence, including the mixed NS3-250-Glu/Val locus. Although the NS3-250-Val mutation clearly affected virus replication in vitro, it was not a major determinant of attenuation for PDK-53 virus in suckling mice. C1 MAHIDOL UNIV,INST SCI & TECHNOL DEV,CTR VACCINE DEV,NAKHON PATHOM 73170,THAILAND. RP Kinney, RM (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VECTOR BORNE INFECT DIS,US DEPT HHS,FT COLLINS,CO 80522, USA. OI Roehrig, John/0000-0001-7581-0479 NR 44 TC 210 Z9 219 U1 1 U2 3 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0042-6822 J9 VIROLOGY JI Virology PD APR 14 PY 1997 VL 230 IS 2 BP 300 EP 308 DI 10.1006/viro.1997.8500 PG 9 WC Virology SC Virology GA WV204 UT WOS:A1997WV20400017 PM 9143286 ER PT J AU Hill, RH Cameron, DN Jones, JJ Maslanka, SE Mathews, HM AF Hill, RH Cameron, DN Jones, JJ Maslanka, SE Mathews, HM TI Laboratory safety: Getting the ''buy-in''. SO ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY LA English DT Meeting Abstract C1 OFF HLTH & SAFETY,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,OFF HLTH & SAFETY F05,ATLANTA,GA 30333. NR 0 TC 0 Z9 0 U1 0 U2 1 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 SN 0065-7727 J9 ABSTR PAP AM CHEM S JI Abstr. Pap. Am. Chem. Soc. PD APR 13 PY 1997 VL 213 BP 49 EP CHAS PN 1 PG 1 WC Chemistry, Multidisciplinary SC Chemistry GA WP185 UT WOS:A1997WP18502074 ER PT J AU Wang, J Ashley, K AF Wang, J Ashley, K TI Development of efficient flow injection methods for field-test industrial hygiene samples SO ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY LA English DT Meeting Abstract C1 NIOSH,US DEPT HHS,PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 SN 0065-7727 J9 ABSTR PAP AM CHEM S JI Abstr. Pap. Am. Chem. Soc. PD APR 13 PY 1997 VL 213 BP 72 EP ANYL PN 1 PG 1 WC Chemistry, Multidisciplinary SC Chemistry GA WP185 UT WOS:A1997WP18500428 ER PT J AU Ma, L Sirimanne, SR Justice, JB Patterson, DG AF Ma, L Sirimanne, SR Justice, JB Patterson, DG TI New approach for cloud-point extraction of polycyclic aromatic hydrocarbons in human serum at trace level. SO ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY LA English DT Meeting Abstract C1 EMORY UNIV,DEPT CHEM,ATLANTA,GA 30322. CTR DIS CONTROL & PREVENT,CDC,ATLANTA,GA 30341. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 SN 0065-7727 J9 ABSTR PAP AM CHEM S JI Abstr. Pap. Am. Chem. Soc. PD APR 13 PY 1997 VL 213 BP 102 EP ANYL PN 1 PG 1 WC Chemistry, Multidisciplinary SC Chemistry GA WP185 UT WOS:A1997WP18500457 ER PT J AU Niemeier, RW Jones, P AF Niemeier, RW Jones, P TI Pesticide safety and the National Ag Safety Database (NASD). SO ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY LA English DT Meeting Abstract C1 UNIV FLORIDA,GAINESVILLE,FL 32611. NIOSH,CINCINNATI,OH 45226. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 SN 0065-7727 J9 ABSTR PAP AM CHEM S JI Abstr. Pap. Am. Chem. Soc. PD APR 13 PY 1997 VL 213 BP 152 EP AGRO PN 1 PG 1 WC Chemistry, Multidisciplinary SC Chemistry GA WP185 UT WOS:A1997WP18500342 ER PT J AU Ekpini, ER Wiktor, SZ Satten, GA AdjorloloJohnson, GT Sibailly, TS Ou, CY Karon, JM Brattegaard, K Whitaker, JP Gnaore, E DeCock, KM Greenberg, AE AF Ekpini, ER Wiktor, SZ Satten, GA AdjorloloJohnson, GT Sibailly, TS Ou, CY Karon, JM Brattegaard, K Whitaker, JP Gnaore, E DeCock, KM Greenberg, AE TI Late postnatal mother-to-child transmission of HIV-1 in Abidjan, Cote d'Ivoire SO LANCET LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; BREAST-MILK; TYPE-1; INFANT; INFECTION; RISK AB Background HIV-1 can be transmitted from an infected mother to her infant through breastfeeding, although the precise risk of transmission by this route is unknown. A long-term follow-up of children born to HIV-infected women in Abidjan, Gate d'lvoire, has enabled us to estimate this risk. Methods Children born to 138 HIV-1-seropositive women, 132 HIV-2-seropositive women, 69 women seroreactive to both HIV-1 and HIV-2, and 274 HIV-seronegative women were enrolled at birth and followed up for as long as 48 months. All chidren were breastfed (median duration 20 months). Blood samples for either or both HIV PCR and HIV serology were obtained at 1, 2, and 3 months of age, and every 3 months thereafter. Early HIV infection was defined as a positive HIV-1 PCR result obtained in the first 6 months of life. Late postnatal transmission was diagnosed when a child had a negative PCR at 3 or 6 months of age, followed by either or both a positive HIV-1 PCR at 9 months or older, or persistently positive HIV-1 serology at 15 months or older. Findings 82 children born to HIV-1-seropositive mothers and 57 children born to mothers seropositive for both HIV-1 and HIV-2 had PCR results for samples taken within the first 6 months. By 6 months of age, 23 (28%; 95% CI 19-39) of the 82 children born to HIV-l-seropositive mothers and ten (18%; 95% CI 9-30) of the 57 children born to dually seropositive mothers were HIV-1 infected, Among children whose PCR results were negative at or before age 6 months, and who were followed up beyond 6 months, an additional four (9%) of the 45 children born to HIV-1-seropositive mothers and two (5%) of the 39 children born to dually seropositive mothers became HIV infected. The estimated rates of late postnatal transmission, with account taken of loss to follow-up and the observed pattern of weaning, were 12% (95% CI 3-23) and 6% (0-14), respectively. One of the five children whose mothers seroconverted from HIV-negative to HIV-1, and one of seven children whose mothers seroconverted from HIV-2 to dual reactivity, became HIV-1 positive. No case of late postnatal transmission occurred in children born to HIV-2-positive or persistently HIV-negative mothers. Interpretation Breastfed children born to mothers seropositive for HIV-1 alone or seropositive for HIV-1 and HIV-2 in Abidjan are at substantial risk of late postnatal transmission. Early cessation of breastfeeding at 6 months of age should be assessed as a possible intervention to reduce postnatal transmission of HIV. C1 PROJET RETRO CI,ABIDJAN 01,COTE IVOIRE. NATL AIDS CONTROL PROGRAM,ABIDJAN,COTE IVOIRE. CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. UNIV LONDON LONDON SCH HYG & TROP MED,LONDON WC1E 7HT,ENGLAND. NR 24 TC 120 Z9 123 U1 0 U2 0 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD APR 12 PY 1997 VL 349 IS 9058 BP 1054 EP 1059 DI 10.1016/S0140-6736(96)06444-6 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WU002 UT WOS:A1997WU00200009 PM 9107243 ER PT J AU Bonafonte, MT Priest, JW Garmon, D Arrowood, MJ Mead, JR AF Bonafonte, MT Priest, JW Garmon, D Arrowood, MJ Mead, JR TI Isolation of the gene coding for elongation factor-1 alpha in Cryptosporidium parvum SO BIOCHIMICA ET BIOPHYSICA ACTA-GENE STRUCTURE AND EXPRESSION LA English DT Article DE elongation factor 1 alpha; GTP-binding protein; (Cryptosporidium parvum) ID AMINO-ACID-SEQUENCE; FACTOR-TU; BINDING-SITE; TRANSFER-RNA; 2 GENES; PROTEINS; IDENTIFICATION; ANIMALS; EXPRESSION; CLONING AB A gene encoding for Cryptosporidium parvum (C. parvum) elongation factor 1 alpha (EF-1 alpha) was isolated and sequenced from a cDNA expression library. The recombinant protein cross-reacted with a monoclonal antibody that was raised to a sporozoite cell surface antigen. The gene encoded a 435 amino acid protein with a predicted molecular weight of 48.1 kDa. The predicted C. parvum EF-1 alpha protein sequence showed extensive homology with the EF-1 alpha proteins of other eukaryotic organisms and included three conserved sequence motifs implicated in GTP binding. (C) 1997 Elsevier Science B.V. C1 EMORY UNIV,ATLANTA,GA 30033. VET ADM MED CTR,DECATUR,GA 30033. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30341. FU PHS HHS [A136680] NR 31 TC 17 Z9 18 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0167-4781 J9 BBA-GENE STRUCT EXPR JI Biochim. Biophys. Acta-Gene Struct. Expression PD APR 10 PY 1997 VL 1351 IS 3 BP 256 EP 260 DI 10.1016/S0167-4781(97)00013-4 PG 5 WC Biochemistry & Molecular Biology; Biophysics SC Biochemistry & Molecular Biology; Biophysics GA WU040 UT WOS:A1997WU04000002 PM 9130588 ER PT J AU Miller, BA Davidson, M Myerson, D Icenogle, J Lanier, AP Tan, J Beckmann, AM AF Miller, BA Davidson, M Myerson, D Icenogle, J Lanier, AP Tan, J Beckmann, AM TI Human papillomavirus type 16 DNA in esophageal carcinomas from Alaska natives SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article ID POLYMERASE CHAIN-REACTION; SQUAMOUS-CELL CARCINOMAS; INFECTION; CANCER; WOMEN; NEOPLASIA; LESIONS; ABSENCE; JAPAN; CHINA AB The possible etiological role of human papillomavirus (HPV) in esophageal carcinogenesis was evaluated in Alaska Natives in whom the incidence of esophageal cancer is 1.3 and 3.8 times higher than in US Caucasian men and women, respectively. Fixed paraffin-embedded esophageal tissues from 32 cases of squamous-cell carcinoma (SCC) and 3 cases of adenocarcinoma (AC) diagnosed between 1957 and 1988 were analyzed by polymerase chain reaction (PCR) and in situ hybridization for HPV DNA sequences. Detection of the human beta-globin gene by PCR was used as a control for sufficiency of DNA and its potential for amplification in the tissue samples. Twenty-five of the tumor tissues were considered adequate for PCR analyses; HPV DNA was detected in 10 of 22 SCCs and was not found in 3 ACs. Seven of the 10 HPV-positive tissues contained sequences from the E6 gene of HPV type 16. Koilocytosis, an epithelial change consistent with HPV infection, was found in 80% of the esophageal squamous-cell tumors with HPV DNA and in 75% of those without HPV DNA. The detection of amplifiable cellular DNA was related to recentness of diagnosis; however, the detection of HPV DNA within amplifiable specimens was not related to recentness of diagnosis. A 413-bp sequence from the LI open reading frame of HPV 16 from esophageal tissue of 2 patients was identical to sequences previously identified in cervical cells from other Alaska Natives. Our results provide molecular evidence of HPV infection, especially type 16, in archival esophageal cancer tissues from 45% of those patients whose specimens contain adequate DNA for PCR analysis. (C) 1997 Wiley-Liss, Inc. C1 FRED HUTCHINSON CANC RES CTR, DIV PUBL HLTH SCI, PROGRAM CANC BIOL, SEATTLE, WA 98104 USA. CTR DIS CONTROL, ARCTIC INVEST PROGRAM, NATL CTR INFECT DIS, ANCHORAGE, AK USA. FRED HUTCHINSON CANC RES CTR, DIV CLIN RES, SEATTLE, WA 98104 USA. CTR DIS CONTROL, VIRAL EXANTHEMS & HERPESVIRUS BRANCH, NATL CTR INFECT DIS, ATLANTA, GA 30333 USA. ALASKA NATIVE MED CTR, ANCHORAGE, AK USA. FU NCI NIH HHS [CA15704, CA18029, CA42792] NR 28 TC 23 Z9 23 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0020-7136 EI 1097-0215 J9 INT J CANCER JI Int. J. Cancer PD APR 10 PY 1997 VL 71 IS 2 BP 218 EP 222 PG 5 WC Oncology SC Oncology GA WW905 UT WOS:A1997WW90500016 PM 9139846 ER PT J AU Purdy, A Smith, F Salehi, E Halpin, TJ Quale, J Landman, D Atwood, E Ditore, V Ackman, D Smith, PF AF Purdy, A Smith, F Salehi, E Halpin, TJ Quale, J Landman, D Atwood, E Ditore, V Ackman, D Smith, PF TI Nosocomial hepatitis B virus infection associated with reusable fingerstick blood sampling devices - Ohio and New York City, 1996 (Reprinted from MMWR, vol 46, pg 217-221, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 OHIO DEPT HLTH,COLUMBUS,OH 43266. DEPT VET AFFAIRS MED CTR,BROOKLYN,NY. NEW YORK STATE DEPT HLTH,ALBANY,NY 12237. CDC,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV CANC PREVENT & CONTROL,ATLANTA,GA 30333. CDC,DIV APPL PUBL HLTH TRAINING,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. CDC,NATL CTR INFECT DIS,HEPATITIS BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. RP Purdy, A (reprint author), ALLEN CTY HLTH DEPT,LIMA,OH 45802, USA. NR 8 TC 6 Z9 6 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 9 PY 1997 VL 277 IS 14 BP 1106 EP 1107 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WR342 UT WOS:A1997WR34200010 ER PT J AU Blythe, D Goldoft, M Lewis, J StehrGreen, P Chehey, R Greenblatt, J Cieslak, PR Stefonek, KR Hoesly, FC Fleming, D AF Blythe, D Goldoft, M Lewis, J StehrGreen, P Chehey, R Greenblatt, J Cieslak, PR Stefonek, KR Hoesly, FC Fleming, D TI Salmonella serotype Montevideo infections associated with chicks - Idaho, Washington, and Oregon, Spring 1995 and 1996 (Reprinted from MMWR, vol 46, pg 237-239, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 IDAHO DEPT HLTH & WELF,BOISE,ID 83720. OREGON DEPT HUMAN RESOURCES,STATE HLTH DIV,PORTLAND,OR. CDC,NATL CTR INFECT DIS,FOODBORNE & DIARRHEAL DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. CDC,DIV APPL PUBL HLTH TRAINING,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. RP Blythe, D (reprint author), WASHINGTON DEPT HLTH,OLYMPIA,WA 98504, 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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 9 PY 1997 VL 277 IS 14 BP 1108 EP 1109 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WR342 UT WOS:A1997WR34200011 ER PT J AU Ursicz, G Kiss, E Lun, K AF Ursicz, G Kiss, E Lun, K TI Prevalence of cigarette smoking among secondary school students - Budapest, Hungary, 1995 (Reprinted from MMWR, vol 46, pg 56-59, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 DIV CHILD & ADOLESCENT HLTH,BUDAPEST,HUNGARY. BUDAPEST INST PUBL HLTH,BUDAPEST,HUNGARY. MINIST CULTURE & EDUC,BUDAPEST,HUNGARY. CDC,DIV INT HLTH,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. CDC,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,OFF SMOKING & HLTH,ATLANTA,GA 30333. RP Ursicz, G (reprint author), MINIST WELF,HUNGARIAN FIELD EPIDEMIOL TRAINING PROGRAM,BUDAPEST,HUNGARY. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 9 PY 1997 VL 277 IS 14 BP 1110 EP 1111 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WR342 UT WOS:A1997WR34200013 ER PT J AU Mahoney, F Lloyd, JC Euler, GL AF Mahoney, F Lloyd, JC Euler, GL TI Perspectives on hepatitis B vaccination - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter RP Mahoney, F (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 6 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 9 PY 1997 VL 277 IS 14 BP 1124 EP 1125 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WR342 UT WOS:A1997WR34200027 ER PT J AU Yip, R Limburg, PJ Ahlquist, DA Carpenter, HA ONeill, A Kruse, D Stitham, S Gold, BD Gunter, EW Looker, AC Parkinson, AJ Nobmann, ED Petersen, KM Ellefson, M Schwartz, S AF Yip, R Limburg, PJ Ahlquist, DA Carpenter, HA ONeill, A Kruse, D Stitham, S Gold, BD Gunter, EW Looker, AC Parkinson, AJ Nobmann, ED Petersen, KM Ellefson, M Schwartz, S TI Pervasive occult gastrointestinal bleeding in an Alaska native population with prevalent iron deficiency - Role of Helicobacter pylori gastritis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article; Proceedings Paper CT 1995 Swedish-Society-of-Medicine Berzeliuos Symposium XXXI on Iron Nutrition in Health and Disease CY SEP, 1995 CL STOCKHOLM, SWEDEN SP Swedish soc Med ID PEPTIC-ULCER DISEASE; CAMPYLOBACTER-PYLORI; INFECTION; HEMOQUANT; BLOOD; SEROEPIDEMIOLOGY; HEMOGLOBIN; ESKIMOS; ADULTS; HEME AB Objective.-To confirm prevalent iron deficiency among Yupik Eskimos living in Alaska and to explore the frequency of and potential lesions accounting for occult gastrointestinal bleeding. Design.-Descriptive survey. Setting.-Rural Arctic community. Subjects.-A total of 140 adult volunteers from 3 villages in the Yukon-Kuskokwim Delta region of western Alaska. Main Outcome Measures.-Daily iron intake, hematologic and biochemical indexes of iron status, fecal hemoglobin levels, stool parasites, and endoscopic findings. Results.-While dietary iron intake by Yupiks was similar to that of a reference population, iron deficiency prevalence was increased 13-fold in Yupik men and 4-fold in Yupik women, Fecal hemoglobin levels were elevated in 90% of subjects contrasted with only 4% of a reference group; median levels were 5.9 and 0.5 mg of hemoglobin per gram of stool, respectively, Among 70 Yupik subjects with elevated fecal hemoglobin levels who had endoscopy performed, 68 (97%) had an abnormal gastric appearance consisting of erythema, mucosal thickening, diffuse mucosal hemorrhages, erosions, or ulcerations. Gastric biopsies revealed chronic active gastritis with associated Helicobacter pylori in 68 (99%) of 69. No other hemorrhagic gastrointestinal disease was detected. Conclusions.-Based on this study sample, occult gastrointestinal bleeding appears to be pervasive in the Yupik population and likely underlies the prevalent iron deficiency. An atypical hemorrhagic gastritis associated with H pylori infection is present almost universally and may represent the bleeding source. C1 MAYO CLIN,DIV GASTROENTEROL,DEPT INTERNAL MED,ROCHESTER,MN 55905. CTR DIS CONTROL & PREVENT,DIV NUTR,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA. CTR DIS CONTROL & PREVENT,DIV BACTERIAL & MYCOT DIS,NATL CTR INFECT DIS,ATLANTA,GA. CTR DIS CONTROL & PREVENT,DIV ENVIRONM HLTH LAB SCI,NATL CTR ENVIRONM HLTH,ATLANTA,GA. YUKON KUSKOKWIM HLTH CORP,BETHEL,AK. EMORY UNIV,SCH MED,DEPT PEDIAT,ATLANTA,GA. CDC,DIV HLTH EXAMINAT STAT,NATL CTR HLTH STAT,HYATTSVILLE,MD. CDC,ARCTIC INVEST PROGRAM,NATL CTR INFECT DIS,ANCHORAGE,AK. ALASKA AREA NATIVE HLTH SERV,INDIAN HLTH SERV,ANCHORAGE,AK. ELLEFSON ANALYT INC,LINO LAKES,MN. MINNEAPOLIS MED RES FDN INC,MINNEAPOLIS,MN. MAYO CLIN,DEPT LAB MED & PATHOL,ROCHESTER,MN 55905. NR 41 TC 107 Z9 109 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 9 PY 1997 VL 277 IS 14 BP 1135 EP 1139 DI 10.1001/jama.277.14.1135 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WR342 UT WOS:A1997WR34200032 PM 9087468 ER PT J AU Birmingham, ME Lee, LA Ndayimirije, N Nkurikiye, S Hersh, BS Wells, JG Deming, MS AF Birmingham, ME Lee, LA Ndayimirije, N Nkurikiye, S Hersh, BS Wells, JG Deming, MS TI Epidemic cholera in Burundi: Patterns of transmission in the Great Rift Valley Lake region SO LANCET LA English DT Article ID VIBRIO-CHOLERAE; RISK AB Background After a 14-year hiatus, epidemic cholera swept through Burundi between January and May, 1992, The pattern of transmission was similar to that in 1978, when the seventh pandemic first reached this region, Communities affected were limited to those near Lake Tanganyika and the Rusizi River, The river connects Lake Tanganyika with Lake Kivu to the north in Zaire and Rwanda. Methods To identify sources of infection and risk factors for illness, an epidemiological study was carried out in Rumonge, a lake-shore town where 318 people were admited to hospital with cholera between April 9 and May 31, 1992, The investigation included a case-control study of 56 case-patients and 112 matched controls. Findings Attack rates according to street increased with the street's proximity to Lake Tanganyika (chi(2) test for linear trend, p < 0.01) which suggests that exposure to the lake was a risk factor for illness, Comparison of the 56 case-patients with matched controls showed that bathing in the lake (odds ratio 1.6, attributable risk percentage 37%) and drinking its water (2.78, 14%) were independently and significantly (p < 0.05) linked with illness, No food-borne risk factors were identified, Vibrio cholera 01 was isolated from Lake Tanganyiha during, but not after, the outbreak in Rumonge, Isolates from the lake and from patients with acute watery diarrhoea had the same serotype, biotype, and antimicrobial susceptibility profiles, The number of cases rapidly declined when access to the lake was blocked. Interpretation This study identifies bathing in contaminated surface water as a major risk factor for cholera in sub-Saharan Africa, and suggests that improving the quality of drinking water alone will have only limited impact on the transmission of the disease in the Great Rift Valley Lake region. The similarity in the patterns of transmission during the 1978 and 1992 epidemics suggests that extensive use of the Great Lakes and connecting rivers for transportation and domestic purposes may be the reason for the explosive cholera outbreaks that occur sporadically in this region. C1 CTR DIS CONTROL & PREVENT,INT HLTH PROGRAM OFF,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,DIV BACTERIAL & MYCOT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. MINIST PUBL HLTH,BUJUMBURA,BURUNDI. NR 24 TC 26 Z9 27 U1 1 U2 3 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD APR 5 PY 1997 VL 349 IS 9057 BP 981 EP 985 DI 10.1016/S0140-6736(96)08478-4 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WR621 UT WOS:A1997WR62100010 PM 9100624 ER PT J AU Franko, EM Stasiuk, WN Svenson, RW AF Franko, EM Stasiuk, WN Svenson, RW TI Children with elevated blood lead levels attributed to home renovation and remodeling activities - New York, 1993-1994 (Reprinted from MMWR, vol 45, pg 1120-1123, 1996) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CDC,LEAD POISONING PREVENT BRANCH,DIV ENVIRONM HAZARDS & HLTH EFFECTS,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333. RP Franko, EM (reprint author), NEW YORK STATE DEPT HLTH,ALBANY,NY 12237, USA. NR 1 TC 4 Z9 4 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 2 PY 1997 VL 277 IS 13 BP 1030 EP 1031 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WQ089 UT WOS:A1997WQ08900009 ER PT J AU Schendel, DE Berg, CJ YearginAllsopp, M Boyle, CA Decoufle, P AF Schendel, DE Berg, CJ YearginAllsopp, M Boyle, CA Decoufle, P TI Prenatal magnesium sulfate exposure and risk of cerebral palsy - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter RP Schendel, DE (reprint author), CTR DIS CONTROL & PREVENT,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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 2 PY 1997 VL 277 IS 13 BP 1033 EP 1034 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WQ089 UT WOS:A1997WQ08900012 ER PT J AU Pelletier, A AF Pelletier, A TI Deaths among railroad trespassers - The role of alcohol in fatal injuries SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID ACCIDENTS; TRAIN AB Objective.-To describe the characteristics of persons killed by trains while trespassing (ie, using railroad property for activities unrelated to railroad operations). Design.-Case series obtained from records of the state medical examiner. Setting.-North Carolina, 1990 through 1994. Subjects.-One hundred twenty-eight persons ranging in age from 7 to 84 years who were killed in 125 separate incidents. Results.-Of 224 railroad-related deaths during the study period, 128 cases (57%) involved trespassers. Trespasser fatalities typically involved unmarried male pedestrians 20 to 49 years of age with less than a high school education. Eighty-two percent of incidents occurred in the trespassers' county of residence, indicating that few deaths involved transients. Fatalities among railroad trespassers exhibited both geographic and temporal clustering. Seventy-eight percent of trespassers were killed while intoxicated (median alcohol level, 56 mmol/L [260 mg/dL]). Conclusions.-Deaths among trespassers are the leading cause of railroad-related mortality in North Carolina. Greater efforts are needed to reduce this type of preventable injury. Prevention of trespasser fatalities is dependent on control of alcohol abuse, enforcement of existing laws, and education of the public regarding the dangers of railroad trespassing. RP Pelletier, A (reprint author), CTR DIS CONTROL & PREVENT,STATE BRANCH,DIV APPL PUBL HLTH TRAINING,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333, USA. NR 12 TC 15 Z9 15 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD APR 2 PY 1997 VL 277 IS 13 BP 1064 EP 1066 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA WQ089 UT WOS:A1997WQ08900032 PM 9091695 ER PT J AU Pawlowski, ZS Schantz, PM AF Pawlowski, ZS Schantz, PM TI Advances in clinical management of cystic echinococcosis SO ACTA TROPICA LA English DT Editorial Material C1 NATL CTR INFECT DIS, EPIDEMIOL BRANCH, DIV PARASIT DIS, CTR DIS CONTROL & PREVENT, ATLANTA, GA USA. RP Pawlowski, ZS (reprint author), UNIV MED SCI, POZNAN, POLAND. NR 7 TC 1 Z9 1 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0001-706X EI 1873-6254 J9 ACTA TROP JI Acta Trop. PD APR 1 PY 1997 VL 64 IS 1-2 BP 1 EP 4 PG 4 WC Parasitology; Tropical Medicine SC Parasitology; Tropical Medicine GA WQ302 UT WOS:A1997WQ30200001 PM 9095284 ER PT J AU Hughes, JR Giovino, GA Klevens, RM Fiore, MC AF Hughes, JR Giovino, GA Klevens, RM Fiore, MC TI Assessing the generalizability of smoking studies SO ADDICTION LA English DT Article ID TRANSDERMAL NICOTINE PATCH; UNITED-STATES; CIGARETTE-SMOKING; QUIT SMOKING; CESSATION; TRENDS AB We used data from the 1986 Adult Use of Tobacco Survey, 10 studies of self-quitters and seven studies of treatment seekers, to illustrate how subpopulations of smokers might differ; e.g. treatment seekers vs. self-quitters and research volunteers vs. smokers in the general population. Smoking researchers may wish to use our results to determine whether their sample is similar to the population of interest. C1 CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,OFF SMOKING & HLTH,ATLANTA,GA. UNIV WISCONSIN,CTR TOBACCO RES & INTERVENT,MADISON,WI 53706. RP Hughes, JR (reprint author), UNIV VERMONT,HUMAN BEHAV PHARMACOL LAB,DEPT PSYCHIAT,38 FLETCHER PL,BURLINGTON,VT 05401, USA. FU PHS HHS [00109] NR 16 TC 53 Z9 53 U1 0 U2 0 PU CARFAX PUBL CO PI ABINGDON PA PO BOX 25, ABINGDON, OXFORDSHIRE, ENGLAND OX14 3UE SN 0965-2140 J9 ADDICTION JI Addiction PD APR PY 1997 VL 92 IS 4 BP 469 EP 472 PG 4 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA WU810 UT WOS:A1997WU81000011 PM 9177068 ER PT J AU Dowell, SF Schwartz, B AF Dowell, SF Schwartz, B TI Resistant pneumococci: Protecting patients through judicious use of antibiotics SO AMERICAN FAMILY PHYSICIAN LA English DT Article ID DAY-CARE-CENTER; STREPTOCOCCUS-PNEUMONIAE; OTITIS-MEDIA; RISK-FACTORS; MIDDLE-EAR; PENICILLIN; MENINGITIS; INFECTIONS; CHILDREN; THERAPY AB Increasing resistance to antimicrobial agents has occurred among many pathogens, but the emergence of resistant Streptococcus pneumoniae will have the greatest impact on the practice of outpatient medicine. Consequences of resistance include complicated management of acute otitis media and meningitis treatment failures. Pneumococci have acquired resistance to penicillin, third-generation cephalosporins and other antibiotics at an alarming rate; in some areas, 25 percent of isolates are nonsusceptible to penicillin. In areas with high resistance rates, the addition of vancomycin to cefotaxime or ceftriaxone is warranted for empiric treatment of bacterial meningitis. Changes in empiric therapy for pneumonia, bacteremia and otitis media may eventually be necessary. Previous antibiotic use is a risk factor for invasive disease with resistant pneumococci. Patients may be best protected by avoiding unnecessary use of antibiotics. Patient education materials as well as recommendations for avoiding the use of antibiotics for some upper respiratory tract infections are currently being developed to help physicians achieve this goal. RP Dowell, SF (reprint author), CTR DIS CONTROL & PREVENT,MAILSTOP C-23,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 33 TC 140 Z9 142 U1 0 U2 1 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD APR PY 1997 VL 55 IS 5 BP 1647 EP 1654 PG 8 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA WU124 UT WOS:A1997WU12400022 PM 9105195 ER PT J AU Esche, CA Groff, JH AF Esche, CA Groff, JH TI ELPAT program report: Background and current status (January 1997) SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Editorial Material RP Esche, CA (reprint author), NIOSH,DEPT HLTH & HUMAN SERV,ROBERT A TAFT LABS,US PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226, USA. NR 13 TC 0 Z9 0 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD APR PY 1997 VL 58 IS 4 BP 302 EP 306 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WU501 UT WOS:A1997WU50100010 PM 9115088 ER PT J AU Briefel, RR Sempos, CT McDowell, MA Chien, SCY Alaimo, K AF Briefel, RR Sempos, CT McDowell, MA Chien, SCY Alaimo, K TI Dietary methods research in the third national health and nutrition examination survey: Underreporting of energy intake SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT Proceedings of a Symposium / 2nd International Conference on Dietary Assessment Methods CY JAN 22-24, 1995 CL BOSTON, MA DE dietary assessment methods; energy; national nutrition surveys; National Health and Nutrition Examination Survey; NHANES; energy intake; estimated basal metabolic rate; underreporting ID MAINTAIN BODY-WEIGHT; NHANES-III; RECORDS; ADULTS AB Assessment of diet is a critical component of the third National Health and Nutrition Examination Survey (NHANES III), which was designed to describe the health and nutritional status of the US population. We analyzed data collected with the primary dietary assessment instrument used in NHANES III, the 24-h recall, for 7769 nonpregnant adults aged greater than or equal to 20 y to investigate underreporting of total energy intake. Underreporting was addressed by computing a ratio of energy intake (EI) to estimated basal metabolic rate (BMR(est)). EI:BMR(est) was 1.47 for men and 1.26 for nonpregnant women; a population level of 1.55 is expected for a sedentary population. About 18% of the men and 28% of the women were classified as underreporters. Underreporting of energy intake was highest in women and persons who were older, overweight, or trying to lose weight. Underreporting varied according to smoking status, level of education, physical activity, and the day of the week the 24-h recall covered. Additionally, underreporting was associated with diets lower in fat (P < 0.01) and alcohol (P < 0.01 in women) when expressed as a percentage of total energy intake. RP Briefel, RR (reprint author), CTR DIS CONTROL & PREVENT, DIV HLTH EXAMINAT STAT, NATL CTR HLTH STAT, 6525 BELCREST RD, ROOM 1000, HYATTSVILLE, MD 20782 USA. NR 41 TC 301 Z9 304 U1 2 U2 7 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD APR PY 1997 VL 65 IS 4 SU S BP 1203 EP 1209 PG 7 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WR606 UT WOS:A1997WR60600021 ER PT J AU Byers, T Serdula, M Kuester, S Mendlein, J Ballew, C McPherson, RS AF Byers, T Serdula, M Kuester, S Mendlein, J Ballew, C McPherson, RS TI Dietary surveillance for states and communities SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT Proceedings of a Symposium / 2nd International Conference on Dietary Assessment Methods CY JAN 22-24, 1995 CL BOSTON, MA DE dietary assessment; dietary surveillance; dietary intervention; community; state; populations; health agency; dietary behaviors; Youth Risk Behavior Surveillance System; Behavioral Risk Factor Surveillance System ID BEHAVIOR; FAT; QUESTIONNAIRE AB Information about dietary behaviors, attitudes, and knowledge is important for state and local health agencies because national monitoring lacks the local representativeness and timeliness necessary to catalyze community interest and to design, target, and evaluate dietary intervention programs. Currently, however, both methods and resources are limited for surveying diet in the population of a state or community. Brief assessments are included in the Youth Risk Behavior Surveillance System for adolescents, which is conducted by state departments of education, and in the Behavioral Risk Factor Surveillance System for adults, which is operated by state departments of health. More quantitatively precise measurements are being made by a few stales and communities but personnel and financial resources for such surveys are limited. Nutritionists in state and local health agencies should explore the possibility of developing public-private partnerships with food producers, retailers, and marketers to collect information about dietary determinants and behaviors in states and communities. Better standardization of dietary assessment methods is needed, asis development of better methods to identify attitudes about diet and barriers to dietary improvement. Most important, though, dietary surveillance in stales and communities must be more strongly tied to intervention programs intended to improve nutrition in those populations. C1 CTR DIS CONTROL & PREVENT, DIV NUTR & PHYS ACT, NATL CTR CHRON DIS PREVENT & HLTH PROMOT, ATLANTA, GA 30341 USA. UNIV COLORADO, SCH MED, DENVER, CO USA. UNIV TEXAS, SCH PUBL HLTH, SW CTR PREVENT RES, HOUSTON, TX USA. NR 22 TC 6 Z9 6 U1 0 U2 0 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD APR PY 1997 VL 65 IS 4 SU S BP 1210 EP 1214 PG 5 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WR606 UT WOS:A1997WR60600022 ER PT J AU Marshall, JR Lanza, E Bloch, A Caan, B Caggiula, A Quandt, S Iber, F Kikendall, W Slattery, M Sowell, A AF Marshall, JR Lanza, E Bloch, A Caan, B Caggiula, A Quandt, S Iber, F Kikendall, W Slattery, M Sowell, A TI Indexes of food and nutrient intakes as predictors of serum concentrations of nutrients: The problem of inadequate discriminant validity SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article; Proceedings Paper CT Proceedings of a Symposium / 2nd International Conference on Dietary Assessment Methods CY JAN 22-24, 1995 CL BOSTON, MA DE alpha-carotene; beta-carotene; vitamin E; alpha-tocopherol; validity; food-frequency questionnaire; discriminant validity; convergent validity ID FREQUENCY QUESTIONNAIRE; BETA-CAROTENE; ALPHA-TOCOPHEROL; CANCER; MEN; DATABASE; DIET; FAT AB Nutrient indexes derived from food-frequency questionnaires have generally been regarded as acceptably valid for epidemiologic purposes. Evaluations of these indexes, however, have considered only their convergent validity. We suggest that discriminant validity, or the ability to distinguish among exposures to different nutrients, is also important. Using baseline data from a large clinical trial, we tested the discriminant validity of indexes of intake of vitamin E, alpha-carotene, and beta-carotene. Our results suggest that the vitamin E index possesses neither convergent nor discriminant validity, the alpha-carotene index adequate convergent and discriminant validity, and the beta-carotene index adequate convergent but no discriminant validity. C1 SUNY BUFFALO, SCH MED & BIOMED SCI, DEPT SOCIAL & PREVENT MED, BUFFALO, NY 14260 USA. NCI, BETHESDA, MD 20892 USA. MEM SLOAN KETTERING CANC CTR, NEW YORK, NY 10021 USA. KAISER FDN RES INST, OAKLAND, CA USA. UNIV PITTSBURGH, PITTSBURGH, PA 15260 USA. WAKE FOREST UNIV, WINSTON SALEM, NC 27109 USA. EDWARD HINES JR VET ADM HOSP, HINES, IL 60141 USA. WALTER REED ARMY MED CTR, WASHINGTON, DC 20307 USA. UNIV UTAH, SALT LAKE CITY, UT USA. CTR DIS CONTROL & PREVENT, ATLANTA, GA USA. RP Marshall, JR (reprint author), UNIV ARIZONA, ARIZONA CANC CTR, 1515 N CAMPBELL AVE, POB 245024, TUCSON, AZ 85724 USA. NR 31 TC 13 Z9 13 U1 14 U2 14 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD APR PY 1997 VL 65 IS 4 SU S BP 1269 EP 1274 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WR606 UT WOS:A1997WR60600031 ER PT J AU Subar, AF Thompson, FE Smith, AF Jobe, JB Ziegler, RG Potischman, N Schatzkin, A Hartman, A Swanson, C Kruse, L Hayes, RB Lewis, DR Harlan, LC AF Subar, AF Thompson, FE Smith, AF Jobe, JB Ziegler, RG Potischman, N Schatzkin, A Hartman, A Swanson, C Kruse, L Hayes, RB Lewis, DR Harlan, LC TI Improving food-frequency questionnaires: A qualitative approach using cognitive interviewing SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Meeting Abstract DE food-frequency questionnaire; portion size; seasonal intake; food preparation; low-fat foods; interview; frequency C1 NCI, DIV CANC PREVENT & CONTROL, BETHESDA, MD 20892 USA. STATE UNIV COLL, DEPT PSYCHOL, BINGHAMTON, NY USA. CTR DIS CONTROL & PREVENT, NATL CTR HLTH STAT, ATLANTA, GA 30333 USA. NCI, DIV CANC ETIOL, BETHESDA, MD 20892 USA. NR 0 TC 3 Z9 3 U1 2 U2 8 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD APR PY 1997 VL 65 IS 4 SU S BP 1317 EP 1318 PG 2 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WR606 UT WOS:A1997WR60600106 ER PT J AU Kott, PS Guenther, PM Sempos, CT AF Kott, PS Guenther, PM Sempos, CT TI Using multiday data from the Continuing Survey of Food Intakes by Individuals and the Iowa State University method to remove within-person variability from a 1-d dietary data SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Meeting Abstract DE distribution; usual intake; Continuing Survey of Food Intakes by Individuals; percentile; estimate C1 CTR DIS CONTROL & PREVENT, NATL CTR HLTH STAT, ATLANTA, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD APR PY 1997 VL 65 IS 4 SU S BP 1329 EP 1329 PG 1 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WR606 UT WOS:A1997WR60600135 ER PT J AU Kolbe, LJ AF Kolbe, LJ TI Meta-analysis of interventions to prevent mental health problems among youth: A public health commentary SO AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY LA English DT Editorial Material RP Kolbe, LJ (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV ADOLESCENT & SCH HLTH,ATLANTA,GA 30333, USA. NR 17 TC 7 Z9 7 U1 0 U2 1 PU PLENUM PUBL CORP PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 SN 0091-0562 J9 AM J COMMUN PSYCHOL JI Am. J. Community Psychol. PD APR PY 1997 VL 25 IS 2 BP 227 EP 232 DI 10.1023/A:1024622614351 PG 6 WC Public, Environmental & Occupational Health; Psychology, Multidisciplinary; Social Work SC Public, Environmental & Occupational Health; Psychology; Social Work GA XK665 UT WOS:A1997XK66500011 PM 9226867 ER PT J AU Ford, ES Freedman, DS Byers, T AF Ford, ES Freedman, DS Byers, T TI Baldness and ischemic heart disease in a national sample of men - Reply SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Letter ID MYOCARDIAL-INFARCTION RP Ford, ES (reprint author), CTR DIS CONTROL & PREVENT,DIV NUTR,CHRON DIS PREVENT BRANCH,4770 BUFORD HIGHWAY,NE,MAILSTOP K-26,ATLANTA,GA 30341, USA. NR 5 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 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD APR 1 PY 1997 VL 145 IS 7 BP 670 EP 671 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WR876 UT WOS:A1997WR87600016 ER PT J AU Horan, TC Lee, TB AF Horan, TC Lee, TB TI Surveillance: Into the next millennium SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Editorial Material ID INFECTION RP Horan, TC (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30332, USA. NR 11 TC 10 Z9 11 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD APR PY 1997 VL 25 IS 2 BP 73 EP 76 DI 10.1016/S0196-6553(97)90031-6 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WT990 UT WOS:A1997WT99000001 PM 9113281 ER PT J AU Horan, TC Emori, TG AF Horan, TC Emori, TG TI Definitions of key terms used in the NNIS system SO AMERICAN JOURNAL OF INFECTION CONTROL LA English DT Article; Proceedings Paper CT Surveillance Symposium at the 23rd Annual Educational Conference and International Meeting of the Association-for-Professionals-in-Infection-Control-and-Epidemiology CY JUN, 1996 CL ATLANTA, GA SP Assoc Profess Infect Control & Epidemiol (APIC) ID NOSOCOMIAL INFECTIONS; CDC DEFINITIONS AB For valid comparisons with the published NNIS nosocomial infection rates, hospitals must define data elements in the same way. Definitions for infections, risk factors, and populations monitored are specified in the NNIS System, but thus far only infection definitions and the list of NNIS operative procedure categories have been published. This article defines other key terms used in the NNIS System. RP Horan, TC (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333, USA. NR 12 TC 155 Z9 156 U1 0 U2 0 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0196-6553 J9 AM J INFECT CONTROL JI Am. J. Infect. Control PD APR PY 1997 VL 25 IS 2 BP 112 EP 116 DI 10.1016/S0196-6553(97)90037-7 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WT990 UT WOS:A1997WT99000007 PM 9113287 ER PT J AU Angulo, FJ Tippen, S Sharp, DJ Payne, BJ Collier, C Hill, JE Barrett, TJ Clark, RM Geldreich, EE Donnell, HD Swerdlow, DL AF Angulo, FJ Tippen, S Sharp, DJ Payne, BJ Collier, C Hill, JE Barrett, TJ Clark, RM Geldreich, EE Donnell, HD Swerdlow, DL TI A community waterborne outbreak of salmonellosis and the effectiveness of a boil water order SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article; Proceedings Paper CT 34th Interscience Conference on Antimicrobial Agents and Chemotherapy CY OCT 03-07, 1994 CL ORLANDO, FL ID CRYPTOSPORIDIUM; INFECTION AB Objectives. A 1993 large waterborne outbreak of Salmonella typhimurium infections in Gideon, Mo, a city of 1100 with an unchlorinated community water supply, was investigated to determine the source of contamination and the effectiveness of an order to boil water. Methods. A survey of household members in Gideon and the surrounding township produced information on diarrheal illness, water consumption, and compliance with the boil water order. Results. More than 650 persons were ill; 15 were hospitalized, and 7 died. Persons consuming city water were more likely to be ill (relative risk [RR] = 9.1, 95% confidence interval [CI] = 2.9, 28.4), and the attack rate increased with increased water consumption. S. typhimurium was recovered from samples taken from a city fire hydrant and a water storage tower. Persons in 318 (30/98) of city households had drunk unboiled water after being informed about the boil water order, including 14 individuals who subsequently became ill. Reasons for noncompliance included ''not remembering'' (44%) and ''disbelieving'' (25%) the order. Conclusions. Communities with deteriorating water systems risk widespread illness unless water supplies are properly operated and maintained. Effective education to improve compliance during boil water orders is needed. C1 MISSOURI DEPT HLTH,JEFFERSON CITY,MO. CTR DIS CONTROL & PREVENT,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. MISSOURI DEPT NAT RESOURCES,JEFFERSON CITY,MO. US EPA,DIV DRINKING WATER RES,CINCINNATI,OH 45268. RP Angulo, FJ (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,FOODBORNE & DIARRHEAL DIS BRANCH,MAIL STOP A-38,ATLANTA,GA 30333, USA. NR 23 TC 59 Z9 62 U1 1 U2 11 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD APR PY 1997 VL 87 IS 4 BP 580 EP 584 DI 10.2105/AJPH.87.4.580 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WY039 UT WOS:A1997WY03900012 PM 9146435 ER PT J AU Stayner, LT Dankovic, DA Lemen, RA AF Stayner, LT Dankovic, DA Lemen, RA TI Asbestos-related cancer and the amphibole hypothesis - Response SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter RP Stayner, LT (reprint author), NIOSH,ROBERT A TAFT LABS,4616 COLUMBIA PKWY,MAILSTOP C15,CINCINNATI,OH 45226, USA. NR 5 TC 1 Z9 1 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD APR PY 1997 VL 87 IS 4 BP 688 EP 688 DI 10.2105/AJPH.87.4.688 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WY039 UT WOS:A1997WY03900035 ER PT J AU Stayner, LT Dankovic, DA Lemen, RA AF Stayner, LT Dankovic, DA Lemen, RA TI The hypothesis is still supported by scientists and scientific data - Response SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter RP Stayner, LT (reprint author), NIOSH,ROBERT A TAFT LABS,4676 COLUMBIA PKWY,MAILSTOP C15,CINCINNATI,OH 45226, USA. NR 7 TC 2 Z9 2 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD APR PY 1997 VL 87 IS 4 BP 691 EP 691 DI 10.2105/AJPH.87.4.691 PG 1 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WY039 UT WOS:A1997WY03900039 ER PT J AU Glass, GE Johnson, JS Hodenbach, GA Disalvo, CLJ Peters, CJ Childs, JE Mills, JN AF Glass, GE Johnson, JS Hodenbach, GA Disalvo, CLJ Peters, CJ Childs, JE Mills, JN TI Experimental evaluation of rodent exclusion methods to reduce hantavirus transmission to humans in rural housing SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID SOUTHWESTERN UNITED-STATES; GENETIC IDENTIFICATION; PULMONARY SYNDROME; OUTBREAK AB An experimental assessment of methods to reduce rodent infestations in rural housing was conducted in Yosemite National Park, California, Sequoia/Kings Canyon National Parks, California, and Shenandoah National Park, Virginia. During pretreatment surveys, nearly all (63 of 68) selected units had past or ongoing rodent activity inside. Active infestations were found in 58.8% of the units. Peromyscus spp. represented 91.2% of all animals caught inside housing units. Despite little harborage, rodent activity was common near housing (290 animals/2,254 trap nights). The most common species present was Peromyscus maniculatus (43-50% of all captures). This species was especially frequent (49-87% of Peromyscus captures) around the foundations of housing units. Habitat had little effect on captures. There were 1.8 Peromyscus caught per unit along the foundations of housing in modified rural settings with grass lawns compared with 1.2 Peromyscus caught per unit in sites located in mature woodlands. During autumn of 1994, randomly selected housing units were rodent proofed by sealing openings associated with chases, roof eaves, and attics with insulation and wire mesh. Housing was examined and the fauna was resampled in the spring-summer of 1995. Rodent-proofed houses were infested significantly less often (3 of 28) than control houses (13 of 36) (P = 0.02) and the intensity of infestation was lower in experimental houses (6 versus 23 mice/treatment). More than 25% of the mice trapped inside the houses had been marked outside the houses during the three-day surveys, demonstrating movement of mice adjacent to the buildings into not rodent-proofed housing. As in the previous autumn, most of the animals captured in (98.9%) and along the foundations of the houses (77.5%) were Peromyscus spp. These results demonstrate that Peromyscus frequently invade rural housing but rodent-proofing effectively eliminates or substantially reduces rodent activity. C1 JOHNS HOPKINS UNIV,SCH PUBL HLTH,DEPT MOL MICROBIOL & IMMUNOL,BALTIMORE,MD 21205. NATL PK SERV,PUBL HLTH SERV,WASHINGTON,DC 20002. CTR DIS CONTROL & PREVENT,SPECIAL PATHOGENS BRANCH,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,VIRAL & RICKETTSIAL ZOONOSES BRANCH,ATLANTA,GA 30333. RI Childs, James/B-4002-2012 NR 12 TC 27 Z9 31 U1 0 U2 4 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD APR PY 1997 VL 56 IS 4 BP 359 EP 364 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WY260 UT WOS:A1997WY26000001 PM 9158040 ER PT J AU Zheng, DY Macera, CA Croft, JB Giles, WH Davis, D Scott, WK AF Zheng, DY Macera, CA Croft, JB Giles, WH Davis, D Scott, WK TI Major depression and all cause mortality among white adults in the United States SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE epidemiology; major depression; mortality; National Health Interview Survey ID EPIDEMIOLOGIC CATCHMENT-AREA; NATIONAL-COMORBIDITY-SURVEY; PSYCHIATRIC-DISORDERS; GENERAL-POPULATION; MENTAL-DISORDERS; COMMUNITY SAMPLE; PREVALENCE; ILLNESS; SYMPTOMS; RECOVERY AB PURPOSE: Depression is the most common psychiatric illness affecting adults. Despite the importance of a potential link between major depression and mortality, research has been surprisingly sparse. METHODS: Information on 57,897 white adults aged 25 years and older who were included in the mental health supplement of the 1989 National Health interview Survey was linked with the National Death Index to examine the relationship of major depression to mortality. Death status was obtained through December 1991. Sex-specific hazard rate ratios for mortality were calculated by Cox proportional hazards regression and Poisson regression to adjust for potential confounders (age, education, marital status, body mass index, and whether the target subject or a family member completed the survey about the subject). RESULTS: Major depression was reported for 223 (0.8%) of 27,345 men and 392 (1.30%) of 30,552 women. During the 2.5-year follow up, death certificate data were obtained for 848 (3.1%) men and 651 (2.1%) women. The adjusted hazard rate ratios for all cause mortality associated with major depression were 3.1 (95% confidence interval; 2.0-4.9) for men and 1.7 (95% confidence interval; 0.9-3.1) for women. CONCLUSIONS: These results suggest that major depression increases risk of all cause mortality, particularly among men. Further research is needed to explain the mechanism. (C) 1997 by Elsevier Science Inc. C1 UNIV S CAROLINA, SCH PUBL HLTH, PREVENT CTR, COLUMBIA, SC 29208 USA. CTR DIS CONTROL & PREVENT, NATL CTR CHRON DIS PREVENT & HLTH PROMOT, ATLANTA, GA 30333 USA. RI Scott, William/A-7593-2009 NR 48 TC 111 Z9 111 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD APR PY 1997 VL 7 IS 3 BP 213 EP 218 DI 10.1016/S1047-2797(97)00014-8 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WX578 UT WOS:A1997WX57800009 PM 9141645 ER PT J AU Slutsker, L Ries, AA Greene, KD Wells, JG Hutwagner, L Griffin, PM AF Slutsker, L Ries, AA Greene, KD Wells, JG Hutwagner, L Griffin, PM TI Escherichia coli O157:H7 diarrhea in the United States: Clinical and epidemiologic features SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID HEMOLYTIC-UREMIC-SYNDROME; HEMORRHAGIC COLITIS; WASHINGTON-STATE; 0157-H7 INFECTIONS; BLOODY DIARRHEA; NURSING-HOME; OUTBREAK; MINNESOTA; CULTURES AB Background: Escherichia coli O157:H7 is increasingly recognized as a cause of bacterial diarrhea in the United States, but the frequency of its isolation and the clinical and epidemiologic features of E. coli O157:H7 infection in a large, geographically diverse population of patients have not been well described. Objective: To determine the frequency of isolation of E. coli O157:H7 relative to that of other bacterial enteric pathogens in a nationwide sample of patients and to identify the clinical and epidemiologic features of E. coli O157:H7 infection. Design: Population prevalence study from October 1990 to October 1992. Setting: 10 U.S. hospitals. Patients: Both inpatients and outpatients who had stool samples submitted to 1 of 10 laboratories for routine pathogen identification. Measurements: Clinical, epidemiologic, and laboratory information was collected for infected and uninfected patients. Isolates of E. coli O157:H7 were tested for production of Shiga toxin. Patient charts were then reviewed. Results: Escherichia coli O157:H7 was isolated from 118 (0.39%) of the 30 463 fecal specimens tested. The proportion of fecal specimens with isolates was higher at northern sites (0.57%) than at southern sites (0.13%) (P < 0.001). Escherichia coli O157:H7 was more likely to be isolated from visibly bloody stool specimens than from specimens without visible blood (odds ratio [OR], 59.2 [95% CI, 36.6 to 96.01]) and was the pathogen most commonly isolated from visibly bloody stool specimens that yielded a bacterial enteric pathogen (39% of such specimens). The highest age-specific isolation proportions from fecal specimens for E. coli O157:H7 were in patients 5 to 9 years of age (0.90%) and 50 to 59 years of age (0.89%). Clinical features independently associated with E. coli O157:H7 infection com pared with the other enteric pathogens included a history of bloody diarrhea (OR, 18.6 [CI, 7.4 to 48.6]), visibly bloody stool specimens (OR, 8.1 [CI, 3.6 to 18.3]), no reported fever (OR, 8.3 [CI, 1.6 to 50.0]), leukocyte count greater than 10 x 10(9)/L(OR, 4.0 [CI, 1.7 to 9.5]), and abdominal tenderness on physical examination (OR, 2.9 [CI, 1.2 to 7.2]). Conclusions: In some geographic areas and some age groups, isolation proportions from fecal specimens for E. coli O157:H7 surpassed those of other common enteric pathogens. One third of isolates of this organism came from nonbloody specimens. Because person-to-person transmission of E. coli O157:H7 is not uncommon and infection with this organism may cause severe disease, stool specimens from all patients with a history of acute bloody diarrhea should be cultured for E. coli O157:H7. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,BIOSTAT & INFORMAT MANAGEMENT BRANCH,ATLANTA,GA 30333. RP Slutsker, L (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,FOODBORNE & DIARRHEAL DIS BRANCH,MAILSTOP A-38,ATLANTA,GA 30333, USA. NR 44 TC 171 Z9 180 U1 1 U2 20 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD APR 1 PY 1997 VL 126 IS 7 BP 505 EP & PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA WQ195 UT WOS:A1997WQ19500011 PM 9092315 ER PT J AU Venczel, LV Arrowood, M Hurd, M Sobsey, MD AF Venczel, LV Arrowood, M Hurd, M Sobsey, MD TI Inactivation of Cryptosporidium parvum oocysts and Clostridium perfringens spores by a mixed-oxidant disinfectant and by free chlorine SO APPLIED AND ENVIRONMENTAL MICROBIOLOGY LA English DT Article ID WATER-TREATMENT; DRINKING-WATER; VIRUSES; OZONE AB Cryptosporidium parvum oocysts and Clostridium perfringens spores are very resistant to chlorine and other drinking-water disinfectants, Clostridium perfringens spores have been suggested as a surrogate indicator of disinfectant activity against Cryptosporidium parvum and other hardy pathogens in water. In this study, an alternative disinfection system consisting of an electrochemically produced mixed-oxidant solution (MIOX; LATA Inc.) was evaluated for inactivation of both Cryptosporidium parvum oocysts and Clostridium perfringens spores. The disinfection efficacy of the mixed-oxidant solution was compared to that of free chlorine on the basis of equal weight per volume concentrations of total oxidants. Batch inactivation experiments were done on purified oocysts and spores in buffered, oxidant demand-free water at pH 7 and 25 degrees C by using a disinfectant dose of 5 mg/liter and contact times of up to 24 h. The mixed-oxidant solution was considerably more effective than free chlorine in inactivating both microorganisms. A 5-mg/liter dose of mixed oxidants produced a >3-log(10)-unit (>99.9%) inactivation of Cryptosporidium parvum oocysts and Clostridium perfringens spores in 4 h. Free chlorine produced no measurable inactivation of Cryptosporidium parvum oocysts by 4 or 24 h, although Clostridium perfringens spores were inactivated by 1.4 log(10) units after 4 h. The on-site generation of mixed oxidants may be a practical and cost-effective system of drinking water disinfection protecting against even the most resistant pathogens, including Cryptosporidium oocysts. C1 CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,ATLANTA,GA 30341. RP Venczel, LV (reprint author), UNIV N CAROLINA,CHAPEL HILL,NC 27599, USA. NR 17 TC 104 Z9 108 U1 0 U2 14 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0099-2240 J9 APPL ENVIRON MICROB JI Appl. Environ. Microbiol. PD APR PY 1997 VL 63 IS 4 BP 1598 EP 1601 PG 4 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA WR162 UT WOS:A1997WR16200060 PM 9097455 ER PT J AU Grant, KA Habes, DJ AF Grant, KA Habes, DJ TI An electromyographic study of strength and upper extremity muscle activity in simulated meat cutting tasks SO APPLIED ERGONOMICS LA English DT Article DE electromyography (EMG); musculoskeletal disorders; force; posture; meatpacking ID MUSCULOSKELETAL ILLNESSES; FORCES; LOAD AB Meat cutting has long been associated with a high incidence rate of upper extremity musculoskeletal disorders, This study examined upper extremity muscle activities and force exertion capabilities to identify postures which have potential for causing overexertion injuries, Fifteen subjects exerted force against a handle in postures similar to those observed in the meatpacking industry, Exertion level, direction of exertion, handle height, reach distance and grip type were varied, Activity in the posterior deltoid, biceps brachii, triceps brachii, extensor digitorum and flexor digitorum superficialis was monitored via surface electromyography (EMG), The ratio of normalized EMG activity to force produced during the exertion was computed for each muscle under each condition, The results showed that handle-position had a significant effect on force exertion capability and the EMG/force ratio in all muscles, Force exertion capability was maximized, and the EMG/force ratio was generally minimized when participants pulled downward on a handle positioned at full arm's reach above the shoulder, For vertical cuts, force decreased and muscle activity generally increased as the handle height was lowered, For horizontal cuts, the full reach distance tended to allow greater force exertion with lower EMG/force ratios, The stab grip also tended to be associated with higher forces and lower EMG/force ratios than the slice grip, This study supports the premise that musculoskeletal stresses in meatpacking tasks can be altered through tool and-workstation redesign, The data provided herein may be useful in selecting design modifications that reduce biomechanical stress on the upper extremities. RP Grant, KA (reprint author), NIOSH, US DEPT HHS, CTR DIS CONTROL & PREVENT, 4676 COLUMBIA PKWY, MS C-24, CINCINNATI, OH 45226 USA. NR 18 TC 20 Z9 22 U1 2 U2 6 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 APR PY 1997 VL 28 IS 2 BP 129 EP 137 DI 10.1016/S0003-6870(96)00049-X PG 9 WC Engineering, Industrial; Ergonomics; Psychology, Applied SC Engineering; Psychology GA WL693 UT WOS:A1997WL69300006 PM 9414348 ER PT J AU Hanzlick, R AF Hanzlick, R TI Principles for including or excluding 'mechanisms' of death when writing cause-of-death statements SO ARCHIVES OF PATHOLOGY & LABORATORY MEDICINE LA English DT Article AB Objective.-To develop principles and refined definitions designed to improve the content of cause-of-death statements regarding inclusion or exclusion of so-called mechanisms of death. Data Sources.-Survey of readily available instruction manuals and other literature regarding mechanisms of death and instructions for death certificate completion. Data Synthesis.-Definitions and principles contained in the information sources were reviewed, and a set of specific principles, criteria, and definitions were written. These principles are consistent with, but are more extensive and practically applicable than, those found in each of the information sources surveyed and may be used to decide which conditions to report in cause-of-death statements. Conclusions.-Mechanisms of death include a defined list of terminal events (such as asystole) and a larger group of nonspecific physiologic derangements (such as portal hypertension) and are differentiated by definition from nonspecific anatomic processes (such as cirrhosis). Three principles may be applied in individual cases. Principle 1 states that terminal events are not reported in cause-of-death statements. Principle 2 states that a nonspecific physiologic derangement or a nonspecific anatomic process should be reported if (1) it is a recognized, potentially fatal complication of the underlying cause of death; (2) it constitutes part of the sequence of conditions that led to the death of the patient in question; (3) it is not a symptom or sign; (4) its existence in the patient would not be apparent unless included and explicitly stated in the cause-of-death statement; (5) its inclusion does not constitute an oversimplification of the facts; and (6) an etiologically specific underlying cause of death is also reported. Principle 3 states that if the existence of the complication is obvious based on the underlying cause of death or another reported complication, it need not be reported. C1 EMORY UNIV,SCH MED,DEPT PATHOL,ATLANTA,GA 30322. CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV ENVIRONM HAZARDS & HLTH EFFECTS,ATLANTA,GA. NR 8 TC 10 Z9 10 U1 0 U2 0 PU COLLEGE AMER PATHOLOGISTS PI NORTHFIELD PA C/O KIMBERLY GACKI, 325 WAUKEGAN RD, NORTHFIELD, IL 60093-2750 SN 0003-9985 J9 ARCH PATHOL LAB MED JI Arch. Pathol. Lab. Med. PD APR PY 1997 VL 121 IS 4 BP 377 EP 380 PG 4 WC Medical Laboratory Technology; Medicine, Research & Experimental; Pathology SC Medical Laboratory Technology; Research & Experimental Medicine; Pathology GA WW544 UT WOS:A1997WW54400010 PM 9140306 ER PT J AU Chapman, P AF Chapman, P TI Biological aspects of bereavement in older adults and treatment implications SO BIOLOGICAL PSYCHIATRY LA English DT Meeting Abstract C1 CTR DIS CONTROL & PREVENT,DIV ADULT COMMUNITY HLTH,ATLANTA,GA 30341. NR 0 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 SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD APR 1 PY 1997 VL 41 SU 7 BP 89 EP 89 PG 2 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA WQ709 UT WOS:A1997WQ70900091 ER PT J AU Holmberg, L Ekbom, A Calle, E Mokdad, A Byers, T AF Holmberg, L Ekbom, A Calle, E Mokdad, A Byers, T TI Breast cancer mortality in relation to self-reported use of breast self-examination. A cohort study of 450,000 women SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Article DE breast cancer; breast self-examination; cohort study; mortality AB The benefits of breast self-examination (BSE) for reducing mortality from breast cancer are uncertain. We conducted an analysis of the relationship between self-reported practicing of BSE and mortality from breast cancer over 13 years in a cohort of over 548,000 women. The report of practicing BSE was unrelated to breast cancer mortality. There was a small beneficial effect in those women who were the thinnest, but this effect was small and not statistically significant. BSE was otherwise equally ineffective in subgroups defined by obesity level and family history of breast cancer. We conclude that BSE, as practiced by American women in 1959, did not reduce the risk of mortality from breast cancer. C1 AMER CANC SOC,ATLANTA,GA 30329. CTR DIS CONTROL,DIV NUTR,ATLANTA,GA 30333. RP Holmberg, L (reprint author), UNIV UPPSALA HOSP,DEPT SURG,DEPT CANC EPIDEMIOL,S-75185 UPPSALA,SWEDEN. NR 6 TC 34 Z9 34 U1 0 U2 0 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA SPUIBOULEVARD 50, PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD APR PY 1997 VL 43 IS 2 BP 137 EP 140 DI 10.1023/A:1005788729145 PG 4 WC Oncology SC Oncology GA WV446 UT WOS:A1997WV44600006 PM 9131269 ER PT J AU Steiner, B RomeroSteiner, S Cruce, D George, R AF Steiner, B RomeroSteiner, S Cruce, D George, R TI Cloning and sequencing of the hyaluronate lyase gene from Propionibacterium acnes SO CANADIAN JOURNAL OF MICROBIOLOGY LA English DT Article DE Propionibacterium acnes; hyaluronidase; leader sequence; hyaluronate binding domain; sequence homology among hyaluronidases ID NUCLEOTIDE-SEQUENCE; ESCHERICHIA-COLI; EXPRESSION; PROTEIN; PURIFICATION; BACTERIA AB The hyaluronate lyase (hyaluronidase) gene from Propionibacterium acnes was cloned and sequenced. The gene was isolated on an EcoRI-generated 3-kb piece of DNA. Expression was less in Escherichia coli than in P. acnes; in E. coli, active enzyme was only cell associated and not secreted. The gene is 2256-bp long and codes for a protein of 82 kDa. Amino terminal sequencing of the protein of the partially purified gene indicated the presence of a 32-amino-acid leader sequence. The leader sequence showed a membrane-spanning domain and all of the features usually associated with the leader for a secreted protein. The amino acid sequence is predicted to share homology with the hyaluronidase enzymes from Streptococcus pneumoniae, Streptococcus agalactiae, and Staphylococcus aureus. A potential hyaluronate-binding domain was identified and antibody against this domain was inhibitory to the enzyme. RP Steiner, B (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. OI Romero-Steiner, Sandra/0000-0003-4128-7768 NR 27 TC 18 Z9 20 U1 0 U2 2 PU NATL RESEARCH COUNCIL CANADA PI OTTAWA PA RESEARCH JOURNALS, MONTREAL RD, OTTAWA ON K1A 0R6, CANADA SN 0008-4166 J9 CAN J MICROBIOL JI Can. J. Microbiol. PD APR PY 1997 VL 43 IS 4 BP 315 EP 321 PG 7 WC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Immunology; Microbiology SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Immunology; Microbiology GA XB727 UT WOS:A1997XB72700002 PM 9115089 ER PT J AU Chakrabarti, A Kumar, P Padhye, AA Chatha, L Singh, SK Das, A Wig, JD Kataria, RN AF Chakrabarti, A Kumar, P Padhye, AA Chatha, L Singh, SK Das, A Wig, JD Kataria, RN TI Primary cutaneous zygomycosis due to Saksenaea vasiformis and Apophysomyces elegans SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID NECROTIZING FASCIITIS; MUCORMYCOSIS; OSTEOMYELITIS; INFECTION; PATIENT AB We report three cases of primary cutaneous zygomycosis due to either Saksenaea vasiformis (two patients) or Apophysomyces elegans (one patient). Extensive surgical debridement helped two patients recover from their infections. The underlying disease in the one patient who died was diabetes mellitus. We reviewed the literature on primary cutaneous zygomycosis and found that S. vasiformis and A. elegans were the etiologic agents in 16 and 13 earlier cases, respectively. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,PUBL HLTH SERV,ATLANTA,GA 30333. POSTGRAD INST MED EDUC & RES,DEPT MED MICROBIOL,CHANDIGARH 160012,INDIA. POSTGRAD INST MED EDUC & RES,DEPT UROL,CHANDIGARH 160012,INDIA. POSTGRAD INST MED EDUC & RES,DEPT HISTOPATHOL,CHANDIGARH 160012,INDIA. POSTGRAD INST MED EDUC & RES,DEPT GEN SURG,CHANDIGARH 160012,INDIA. NR 29 TC 47 Z9 52 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD APR PY 1997 VL 24 IS 4 BP 580 EP 583 DI 10.1093/clind/24.4.580 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WT725 UT WOS:A1997WT72500008 PM 9145731 ER PT J AU Kilgore, PE Ksiazek, TG Rollin, PE Mills, JN Villagra, MR Montenegro, MJ Costales, MA Paredes, LC Peters, CJ AF Kilgore, PE Ksiazek, TG Rollin, PE Mills, JN Villagra, MR Montenegro, MJ Costales, MA Paredes, LC Peters, CJ TI Treatment of Bolivian hemorrhagic fever with intravenous ribavirin SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) CY SEP 17-22, 1995 CL SAN FRANCISCO, CA SP Amer Soc Microbiol ID THERAPY; VIRUS AB Bolivian hemorrhagic fever (BHF) is a potentially severe febrile illness caused by Machupo virus (family Arenaviridae). Initial symptoms include headache, fever, arthralgia, and myalgia. In the later stages of this illness, patients may develop hemorrhagic manifestations including subconjunctival hemorrhage, epistaxis, hematemesis, melena, and hematuria, as well as neurological signs including tremor, seizures, and coma. During the BHF epidemics of the 1960s, convalescent-phase immune plasma from survivors of BHF was administered to selected patients infected with Machupo virus, However, there is currently a paucity of survivors of BHF who can donate immune plasma, and there is no active program for collection and storage of BHF immune plasma; therefore, we had the opportunity to offer intravenous ribavirin to two of three patients with this potentially life-threatening infection, One patient with laboratory-confirmed Machupo virus infection who received ribavirin recovered without sequelae, as did a second patient with suspected BHF whose epidemiological and clinical features were similar to those of the first patient, This report describes the first use of intravenous ribavirin therapy for BHF in humans, and the results suggest the need for more extensive clinical studies to assess the usefulness of ribavirin for treating BHF. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. GERMAN BUSCH HOSP,NATL HLTH SECRETARY BOLIVIA,TRINIDAD,BOLIVIA. JAPANESE MATERNAL INFANT HOSP,TRINIDAD,BOLIVIA. VIEDMA HOSP,COCHABAMBA,BOLIVIA. RI Kilgore, Paul/L-1462-2013 OI Kilgore, Paul/0000-0003-3214-4482 NR 18 TC 81 Z9 87 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD APR PY 1997 VL 24 IS 4 BP 718 EP 722 DI 10.1093/clind/24.4.718 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WT725 UT WOS:A1997WT72500026 PM 9145749 ER PT J AU Fridkin, SK Jarvis, WR AF Fridkin, SK Jarvis, WR TI Letter to the Editor - Nystatin prophylaxis - Reply SO CLINICAL MICROBIOLOGY REVIEWS LA English DT Letter RP Fridkin, SK (reprint author), CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,ATLANTA,GA 30333, USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0893-8512 J9 CLIN MICROBIOL REV JI Clin. Microbiol. Rev. PD APR PY 1997 VL 10 IS 2 BP 368 EP 368 PG 1 WC Microbiology SC Microbiology GA WT191 UT WOS:A1997WT19100011 ER PT J AU Kaufmann, AF Meltzer, MI Schmid, GP AF Kaufmann, AF Meltzer, MI Schmid, GP TI The economic impact of a bioterrorist attack: Are prevention and postattack intervention programs justifiable? SO EMERGING INFECTIOUS DISEASES LA English DT Article ID BRUCELLA-MELITENSIS; LABORATORY WORKERS; OUTBREAK; ANTHRAX AB Understanding and quantifying the impact of a bioterrorist attack are essential in developing public health preparedness for such an attack. We constructed a model that compares the impact of three classic agents of biologic warfare (Bacillus anthracis, Brucella melitensis, and Francisella tularensis) when released as aerosols in the suburb of a major city. The model shows that the economic impact of a bioterrorist attack can range from an estimated $477.7 million per 100,000 persons exposed (brucellosis scenario) to $26.2 billion per 100,000 persons exposed (anthrax scenario). Rapid implementation of a postattack prophylaxis program is the single most important means of reducing these losses. By using an insurance analogy, our model provides economic justification for preparedness measures. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA 30333. NR 22 TC 222 Z9 230 U1 1 U2 9 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 83 EP 94 PG 12 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500001 PM 9204289 ER PT J AU Wells, RM Estani, SS Yadon, ZE Enria, D Padula, P Pini, N Mills, JN Peters, CJ Segura, EL Guthmann, N Arguelo, E Klein, F Levy, R Nagel, C Calfin, R deRosas, F Lazaro, M Rosales, H Sandoval, P AF Wells, RM Estani, SS Yadon, ZE Enria, D Padula, P Pini, N Mills, JN Peters, CJ Segura, EL Guthmann, N Arguelo, E Klein, F Levy, R Nagel, C Calfin, R deRosas, F Lazaro, M Rosales, H Sandoval, P TI An unusual hantavirus outbreak in southern Argentina: Person-to-person transmission? SO EMERGING INFECTIOUS DISEASES LA English DT Article AB Hantavirus pulmonary syndrome is a rodent-borne zoonosis first recognized in the United States in 1993. Person-to-person transmission has not been reported; however, in the outbreak of 20 cases reported here, epidemiologic evidence strongly suggests this route of transmission. C1 INST NACL CHAGAS DR MARIO FATALA CHABEN,BUENOS AIRES,DF,ARGENTINA. ADM NACL LABS & INST SALUD,BUENOS AIRES,DF,ARGENTINA. INST NACL ENFERMEDADES VIRALES HUMANAS DR JULIO I,BUENOS AIRES,DF,ARGENTINA. RP Wells, RM (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. OI Wells, Rachel/0000-0002-6847-0143 NR 9 TC 140 Z9 149 U1 0 U2 3 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 171 EP 174 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500010 PM 9204298 ER PT J AU Jay, M Ascher, MS Chomel, BB Madon, M Sesline, D Enge, BA Hjelle, B Ksiazek, TG Rollin, PE Kass, PH Reilly, K AF Jay, M Ascher, MS Chomel, BB Madon, M Sesline, D Enge, BA Hjelle, B Ksiazek, TG Rollin, PE Kass, PH Reilly, K TI Seroepidemiologic studies of hantavirus infection among wild rodents in California SO EMERGING INFECTIOUS DISEASES LA English DT Article ID SOUTHWESTERN UNITED-STATES; WHITE-FOOTED MOUSE; PULMONARY-SYNDROME; GENETIC IDENTIFICATION; PEROMYSCUS-MANICULATUS; HEMORRHAGIC-FEVER; RENAL SYNDROME; VIRUS; 4-CORNERS-HANTAVIRUS; TRANSMISSION AB A total of 4,626 mammals were serologically tested for antibodies to Sin Nombre virus. All nonrodent species were antibody negative. Among wild rodents, antibody prevalence was 8.5% in murids, 1.4% in heteromyids, and < 0.1% in sciurids. Of 1,921 Peromyscus maniculatus (deer mice), 226 (11.8%) were antibody positive, including one collected in 1975. The highest antibody prevalence (71.4% of 35) was found among a. maniculatus on Santa. Cruz Island, off the southern California coast. Prevalence of antibodies among deer mice trapped near sites of human cases (26.8% of 164) was significantly higher than that of mice from other sites (odds ratio = 4.5; 95% confidence interval = 1.7, 11.6). Antibody prevalence increased with rising elevation (>1,200 meters) and correlated with a spatial cluster of hantavirus pulmonary syndrome cases in the Sierra Nevada. C1 VIRAL & RICKETTSIAL DIS LAB,BERKELEY,CA. UNIV CALIF DAVIS,DAVIS,CA. CALIF DEPT HLTH SERV,ONTARIO,CA. UNIV NEW MEXICO,ALBUQUERQUE,NM 87131. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Jay, M (reprint author), CALIF DEPT HLTH SERV,SACRAMENTO,CA 95814, USA. FU NIAID NIH HHS [R01 AI36336] NR 36 TC 29 Z9 31 U1 0 U2 3 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 183 EP 190 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500013 PM 9204301 ER PT J AU Izurieta, HS Strebel, PM Youngblood, T Hollis, DG Popovic, T AF Izurieta, HS Strebel, PM Youngblood, T Hollis, DG Popovic, T TI The reemergence of Aedes aegypti in Arizona - Reply SO EMERGING INFECTIOUS DISEASES LA English DT Letter C1 ROGERS PEDIAT CLIN,ROGERS,AR. RP Izurieta, HS (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 10 TC 0 Z9 0 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 242 EP 243 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500025 ER PT J AU Lal, AA Tibayrenc, M AF Lal, AA Tibayrenc, M TI The First International Workshop on Molecular Epidemiology and Evolutionary Genetics of Pathogenic Microorganisms SO EMERGING INFECTIOUS DISEASES LA English DT Editorial Material C1 ORSTOM,CNRS UMR,CTR ETUD POLYMORHPISME MICROGANISMES,F-34032 MONTPELLIER,FRANCE. RP Lal, AA (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 244 EP 245 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500026 ER PT J AU LeDuc, JW AF LeDuc, JW TI International conference on emerging infectious diseases in the Pacific Rim, Bangkok, Thailand SO EMERGING INFECTIOUS DISEASES LA English DT Editorial Material RP LeDuc, JW (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 248 EP 249 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500029 ER PT J AU Tsai, T AF Tsai, T TI International Conference on Emerging Zoonotic Infectious Diseases, Taipei, Taiwan SO EMERGING INFECTIOUS DISEASES LA English DT Editorial Material RP Tsai, T (reprint author), CTR DIS CONTROL & PREVENT,FT COLLINS,CO 80522, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD APR-JUN PY 1997 VL 3 IS 2 BP 249 EP 250 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA XL155 UT WOS:A1997XL15500030 ER PT J AU Cromeans, TL AF Cromeans, TL TI Understanding and preventing virus transmission via foods SO FOOD TECHNOLOGY LA English DT Editorial Material RP Cromeans, TL (reprint author), CDC,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333, USA. NR 3 TC 3 Z9 3 U1 0 U2 0 PU INST FOOD TECHNOLOGISTS PI CHICAGO PA SUITE 300 221 N LASALLE ST, CHICAGO, IL 60601-1291 SN 0015-6639 J9 FOOD TECHNOL-CHICAGO JI Food Technol. PD APR PY 1997 VL 51 IS 4 BP 20 EP 20 PG 1 WC Food Science & Technology SC Food Science & Technology GA WT542 UT WOS:A1997WT54200001 ER PT J AU Hernandez, V Fitzgerald, MA Parkinson, AJ Berg, DE AF Hernandez, V Fitzgerald, MA Parkinson, AJ Berg, DE TI Virulence determinants of Helicobacter pylori isolates from Alaska natives. SO GASTROENTEROLOGY LA English DT Meeting Abstract C1 WASHINGTON UNIV, SCH MED, DEPT MICROBIOL, ST LOUIS, MO 63130 USA. NATL CTR INFECT DIS, CDC, ARCTIC INVEST PROGRAM, ANCHORAGE, AK USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD APR PY 1997 VL 112 IS 4 SU S BP A994 EP A994 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA WV419 UT WOS:A1997WV41903962 ER PT J AU Khanna, B Cutler, A Perry, M Lastovica, A Gold, BD AF Khanna, B Cutler, A Perry, M Lastovica, A Gold, BD TI Sensitivity of commercially-available: Serology tests to detect Helicobacter pylori infection in children? SO GASTROENTEROLOGY LA English DT Meeting Abstract C1 EMORY UNIV, SCH MED, DEPT PEDIAT, ATLANTA, GA 30322 USA. CTR DIS CONTROL & PREVENT, ATLANTA, GA USA. SINAI HOSP, DETROIT, MI 48235 USA. RED CROSS CHILDRENS HOSP, DEPT MED MICROBIOL, CAPE TOWN, SOUTH AFRICA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD APR PY 1997 VL 112 IS 4 SU S BP A172 EP A172 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA WV419 UT WOS:A1997WV41900684 ER PT J AU Ngo, DM Newman, GW Quinn, FD Gold, BD AF Ngo, DM Newman, GW Quinn, FD Gold, BD TI Helicobacter pylori induces gastric epithelial and endothelial cells to produce leukocyte chemotactic factors. SO GASTROENTEROLOGY LA English DT Meeting Abstract C1 EMORY UNIV, SCH MED, ATLANTA, GA USA. EMORY UNIV, MOREHOUSE SCH MED, ATLANTA, GA USA. DASTLR, ATLANTA, GA USA. NCID, ATLANTA, GA USA. CDC, ATLANTA, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD APR PY 1997 VL 112 IS 4 SU S BP A235 EP A235 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA WV419 UT WOS:A1997WV41900937 ER PT J AU Ford, ES Eheman, CR AF Ford, ES Eheman, CR TI Radon retesting and mitigation behavior among the US population SO HEALTH PHYSICS LA English DT Article DE radon; safety standards; Rn-222, indoor; health effects ID SCREENING MEASUREMENTS; RISK AB Relatively few data are available about how people comply with Environmental Protection Agency recommendations concerning retesting and mitigation after either an initial screening or long term test for radon gas, Using data from the 1990 and 1991 National Health Interview Surveys, we found that 40.7% (standard error 6.4%) of homes with radon levels above 148 Bq m(-3) in 1990 and 34.3% (standard error 4.9%) of homes with levels above 148 Bq m(-3) in 1991 were retested, Among homes that were retested and had either an initial screening or followup test above 148 Po m(-3), 28.2% (standard error 6.4%) were mitigated in 1990 compared with 48.4% (standard error 14.4%) that did so in 1991. These results suggest that most people are not complying with current EPA recommendations for retesting and mitigation. C1 CTR DIS CONTROL & PREVENT, RADIAT STUDIES BRANCH, DIV HLTH HAZARDS & HLTH EFFECTS, ATLANTA, GA 30341 USA. CTR DIS CONTROL & PREVENT, CHRON DIS BRANCH, DIV NUTR, NATL CTR CHRON DIS PREVENT & HLTH PROMOT, ATLANTA, GA 30341 USA. NR 15 TC 5 Z9 5 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD APR PY 1997 VL 72 IS 4 BP 611 EP 614 DI 10.1097/00004032-199704000-00013 PG 4 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA WN590 UT WOS:A1997WN59000014 PM 9119686 ER PT J AU Indest, KJ Ramamoorthy, R Sole, M Gilmore, RD Johnson, BJB Philipp, MT AF Indest, KJ Ramamoorthy, R Sole, M Gilmore, RD Johnson, BJB Philipp, MT TI Cell-density-dependent expression of Borrelia burgdorferi lipoproteins in vitro SO INFECTION AND IMMUNITY LA English DT Article ID OUTER-SURFACE-PROTEIN; LYME-DISEASE; RHESUS-MONKEY; IMMUNOLOGICAL CHARACTERIZATION; IN-VIVO; INFECTION; BINDING; PLASMID; GROWTH; TICKS AB Previously, we had identified non-OspA-OspB surface proteins of Borrelia burgdorferi that are targeted by the antibody-dependent complement-mediated killing mechanism, Here we demonstrate by Western blotting that one of these proteins, P35, is upregulated at the onset of stationary phase in vitro, Northern analysis revealed that the upregulation of P35 is at the level of transcription, In addition, the expression of an open reading frame (ORF) located downstream of the p35 gene was found to be regulated in the same fashion as that of P35. This ORF encodes a 7.5-kDa lipoprotein, The transcriptional start sites for both of these genes were determined, to aid in the identification of the putative promoter regions. Additional sequencing of the 5' banking region of the p35 gene revealed a region of dyad symmetry 52 bp upstream of the transcription start site, Southern analysis demonstrated that the expression of these genes was not due to a cell-density-dependent rearrangement in the genome of B. burgdorferi. These findings provide an in vitro model for studying mechanisms of gene regulation in B. burgdorferi. C1 TULANE UNIV,MED CTR,TULANE REG PRIMATE RES CTR,DEPT PARASITOL,COVINGTON,LA 70433. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VECTOR BORNE INFECT DIS,FT COLLINS,CO 80522. FU NCRR NIH HHS [RR00164] NR 32 TC 77 Z9 78 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD APR PY 1997 VL 65 IS 4 BP 1165 EP 1171 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ298 UT WOS:A1997WQ29800005 PM 9119447 ER PT J AU Shlaes, DM Gerding, DN John, JF Craig, WA Bornstein, DL Duncan, RA Eckman, MR Farrer, WE Greene, WH Lorian, V Levy, S McGowan, JE Paul, SM Ruskin, J Tenover, FC Watanakunakorn, C AF Shlaes, DM Gerding, DN John, JF Craig, WA Bornstein, DL Duncan, RA Eckman, MR Farrer, WE Greene, WH Lorian, V Levy, S McGowan, JE Paul, SM Ruskin, J Tenover, FC Watanakunakorn, C TI Society for Healthcare Epidemiology of America and Infectious Diseases Society of America Joint Committee on the Prevention of Antimicrobial Resistance: Guidelines for the prevention of antimicrobial resistance in hospitals SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID GRAM-NEGATIVE BACILLI; STAPHYLOCOCCUS-AUREUS; ANTIBIOTIC USE; AMIKACIN USE; AMINOGLYCOSIDE RESISTANCE; CIPROFLOXACIN RESISTANCE; CEPHALOSPORIN USE; ACTIVE EFFLUX; USAGE; SURVEILLANCE AB Antimicrobial resistance results in increased morbidity, mortality, and costs of health care. Prevention of the emergence of resistance and the dissemination of resistant microorganisms will reduce these adverse effects and their attendant costs. Appropriate antimicrobial stewardship that includes optimal selection, dose, and duration of treatment, as well as control of antibiotic use, will prevent or slow the emergence of resistance among microorganisms. A comprehensively applied infection control program will interdict the dissemination of resistant strains. C1 VET AFFAIRS LAKESIDE MED CTR,CHICAGO,IL. UNIV MED & DENT NEW JERSEY,ROBERT WOOD JOHNSON MED SCH,NEW BRUNSWICK,NJ. WILLIAM S MIDDLETON MEM VET ADM MED CTR,MADISON,WI. SUNY HLTH SCI CTR,SYRACUSE,NY 13210. LAHEY CLIN FDN,BURLINGTON,MA. DULUTH CLIN LTD,DULUTH,MN. ST ELIZABETH HOSP,ELIZABETH,NJ. SUNY STONY BROOK,UNIV HOSP,STONY BROOK,NY 11794. BRONX LEBANON HOSP CTR,BRONX,NY 10456. TUFTS UNIV,SCH MED,BOSTON,MA 02111. GRADY MEM HOSP,ATLANTA,GA. NEW JERSEY STATE DEPT HLTH,TRENTON,NJ 08625. KAISER PERMANENTE MED CTR,LOS ANGELES,CA 90034. CTR DIS CONTROL & PREVENT,ATLANTA,GA. ST ELIZABETH HOSP,MED CTR,YOUNGSTOWN,OH 44501. RP Shlaes, DM (reprint author), WYETH AYERST RES,401 N MIDDLETOWN RD,PEARL RIVER,NY 10965, USA. RI mcgowan jr, john/G-5404-2011 NR 85 TC 163 Z9 170 U1 0 U2 2 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD APR PY 1997 VL 18 IS 4 BP 275 EP 291 PG 17 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WV963 UT WOS:A1997WV96300013 PM 9131374 ER PT J AU Mbulaiteye, SM Ziegler, JL KatougoleMbidde, E Tindyebwa, D Marrum, L Newton, R Berral, V Parkin, DM DeeCock, KM Jaffe, H Weiss, R AF Mbulaiteye, SM Ziegler, JL KatougoleMbidde, E Tindyebwa, D Marrum, L Newton, R Berral, V Parkin, DM DeeCock, KM Jaffe, H Weiss, R TI Risk factors for childhood Kaposi's Sarcoma in Uganda: A case control study SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Meeting Abstract C1 MAKERERE UNIV,KAMPALA,UGANDA. IMPERIAL CANC RES FUND,OXFORD,ENGLAND. IARC,LYON,FRANCE. CDC,ATLANTA,GA 30333. CHESTER BEATY INST,LONDON,ENGLAND. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 1 PY 1997 VL 14 IS 4 BP 7 EP 7 PG 1 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WU251 UT WOS:A1997WU25100041 ER PT J AU Yu, YM Lin, JC Unger, ER Gunthel, CJ Browning, PJ Offermann, MK AF Yu, YM Lin, JC Unger, ER Gunthel, CJ Browning, PJ Offermann, MK TI Retention and expression of human herpes virus 8 (HHV-8) in spindle cells cultured from Kaposi's sarcoma lesions SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Meeting Abstract C1 EMORY UNIV,WINSHIP CANC CTR,ATLANTA,GA 30322. EMORY UNIV,DEPT PATHOL,ATLANTA,GA 30322. EMORY UNIV,DEPT MED,ATLANTA,GA 30322. CTR DIS CONTROL,ATLANTA,GA 30333. VANDERBILT UNIV,DEPT MED,NASHVILLE,TN. VANDERBILT UNIV,CTR CANC,NASHVILLE,TN. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 1 PY 1997 VL 14 IS 4 BP 39 EP 39 PG 1 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WU251 UT WOS:A1997WU25100072 ER PT J AU Selik, RM Jones, JL AF Selik, RM Jones, JL TI Impact of HIV infection on rates of death from cancers among men aged 25-44 years in the United States SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Meeting Abstract C1 CDC,DIV HIV AIDS PREVENT,ATLANTA,GA 30333. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 1 PY 1997 VL 14 IS 4 BP 56 EP 56 PG 1 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WU251 UT WOS:A1997WU25100089 ER PT J AU McQuillan, GM Khare, M Karon, JM Schable, CA Vlahov, D AF McQuillan, GM Khare, M Karon, JM Schable, CA Vlahov, D TI Update on the seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1994 SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE human immunodeficiency virus infection; national survey; seroepidemiology; prevalence; urine drug testing ID HIV-INFECTION; COCAINE USE; ADULTS AB To update the estimate of seroprevalence of HIV from the third National Health and Nutrition Examination Survey (NHANES III), data from the second phase of the survey were combined with previously published data to produce a more precise estimate. The testing was performed anonymously on 11,203 individuals 18-59 years of age examined from 1988 to 1994. Fifty nine individuals were HIV positive, for an overall prevalence of 0.32%. The number of individuals living in households with HIV infection based on this estimate was 461,000, with a 95% confidence interval of 290,000-733,000. Analysis of nonresponse demonstrated that white and black men 40-59 years of age were least likely to participate in the survey. A sensitivity analysis demonstrated that this nonresponse may have biased the NHANES III estimate downward by 190,000 persons. Data from the second phase of the survey were used to analyze the association between drug use and HIV infection. Black women who used cocaine were 12 times more likely to be HIV positive compared with all tested black women (6.5% vs. 0.55%). This survey provides an estimate of HIV prevalence for individuals who reside in households but excludes some persons who are at higher risk for HIV infection, including prisoners and the homeless not residing in shelters. C1 CTR DIS CONTROL & PREVENT,NATL CTR HLTH STAT,DIV HLTH EXAMINAT STAT,BALTIMORE,MD. CTR DIS CONTROL & PREVENT,NATL CTR HIV SEXUALLY TRANSMITTED DIS & TB PREVEN,DIV HIV AIDS PREVENT,BALTIMORE,MD. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT EPIDEMIOL,BALTIMORE,MD. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT EPIDEMIOL,BALTIMORE,MD. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV AIDS STD & TB LAB RES,BALTIMORE,MD. NR 18 TC 44 Z9 45 U1 1 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD APR 1 PY 1997 VL 14 IS 4 BP 355 EP 360 PG 6 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WU251 UT WOS:A1997WU25100008 PM 9111478 ER PT J AU DeRosa, CT Brown, D Dhara, R Garrett, W Hansen, H Holler, J Jones, D JordanIzaguirre, D OConnor, R Pohl, H Xintaras, C AF DeRosa, CT Brown, D Dhara, R Garrett, W Hansen, H Holler, J Jones, D JordanIzaguirre, D OConnor, R Pohl, H Xintaras, C TI Dioxin and dioxin-like compounds in soil .1. ATSDR interim policy guideline SO JOURNAL OF CLEAN TECHNOLOGY ENVIRONMENTAL TOXICOLOGY AND OCCUPATIONAL MEDICINE LA English DT Article DE dioxin; human exposure; risk assessment; soil levels; TCDD; TEQs RP DeRosa, CT (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,DIV TOXICOL,MAILSTOP E-29,ATLANTA,GA 30333, USA. NR 8 TC 3 Z9 3 U1 0 U2 0 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 1052-1062 J9 J CLEAN TECHNOL E T JI J. Clean Technol. Environ. Toxicol. Occup. Med. PD APR-JUN PY 1997 VL 6 IS 2 BP 117 EP 126 PG 10 WC Environmental Sciences; Toxicology SC Environmental Sciences & Ecology; Toxicology GA XW849 UT WOS:A1997XW84900001 ER PT J AU DeRosa, CT Brown, D Dhara, R Garrett, W Hansen, H Holler, J Jones, D JordanIzaguirre, D OConnor, R Pohl, H Xintaras, C AF DeRosa, CT Brown, D Dhara, R Garrett, W Hansen, H Holler, J Jones, D JordanIzaguirre, D OConnor, R Pohl, H Xintaras, C TI Dioxin and dioxin-like compounds in soil .2. Technical support document for ATSDR* interim policy guideline SO JOURNAL OF CLEAN TECHNOLOGY ENVIRONMENTAL TOXICOLOGY AND OCCUPATIONAL MEDICINE LA English DT Article DE dioxin; human exposure; risk assessment; soil levels; TCDD; TEQs ID CLINICAL LABORATORY MANIFESTATIONS; OPERATION RANCH HAND; 2,3,7,8-TETRACHLORODIBENZO-PARA-DIOXIN TCDD; GUINEA-PIGS; POLYCHLORINATED-BIPHENYLS; THYROID-HORMONES; REPRODUCTIVE TOXICITY; MANUFACTURING SITE; TRANSFORMER FLUID; CONTAMINATED SOIL RP DeRosa, CT (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,DIV TOXICOL,MAILSTOP E-29,ATLANTA,GA 30333, USA. NR 96 TC 2 Z9 2 U1 0 U2 0 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 1052-1062 J9 J CLEAN TECHNOL E T JI J. Clean Technol. Environ. Toxicol. Occup. Med. PD APR-JUN PY 1997 VL 6 IS 2 BP 127 EP 163 PG 37 WC Environmental Sciences; Toxicology SC Environmental Sciences & Ecology; Toxicology GA XW849 UT WOS:A1997XW84900002 ER PT J AU Gist, GL Burg, JR AF Gist, GL Burg, JR TI Methodology for selecting substances for the National Exposure Registry SO JOURNAL OF CLEAN TECHNOLOGY ENVIRONMENTAL TOXICOLOGY AND OCCUPATIONAL MEDICINE LA English DT Article AB The National Exposure Registry was created in response to the pervasiveness of chemical contamination at the nation's waste sites and the relative lack of information on human health outcomes associated with long-term, low-level exposure to most of these substances. A ranking scheme was developed by the Agency for Toxic Substances and Disease Registry (ATSDR) to select the substances for which substance-specific subregistries of the National Exposure Registry would be developed. This scheme uses a general decision analysis approach that incorporates the most relevant and up-to-date data available on the substances found at sires known to ATSDR. There are currently four general subregistries (volatile organic compounds, dioxins, heavy metals, and radioactive substances) made up of persons exposed to specific primary contaminants, as selected by means of this ranking scheme. RP Gist, GL (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,1600 CLIFTON RD,MAILSTOP E-31,ATLANTA,GA 30333, USA. NR 11 TC 0 Z9 0 U1 0 U2 0 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 1052-1062 J9 J CLEAN TECHNOL E T JI J. Clean Technol. Environ. Toxicol. Occup. Med. PD APR-JUN PY 1997 VL 6 IS 2 BP 165 EP 175 PG 11 WC Environmental Sciences; Toxicology SC Environmental Sciences & Ecology; Toxicology GA XW849 UT WOS:A1997XW84900003 ER PT J AU Mumtaz, MM Poirier, KA Colman, JT AF Mumtaz, MM Poirier, KA Colman, JT TI Risk assessment for chemical mixtures: Fine-tuning the hazard index approach SO JOURNAL OF CLEAN TECHNOLOGY ENVIRONMENTAL TOXICOLOGY AND OCCUPATIONAL MEDICINE LA English DT Article; Proceedings Paper CT Society-of-Toxicology Annual Meeting CY 1994 CL NEW ORLEANS, LA SP Soc Toxicol DE chemical mixtures; hazard index; risk assessment ID RANKING; SYSTEM AB In the absence of whole mixture toxicity testing data, risk assessments ale performed for most chemical mixtures, using the potency-weighted addition of the toxicity of the individual components of the mixtures. This approach, the hazard index (HI) or the component-based approach, assumes no interactions between the components of the mixture and assumes dose additivity. An HI is calculated as the sum of the hazard quotients, that is, the ratio between the exposure level and an acceptable exposure level of each individual component of the mixture. The goal of the HI approach is to construct the plausible toxicity index that would have been calculated had the mixture itself been tested. However, in practice, the guidance is being applied only to the critical effect of each component chemical because acceptable exposure levels for major effects of a chemical are not derived. Thus, the toxicity to several target organs is not being included in the overall toxicity assessment process. In this research study, we investigated the feasibility of developing target-organ toxicity doses (TTDs) for chemicals found at hazardous waste sites and their applicability as alternatives to the acceptable exposure levels (ALs) currently available in calculating the HI for other than ''critical'' effects. TTDs were developed using an approach analogous to that used for minimal risk level (MRL) and reference dose (RfD) derivations. Data to derive TTDs are available for various environmental pollutants, we compared the results of a risk assessment of a simulated mixture employing the published methods and the TTD method proposed in this paper. The published methods, as practiced underestimate or overestimate the mixture toxicity. The use of the TTDs allows evaluation of toxicity to multiple target organs and thus the realization of the actual intent of the mixtures guidelines (USEPA, 1986). Thus, TTDs enhance the utility and consistency of the application of the chemical mixtures guidance towards a fuller and more realistic characterization of risk. C1 PROCTER & GAMBLE CO,SHARON WOODS TECH CTR,CINCINNATI,OH. SYRACUSE RES CORP,SYRACUSE,NY. RP Mumtaz, MM (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,1600 CLIFTON RD,E-29,ATLANTA,GA 30333, USA. NR 19 TC 14 Z9 14 U1 1 U2 7 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 1052-1062 J9 J CLEAN TECHNOL E T JI J. Clean Technol. Environ. Toxicol. Occup. Med. PD APR-JUN PY 1997 VL 6 IS 2 BP 189 EP 204 PG 16 WC Environmental Sciences; Toxicology SC Environmental Sciences & Ecology; Toxicology GA XW849 UT WOS:A1997XW84900005 ER PT J AU Swan, DC Tucker, RA Holloway, BP Icenogle, JP AF Swan, DC Tucker, RA Holloway, BP Icenogle, JP TI A sensitive, type-specific, fluorogenic probe assay for detection of human papillomavirus DNA SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; CERVICAL-CANCER; SOUTHERN HYBRIDIZATION; REACTION PERMITS; PCR; AMPLIFICATION; GENOTYPES; PRIMERS; IDENTIFICATION; INFECTION AB A simple method for the detection of a number of human papillomavirus (HPV) genotypes associated with cervical cancer has been developed, The assay exploits the 5'-->3' exonucleolytic activity of Taq DNA polymerase to increase the signal from fluorescent dyes by releasing them from genotype-specific probes during PCR. The probes are oligonucleotides with a 5' reporter dye (6-carboxyfluorescein), a quencher dye (6-carboxy-tetramethyl-rhodamine), and a phosphate-blocked 3' end, In the intact probe, the proximity of the reporter and the quencher results in suppression of reporter fluorescence by Forster-type energy transfer (V. T. Forster. Ann, Phys. 2:55-75, 1948). If the probe is bound downstream of either primer during PCR, the 5'-->3' exonucleolytic activity of Taq polymerase degrades it, allowing the reporter to diffuse away from the quencher, which results in an increase in reporter fluorescence, The increased fluorescence is directly related to the amount of target DNA and can be detected with an automated fluorometer. Probes for the L1 region of the cervical-cancer-associated HPV types 16, 18, 31, 33, and 35 were synthesized and the assays were optimized, The most sensitive assay can detect as few as two copies of HPV DNA in human cervical specimens. C1 CTR DIS CONTROL & PREVENT,BIOTECHNOL CORE FACIL,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30333. RP Swan, DC (reprint author), CTR DIS CONTROL & PREVENT,HUMAN PAPILLOMAVIRUS SECT,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30333, USA. NR 22 TC 36 Z9 38 U1 2 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD APR PY 1997 VL 35 IS 4 BP 886 EP 891 PG 6 WC Microbiology SC Microbiology GA WP405 UT WOS:A1997WP40500017 PM 9157148 ER PT J AU Yeh, MT Mather, TN Coughlin, RT GingrichBaker, C Sumner, JW Massung, RF AF Yeh, MT Mather, TN Coughlin, RT GingrichBaker, C Sumner, JW Massung, RF TI Serologic and molecular detection of granulocytic ehrlichiosis in Rhode Island SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID AGENT; IDENTIFICATION; INFECTION; HORSES; EQUI; PCR AB A new indirect fluorescent-antibody (IFA) assay with antigen produced in vitro in the human promyelocytic leukemia cell line HL60 was used to identify the first recognized case of human granulocytic ehrlichiosis in Rhode Island, This IFA assay was used to detect granulocytic ehrlichiae in white-footed mice and in a dog inhabiting the area surrounding the patient's residence, Host-seeking Ixodes scapularis ticks found in the same habitat also were infected. I. scapularis ticks collected from other locations were fed on dogs and New Zealand White rabbits to assess the competency of these species as hosts of granulocytotropic Ehrlichia. Tick-induced infections of dogs were confirmed by serologic testing, tissue culture isolation, and PCR amplification, whereas several rabbits seroconverted but were PCR and culture negative. PCR amplification of the 16S rRNA gene and DNA sequencing of the PCR products or culture isolation was used to confirm granulocytic Ehrlichia infections in humans, dogs, white-footed mice, and ticks. C1 UNIV RHODE ISL,CTR VECTOR BORNE DIS,KINGSTON,RI 02881. AQUILA BIOPHARMACEUT INC,WORCESTER,MA 01605. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. FU NIAID NIH HHS [AI 30733]; PHS HHS [U50/CCU106585-06] NR 27 TC 34 Z9 35 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD APR PY 1997 VL 35 IS 4 BP 944 EP 947 PG 4 WC Microbiology SC Microbiology GA WP405 UT WOS:A1997WP40500026 PM 9157157 ER PT J AU Kramer, MH Lerner, CJ Visvesvara, GS AF Kramer, MH Lerner, CJ Visvesvara, GS TI Kidney and liver transplants from a donor infected with Naegleria fowleri SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID PRIMARY AMEBIC MENINGOENCEPHALITIS AB We describe the first reported case of organ transplantation from a boy who had died of undiagnosed Naegleria fowleri infection. While no subsequent amebic infections occurred in the three organ recipients, our report illustrates the need for an improved strategy for evaluating the benefits and risks of transplanting tissues from persons whose illness was likely caused by an infectious agent. C1 CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,PUBL HLTH SERV,ATLANTA,GA 30341. SAN ANTONIO INFECT DIS CONSULTANTS,SAN ANTONIO,TX 78229. NR 5 TC 13 Z9 13 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD APR PY 1997 VL 35 IS 4 BP 1032 EP 1033 PG 2 WC Microbiology SC Microbiology GA WP405 UT WOS:A1997WP40500053 PM 9157127 ER PT J AU Styrt, BA Shinnick, TM Ridderhof, JC Crawford, JT Tenover, FC AF Styrt, BA Shinnick, TM Ridderhof, JC Crawford, JT Tenover, FC TI Turnaround times for mycobacterial cultures SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Letter C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV AIDS STD & TB LAB RES,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,PUBL HLTH PRACTICE PROGRAM OFF,DIV LAB SYST,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333. RP Styrt, BA (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV TB ELIMINAT,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 8 TC 40 Z9 41 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD APR PY 1997 VL 35 IS 4 BP 1041 EP 1041 PG 1 WC Microbiology SC Microbiology GA WP405 UT WOS:A1997WP40500057 PM 9157131 ER PT J AU Croft, JB Giles, WH Roegner, RH Anda, RF Casper, ML Livengood, JR AF Croft, JB Giles, WH Roegner, RH Anda, RF Casper, ML Livengood, JR TI Pharmacologic management of heart failure among older adults by office-based physicians in the United States SO JOURNAL OF FAMILY PRACTICE LA English DT Article DE aged; angiotensin-converting enzyme inhibitors; antihypertensive agents; epidemiology; heart failure ID ACUTE MYOCARDIAL-INFARCTION; AMBULATORY MEDICAL-CARE; ANTIHYPERTENSIVE DRUGS; VASODILATOR THERAPY; TRENDS; MORTALITY; ENALAPRIL; DYSFUNCTION; TRIALS; 1ST AB BACKGROUND. Despite the recent availability of new classes of heart failure medications, little is known about national patterns in the actual physician utilization of these drugs. METHODS. In the National Ambulatory Medical Care Survey, 2912 US physicians reported on 16,968 office visits in 1991-1992 with patients aged greater than or equal to 65 years. National estimates were obtained from weighted results that accounted for the complex sampling design. RESULTS. An estimated 8.3 million (2.6%) office visits with older adults involved heart failure. This included 9.3% of visits to cardiologists, 4.3% to internists, 3.5% to general and family physicians, and 0.6% to other physicians. The most frequently prescribed medications during visits with these patients were diuretics (69%), digitalis compounds (46%), angiotensin-converting enzyme inhibitors (30%), and nitrates (19%). Internists and general and family physicians prescribed angiotensin-converting enzyme inhibitors, digitalis compounds, and loop diuretics for patients with heart failure less often than did cardiologists. CONCLUSIONS. These are the first national surveillance estimates of physician practices in the management of heart failure. These data were collected during the same period in which heart failure clinical trial results were initially published, and they provide a baseline for monitoring the influence of recent clinical practice guidelines and professional education on changes in the management of heart failure by primary care physicians. RP Croft, JB (reprint author), CTR DIS CONTROL & PREVENT,CARDIOVASC HLTH STUDIES BRANCH,ATLANTA,GA 30341, USA. NR 44 TC 29 Z9 29 U1 0 U2 0 PU APPLETON & LANGE PI E NORWALK PA 25 VAN ZANT ST, E NORWALK, CT 06855 SN 0094-3509 J9 J FAM PRACTICE JI J. Fam. Pract. PD APR PY 1997 VL 44 IS 4 BP 382 EP 390 PG 9 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA WU012 UT WOS:A1997WU01200012 PM 9108836 ER PT J AU Rivas, F Diaz, LA Cardenas, VM Daza, E Bruzon, L Alcala, A DelaHoz, O Caceres, FM Aristizabal, G Martinez, JW Revelo, D DelaHoz, F Boshell, J Camacho, T Calderon, L Olano, VA Villarreal, LI Roselli, D Alvarez, G Ludwig, G Tsai, T AF Rivas, F Diaz, LA Cardenas, VM Daza, E Bruzon, L Alcala, A DelaHoz, O Caceres, FM Aristizabal, G Martinez, JW Revelo, D DelaHoz, F Boshell, J Camacho, T Calderon, L Olano, VA Villarreal, LI Roselli, D Alvarez, G Ludwig, G Tsai, T TI Epidemic Venezuelan equine encephalitis in La Guajira, Colombia, 1995 SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article AB In 1995, the first Venezuelan equine encephalitis (VEE) outbreak in Colombia in 22 years caused an estimated 75,000 human cases, 3000 with neurologic complications and 300 fatal, in La Guajira State. Of the state's estimated 50,000 equines, 8% may have died. An epizootic IC virus, probably introduced from Venezuela, was rapidly amplified among unvaccinated equines. Record high rainfall, producing high densities of vector Aedes taeniorhynchus, led to extensive epidemic transmission (30% attack rate) in the four affected municipalities. Native Wayuu Indians, constituting 24% of the state's population, were at increased risk of infection (risk ratio, 3.3; 95% confidence interval, 2.2-5.3). Epidemiologic studies found no evidence of human-to-human transmission. A higher-than-expected number of abortions during the outbreak confirmed a previously suspected abortifacient role of VEE infection. Pesticide applications and a mass equine vaccination program contributed to preventing the outbreak's spread south of La Guajira. C1 CTR DIS CONTROL,DIV VECTOR BORNE INFECT DIS,FT COLLINS,CO 80522. COLOMBIAN FIELD EPIDEMIOL TRAINING PROGRAM,BOGOTA,COLOMBIA. HOSP SANTA CLARA,BOGOTA,COLOMBIA. NATL INST HLTH,DIV EPIDEMIOL,VIROL LAB,BOGOTA,COLOMBIA. NATL INST HLTH,ENTOMOL LAB,BOGOTA,COLOMBIA. MINIST HLTH,DIV RES & DEV,BOGOTA,COLOMBIA. MINIST HLTH,DIV DIRECT CAMPAIGNS,BOGOTA,COLOMBIA. HOSP RAMON GONZALEZ VALENCIA,EPIDEMIOL UNIT,BUCARAMANGA,COLOMBIA. DASALUD,HLTH SERV LA GUAJIRA,RIOHACHA,COLOMBIA. UNIV NORTE & LIBRE,EPIDEMIOL UNIT,BARRANQUILLA,COLOMBIA. HOSP SAN JORGE,EPIDEMIOL UNIT,PEREIRA,COLOMBIA. HLTH SERV PUTUMAYO,PUTAMAYO,COLOMBIA. CTR DIS CONTROL & PREVENT,INT BRANCH,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. USA,MED RES INST INFECT DIS,DIV VIROL,FREDERICK,MD 21701. OI Martinez, Jose William/0000-0003-3515-8572; Rosselli, Diego/0000-0003-0960-9480 NR 20 TC 109 Z9 115 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD APR PY 1997 VL 175 IS 4 BP 828 EP 832 DI 10.1086/513978 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WQ022 UT WOS:A1997WQ02200013 PM 9086137 ER PT J AU Mahon, BE Ponka, A Hall, WN Komatsu, K Dietrich, SE Siitonen, A Cage, G Hayes, PS LambertFair, MA Bean, NH Griffin, PM Slutsker, L AF Mahon, BE Ponka, A Hall, WN Komatsu, K Dietrich, SE Siitonen, A Cage, G Hayes, PS LambertFair, MA Bean, NH Griffin, PM Slutsker, L TI An international outbreak of Salmonella infections caused by alfalfa sprouts grown from contaminated seeds SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 45th Annual Epidemic Intelligence Service Conference CY APR 22-26, 1996 CL CENTERS FOR DIS CONTROL AND PREVENT, ATLANTA, GA HO CENTERS FOR DIS CONTROL AND PREVENT ID VEGETABLE SPROUTS; LETTUCE AB An outbreak of Salmonella serotype stanley infections occurred in the United States and Finland in 1995. The outbreak was investigated through case-control studies in Arizona, Michigan, and Finland; by isolate subtyping; and by tracing and culturing of the implicated food. Alfalfa sprout consumption was the only exposure associated with S. stanley infections in Arizona (matched odds ratio [MOR] = 11.1; 95% confidence interval [CI], 1.4-513), Michigan (MOR = 5.5; CI, 1.6-23), and Finland (MOR undefined; CI, 4.9-infinity). US and Finnish patient isolates were a unique outbreak strain distinct from S. stanley isolates not linked to the outbreak. Alfalfa sprouts eaten by patients in 6 US states and Finland were traced to seed shipped by a Dutch shipper, Thus, it was concluded that alfalfa sprouts grown from contaminated seed caused an international outbreak of greater than or equal to 242 S. stanley infections in greater than or equal to 17 US states and Finland. This outbreak illustrates a new mechanism through which contamination of fresh produce can cause large, widely dispersed outbreaks. C1 CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA 30333. NATL PUBL HLTH INST,HELSINKI CITY CTR ENVIRONM,HELSINKI,FINLAND. NATL PUBL HLTH INST,LAB ENTER PATHOGENS,HELSINKI,FINLAND. MICHIGAN DEPT PUBL HLTH,SECT DIS SURVEILLANCE,LANSING,MI 48909. MICHIGAN DEPT PUBL HLTH,SECT VIROL,LANSING,MI 48909. ARIZONA DEPT HLTH SERV,SECT INFECT DIS EPIDEMIOL,PHOENIX,AZ 85007. ARIZONA DEPT HLTH SERV,SECT CLIN & REFERENCE MICROBIOL,PHOENIX,AZ 85007. NR 24 TC 190 Z9 197 U1 1 U2 24 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD APR PY 1997 VL 175 IS 4 BP 876 EP 882 DI 10.1086/513985 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WQ022 UT WOS:A1997WQ02200020 PM 9086144 ER PT J AU Passaro, DJ Waring, L Armstrong, R Bolding, F Bouvier, B Rosenberg, J Reingold, AW McQuitty, M Philpott, SM Jarvis, WR Werner, SB Tompkins, LS Vugia, DJ AF Passaro, DJ Waring, L Armstrong, R Bolding, F Bouvier, B Rosenberg, J Reingold, AW McQuitty, M Philpott, SM Jarvis, WR Werner, SB Tompkins, LS Vugia, DJ TI Postoperative Serratia marcescens wound infections traced to an out-of-hospital source SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-for-Healthcare-Epidemiology CY APR 22-24, 1995 CL SAN DIEGO, CA SP Soc Healthcare Epidemiol AB From 25 August to 28 September 1994, 7 cardiovascular surgery (CVS) patients at a California hospital acquired postoperative Serratia marcescens infections, and 1 died, To identify the outbreak source, a cohort study was done of all 55 adults who underwent CVS at the hospital during the outbreak, Specimens from the hospital environment and from hands of selected staff were cultured, S, marcescens isolates were compared using restriction-endonuclease analysis and pulsed-field gel electrophoresis, Several risk factors for S, marcescens infection were identified, but hospital and hand cultures were negative, In October, a patient exposed to scrub nurse A (who wore artificial fingernails) and to another nurse-but not to other identified risk factors-became infected with the outbreak strain, Subsequent cultures from nurse A's home identified the strain in a jar of exfoliant cream, Removal of the cream ended the outbreak, S, marcescens does not normally colonize human skin, but artificial nails may have facilitated transmission via nurse A's hands. C1 UNIV CALIF BERKELEY,BERKELEY,CA. STANFORD UNIV,MED CTR,DIV INFECT DIS & INFECT CONTROL PROGRAM,STANFORD,CA 94305. HOSP GOOD SAMARITAN,INFECT CONTROL DEPT,SAN JOSE,CA. CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA. RP Passaro, DJ (reprint author), CALIF DEPT HLTH SERV,DIV COMMUNICABLE DIS CONTROL,2151 BERKELEY WAY,BERKELEY,CA 94704, USA. NR 14 TC 62 Z9 62 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD APR PY 1997 VL 175 IS 4 BP 992 EP 995 DI 10.1086/514008 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WQ022 UT WOS:A1997WQ02200043 PM 9086167 ER PT J AU Sood, SK Salzman, MB Johnson, BJB Happ, CM Feig, K Carmody, L Rubin, LG Hilton, E Piesman, J AF Sood, SK Salzman, MB Johnson, BJB Happ, CM Feig, K Carmody, L Rubin, LG Hilton, E Piesman, J TI Duration of tick attachment as a predictor of the risk of Lyme disease in an area in which Lyme disease is endemic SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 6th International Conference on Lyme Borreliosis CY JUN 19-22, 1994 CL BOLOGNA, ITALY ID BORRELIA-BURGDORFERI; BITES; TRANSMISSION AB Animal studies have shown an exponential increase in the risk of Borrelia burgdorferi infection after 48-72 h of deer tick attachment, Persons with tick bites were prospectively studied to determine if those with prolonged tick attachment constitute a high-risk group for infection, Ticks were identified, measured for engorgement, and assayed by polymerase chain reaction (PCR) for B, burgdorferi DNA. Duration of attachment was determined from the scutal index of engorgement. Of 316 submissions, 229 were deer ticks; 14% were positive by PCR, Paired sera and an intact tick for determination of duration of attachment were available for 105 subjects (109 bites), There were 4 human cases (3.7% of bites) of B, burgdorferi infection, The incidence was significantly higher for duration of attachment greater than or equal to 72 h than for <72 h: 3 (20%) of 15 vs, 1 (1.1%) of 94 (P =.008; odds ratio, 23.3; 95% confidence interval, 2.2-242). PCR was an unreliable predictor of infection. Tick identification and measurement of engorgement can be used to identify a small, high-risk subset of persons who may benefit from antibiotic prophylaxis. C1 LONG ISL JEWISH MED CTR,DEPT MED,NEW HYDE PK,NY 11042. ALBERT EINSTEIN COLL MED,NEW HYDE PK,NY. CTR DIS CONTROL & PREVENT,DIV VECTOR BORNE INFECT DIS,NATL CTR INFECT DIS,FT COLLINS,CO. SUNY STONY BROOK,HLTH SCI CTR,DEPT PREVENT MED,STONY BROOK,NY 11794. RP Sood, SK (reprint author), SCHNEIDER CHILDRENS HOSP,DIV INFECT DIS,DEPT PEDIAT,269-01 76TH AVE,NEW HYDE PK,NY 11040, USA. NR 15 TC 103 Z9 105 U1 0 U2 4 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD APR PY 1997 VL 175 IS 4 BP 996 EP 999 DI 10.1086/514009 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WQ022 UT WOS:A1997WQ02200044 PM 9086168 ER PT J AU Ikeda, RM Kohn, M Rosenberg, ML AF Ikeda, RM Kohn, M Rosenberg, ML TI Gunshot wounds: A public health care crisis SO JOURNAL OF ORTHOPAEDIC TRAUMA LA English DT Editorial Material C1 Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. Louisiana Off Publ Hlth, Injury Res & Prevent Sect, New Orleans, LA USA. Tulane Univ, Sch Med, Dept Pediat, New Orleans, LA 70112 USA. RP Ikeda, RM (reprint author), Ctr Dis Control & Prevent, Natl Ctr Injury Prevent & Control, Atlanta, GA 30333 USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 USA SN 0890-5339 J9 J ORTHOP TRAUMA JI J. Orthop. Trauma PD APR PY 1997 VL 11 IS 3 BP 147 EP 148 DI 10.1097/00005131-199704000-00001 PG 2 WC Orthopedics; Sport Sciences SC Orthopedics; Sport Sciences GA YQ616 UT WOS:000071405700001 PM 9181494 ER PT J AU Katz, JB DeWald, R Dawson, JE Camus, E Martinez, D Mondry, R AF Katz, JB DeWald, R Dawson, JE Camus, E Martinez, D Mondry, R TI Development and evaluation of a recombinant antigen, monoclonal antibody-based competitive ELISA for heartwater serodiagnosis SO JOURNAL OF VETERINARY DIAGNOSTIC INVESTIGATION LA English DT Article ID COWDRIA-RUMINANTIUM; 32-KILODALTON PROTEIN; ASSAY; EHRLICHIA AB Cowdria ruminantium is the etiologic agent of heartwater, a tick-transmitted foreign animal disease with considerable potential for entrance into the USA. A competitive enzyme-linked immunosorbent assay (cELISA) was developed to detect serologic responses to C. ruminantium infection. The cELISA utilized a recombinant form of the C. ruminantium major antigenic protein (MAP-1) as the antigen and an anti-MAP-1 monoclonal antibody as the competing indicator reagent. Experimental antisera to C. ruminantium and a wide variety of related ehrlichial organisms were used to evaluate cELISA reactivity. Only sera against C. ruminantium, Ehrlichia canis, E. chaffeensis, and a recently discovered cervine ehrlichia-like organism reacted positively in the cELISA. Specificity of the cELISA was greater than or equal to 99.5% in a survey of 1,774 southeastern US and Puerto Rican slaughter cattle sera but was only 85% in a group of 79 hunter-killed white-tailed deer (Odocoileus virginianus) from the southeastern USA. Reference true-positive and cELISA false-positive sera were further analyzed by end point titrations using the cELISA and by indirect fluorescent antibody (IFA) tests for reactivity with C. ruminantium, E. canis, and E. chaffeensis antigens. True heartwater-positive sera were significantly more reactive using the cELISA and C. ruminantium IFA procedures (P < 0.05), whereas false-positive sera were significantly more reactive with the antigens used in the E. chaffeensis IFA procedure (P < 0.05). A group of sera from 210 field-origin ruminants residing on known or potentially heartwater-endemic Caribbean islands revealed a substantial (12.4%) prevalence of cELISA-positive specimens. The cELISA is a relatively specific serodiagnostic test for heartwater in cattle and could be used to monitor for possible introduction of the disease into the USA. The cELISA may also be an excellent tool for monitoring the success of an ongoing Caribbean Amblyomma tick eradication program designed to eliminate the biological vector responsible for the perpetuation and spread of this dangerous foreign animal disease. C1 CTR DIS CONTROL & PREVENT,US DEPT HHS,ATLANTA,GA 30333. CTR COOPERAT INT RECH AGRON DEV,POINTE A PITRE 97165,GUADELOUPE. RP Katz, JB (reprint author), ANIM & PLANT HLTH INSPECT SERV,NATL VET SERV LABS,VET SERV,USDA,AMES,IA 50010, USA. NR 20 TC 14 Z9 14 U1 0 U2 0 PU AMER ASSOC VETERINARY LABORATORY DIAGNOSTICIANS INC PI COLUMBIA PA 1600 E ROLLINS, COLUMBIA, MO 65211 SN 1040-6387 J9 J VET DIAGN INVEST JI J. Vet. Diagn. Invest. PD APR PY 1997 VL 9 IS 2 BP 130 EP 135 PG 6 WC Veterinary Sciences SC Veterinary Sciences GA XM722 UT WOS:A1997XM72200004 PM 9211230 ER PT J AU vanLoon, N Dykes, C Deng, HY Dominguez, G Nicholas, J Dewhurst, S AF vanLoon, N Dykes, C Deng, HY Dominguez, G Nicholas, J Dewhurst, S TI Identification and analysis of a lytic-phase origin of DNA replication in human herpesvirus 7 SO JOURNAL OF VIROLOGY LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; BINDING PROTEIN; EXANTHEM-SUBITUM; 6B ORIGIN; INFECTION; CD4; ENCEPHALITIS; INFANT; CYTOMEGALOVIRUS; SUSCEPTIBILITY AB Human herpesvirus 7 (HHV-7) DNA sequences colinear with the HHV-6 lytic-phase origin of DNA replication (oriLyt) were amplified by PCR. Plasmid constructs containing these sequences were replicated in HHV-7-infected cord blood mononuclear cells but not in HHV-6-infected cells. In contrast, plasmids bearing HHV-6 oriLyt were replicated in both HHV-6- and HHV-7-infected cells. Finally, the minimal HHV-7 DNA element necessary for replicator activity was mapped to a 600-bp region which contains two sites with high homolog to the consensus binding site for the HHV-6 origin binding protein. At least one of these binding sites was shown to be essential for replicator function of HHV-7 oriLyt. C1 UNIV ROCHESTER,MED CTR,DEPT MICROBIOL & IMMUNOL,ROCHESTER,NY 14642. UNIV ROCHESTER,CTR CANC,ROCHESTER,NY 14642. JOHNS HOPKINS ONCOL CTR,BALTIMORE,MD 21231. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA 30333. OI Dewhurst, Stephen/0000-0001-7729-7920 FU NIAID NIH HHS [KO4 AI01240, R01 AI34231] NR 39 TC 14 Z9 14 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0022-538X J9 J VIROL JI J. Virol. PD APR PY 1997 VL 71 IS 4 BP 3279 EP 3284 PG 6 WC Virology SC Virology GA WM911 UT WOS:A1997WM91100087 PM 9060695 ER PT J AU Little, SE Dawson, JE Lockhart, JM Stallknecht, DE Warner, CK Davidson, WR AF Little, SE Dawson, JE Lockhart, JM Stallknecht, DE Warner, CK Davidson, WR TI Development and use of specific polymerase reaction for the detection of an organism resembling Ehrlichia sp. in white-tailed deer SO JOURNAL OF WILDLIFE DISEASES LA English DT Article DE Ehrlichia sp.; Ehrlichia chaffeensis; white-tailed deer; Odocoileus virginianus; ehrlichiosis; serology; epizootiology ID HUMAN GRANULOCYTIC EHRLICHIOSIS; AMBLYOMMA-AMERICANUM; ETIOLOGIC AGENT; POTENTIAL VECTOR; UNITED-STATES; CHAFFEENSIS; TRANSMISSION; CANIS AB The role of white-tailed deer (Odocoileus virginianus) in the epidemiology of Ehrlichia chaffeensis and the agent of human granulocytic ehrlichiosis (HGE) is not. fully understood, and diagnostic procedures may be complicated by the recent detection of 16S rDNA sequence from an Ehrlichia sp.-like organism in wild deer. A specific forward primer (DGA) and an Ehrlichia spp, reverse primer (GAIUR) were constructed to amplify this new, distinct Ehrlichia sp.-like 16S rDNA. The DGA primer, a forward primer specific for E. chaffeensis (DCH), forward primer specific for the E. phagocytophila genogroup (GE9f) were each used with GA1UR in nested polymerase chain reactions to amplify 16S rDNA sequences from control samples containing the deer Ehrlichia sp.-like organism, E. chaffeensis, or the HGE agent. Primer pairs DGA/GA1UR and DCH/GA1UR specifically amplified 16S rDNA sequences from the corresponding target organism, whereas GE9f/GA1UR amplified 16S rDNA sequence from both the HGE agent and the deer Ehrlichia sp.-like organism. With a nested PCR using DGA/GA1UR and DCH/GA1UR on DNA extracted from white blood cells from 62 deer from 10 populations in four U.S. states, we observed a high prevalence (65%) of 16S rDNA sequences of the deer Ehrlichia sp.-like organism, and a low prevalence (5%) of the E. chaffeensis sequence. In this field survey, E. chaffeensis-reactive antibodies detected by indirect fluorescence assays were associated (P < 0.001) with PCR evidence of the deer Ehrlichia sp.-like organism, but not E. chaffeensis. Infestations of Amblyomma americanum also were associated (P < 0.001) with PCR evidence of the deer Ehrlichia sp.-like organism. The potential for serologic cross-reactions and non-specific PCR products arising from the deer Ehrlichia sp.-like organism should be considered when evaluating the role of deer and their ticks in the epidemiology of ehrlichial pathogens of humans. C1 US DEPT HHS, VIRAL & RICKETTSIAL ZOONOSES BRANCH, DIV VIRAL & RICKETTSIAL DIS, ATLANTA, GA 30333 USA. UNIV GEORGIA, DB WARNELL SCH FOREST RESOURCES, ATHENS, GA 30602 USA. RP Little, SE (reprint author), UNIV GEORGIA, COLL VET MED, SE COOPERAT WILDLIFE DIS STUDY, ATHENS, GA 30602 USA. FU NIAID NIH HHS [1R15AI 37911-01] NR 23 TC 36 Z9 36 U1 0 U2 1 PU WILDLIFE DISEASE ASSN, INC PI LAWRENCE PA 810 EAST 10TH ST, LAWRENCE, KS 66044-8897 SN 0090-3558 J9 J WILDLIFE DIS JI J. Wildl. Dis. PD APR PY 1997 VL 33 IS 2 BP 246 EP 253 PG 8 WC Veterinary Sciences SC Veterinary Sciences GA WW770 UT WOS:A1997WW77000009 PM 9131554 ER PT J AU Burg, JR Gist, GL AF Burg, JR Gist, GL TI The potential impact on women from environmental exposures SO JOURNAL OF WOMENS HEALTH LA English DT Article RP Burg, JR (reprint author), AGCY TOX SUBS & DIS REGISTRY,EXPOSURE & DIS REGISTRIES BRANCH,1600 CLIFTON RD,E-31,ATLANTA,GA 30333, USA. NR 4 TC 5 Z9 5 U1 0 U2 0 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 SN 1059-7115 J9 J WOMENS HEALTH JI J. Womens Health PD APR PY 1997 VL 6 IS 2 BP 159 EP 161 DI 10.1089/jwh.1997.6.159 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 XF114 UT WOS:A1997XF11400010 PM 9140851 ER PT J AU Richmond, JY Ruble, DL Brown, B Jaax, GP AF Richmond, JY Ruble, DL Brown, B Jaax, GP TI Working safely at animal biosafety levels 3 and 4: Facility design implications SO LAB ANIMAL LA English DT Article AB Relatively few!laboratories in the world manage viral, bacterial, and toxic diseases with exotic and unfamiliar names like Congo Crimean Hemorrhagic Fever and Ebola Fever. The authors describe these laboratories and the operating procedures that take biomedical research into fascinating and somewhat foreboding realms of high-hazard biocontainment. C1 CDC,ANIM RESOURCES BRANCH,ATLANTA,GA 30333. USA,MED RES INST INFECT DIS,FREDERICK,MD. RP Richmond, JY (reprint author), CTR DIS CONTROL & PREVENT,OFF HLTH & SAFETY,1600 CLIFTON RD,FO5,ATLANTA,GA 30333, USA. NR 5 TC 3 Z9 3 U1 0 U2 0 PU NATURE PUBLISHING CO PI NEW YORK PA 345 PARK AVE SOUTH, NEW YORK, NY 10010-1707 SN 0093-7355 J9 LAB ANIMAL JI Lab Anim. PD APR PY 1997 VL 26 IS 4 BP 28 EP & PG 9 WC Veterinary Sciences SC Veterinary Sciences GA WR957 UT WOS:A1997WR95700005 ER PT J AU Qualls, ML Ikeda, RM AF Qualls, ML Ikeda, RM TI Landmine injuries SO MILITARY MEDICINE LA English DT Letter RP Qualls, ML (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 SN 0026-4075 J9 MIL MED JI Milit. Med. PD APR PY 1997 VL 162 IS 4 BP R1 EP R1 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WU281 UT WOS:A1997WU28100001 PM 9110541 ER PT J AU Ibrahim, MS Esposito, JJ Jahrling, PB Lofts, RS AF Ibrahim, MS Esposito, JJ Jahrling, PB Lofts, RS TI The potential of 5' nuclease PCR for detecting a single-base polymorphism in Orthopoxvirus SO MOLECULAR AND CELLULAR PROBES LA English DT Article DE Orthopoxvirus; PCR primers; fluorogenic probe; 5' nuclease assay; haemagglutinin ID POLYMERASE CHAIN-REACTION; DIFFERENTIATION; SMALLPOX; GENOME AB A fluorogenic 5' nuclease PCR assay was evaluated for its abilily to specifically detect and differentiate DNA of two Orthopoxvirus species. A pair of consensus primers that target a DNA segment of the Orthopoxvirus haemagglutinin gene, and two oligonucleotide probes, each labelled with a different fluorescent reporter dye and the same quencher dye, were used in a single-tube assay. The assay is based on the 5'-->3' nuclease activity of AmpliTaq DNA polymerase that cleaves a fluorescein-labelled hybridized probe. Probe cleavage generates specific fluorescent signals whose intensity can be quantified by fluorometry. After evaluating the effects of various annealing temperatures and probe concentrations and normalizing the emission intensities of the reporter dyes, it was possible to detect and differentiate monkeypox and vaccinia virus DNAs on the basis of a single-base polymorphism. The sensitivity of the 5' nuclease PCR assay is comparable to the sensitivity of ethidium bromide-stained gels, but the assay provides higher specificity and virtually eliminates the need for laborious post-PCR processing. (C) 1997 Academic Press Limited. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. RP Ibrahim, MS (reprint author), USA,MED RES INST INFECT DIS,DIAGNOST SYST DIV,FREDERICK,MD 21702, USA. NR 9 TC 44 Z9 48 U1 1 U2 2 PU ACADEMIC PRESS LTD PI LONDON PA 24-28 OVAL RD, LONDON, ENGLAND NW1 7DX SN 0890-8508 J9 MOL CELL PROBE JI Mol. Cell. Probes PD APR PY 1997 VL 11 IS 2 BP 143 EP 147 DI 10.1006/mcpr.1996.0093 PG 5 WC Biochemical Research Methods; Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Cell Biology SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Cell Biology GA WX532 UT WOS:A1997WX53200008 PM 9160329 ER PT J AU Besansky, NJ Fahey, GT AF Besansky, NJ Fahey, GT TI Utility of the white gene in estimating phylogenetic relationships among mosquitoes (Diptera: Culicidae) SO MOLECULAR BIOLOGY AND EVOLUTION LA English DT Article DE base composition; Culicidae; introns; molecular systematics; mosquitoes; nuclear gene; phylogeny; white gene ID NUCLEAR-DNA CONTENT; DROSOPHILA-MELANOGASTER; INTERSPECIFIC VARIATION; INTRASPECIFIC VARIATION; ANOPHELES-GAMBIAE; GENOME EVOLUTION; SEQUENCE; POLYMERASE; SUBGROUP; FAMILIES AB The utility of a nuclear protein-coding gene for reconstructing phylogenetic relationships within the family Culicidae was explored. Relationships among 13 species representing three subfamilies and nine genera of Culicidae were analyzed using a 762-bp fragment of coding sequence from the eye color gene, white. Outgroups for the study were two species from the sister group Chaoboridae. Sequences were determined from cloned PCR products amplified from genomic DNA, and aligned following conceptual intron splicing and amino acid translation. Third codon positions were characterized by high levels of divergence and biased nucleotide composition, the intensity and direction of which varied among taxa. Equal weighting of all characters resulted in parsimony and neighbor-joining trees at odds with the generally accepted phylogenetic hypothesis based on morphology and rDNA sequences. The application of differential weighting schemes recovered the traditional hypothesis, in which the subfamily Anophelinae formed the basal clade. The subfamily Toxorhynchitinae occupied an intermediate position, and was a sister group to the subfamily Culicinae. Within Culicinae, the genera Sabethes and Tripteroides formed an ancestral clade, while the Culex-Deinocerites and Aedes-Haemagogus clades occupied increasingly derived positions in the molecular phylogeny. An intron present in the Culicinae-Toxorhynchitinae lineage and one outgroup taxon was absent in the basal Anophelinae lineage and the second outgroup taxon, suggesting that intron insertions or deletions may not always be reliable systematic characters. C1 CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,ATLANTA,GA. EMORY UNIV,DEPT BIOL,ATLANTA,GA 30322. NR 62 TC 72 Z9 73 U1 1 U2 4 PU SOC MOLECULAR BIOLOGY EVOLUTION PI LAWRENCE PA PO BOX 1897, LAWRENCE, KS 66044-8897 SN 0737-4038 J9 MOL BIOL EVOL JI Mol. Biol. Evol. PD APR PY 1997 VL 14 IS 4 BP 442 EP 454 PG 13 WC Biochemistry & Molecular Biology; Evolutionary Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Evolutionary Biology; Genetics & Heredity GA WR494 UT WOS:A1997WR49400010 PM 9100374 ER PT J AU Qureshi, AI Giles, WH Croft, JB Bliwise, DL AF Qureshi, AI Giles, WH Croft, JB Bliwise, DL TI Habitual sleep patterns and risk for stroke and coronary heart disease: A 10-year follow-up from NHANES I SO NEUROLOGY LA English DT Article ID DAYTIME SLEEPINESS; APNEA SYNDROME; INTRACRANIAL HEMODYNAMICS; ALAMEDA COUNTY; POPULATION; DISORDERS; HYPERTENSION; INFARCTION; MORTALITY; DISTURBANCES AB Background: Habitual sleep patterns may independently affect morbidity and mortality. However, the effect of habitual sleep patterns on the risk for stroke and coronary heart disease is unclear. Methods: We evaluated the association between sleep duration and daytime somnolence (often or almost always taking daytime naps) with the incidence of stroke and coronary heart disease in a national cohort of 7,844 adults who participated in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study. Cox proportional hazards analyses were used to examine these relationships during the 10-year follow-up. Results: After adjusting for differences in age, race, gender, education, cigarette smoking, body mass index, serum cholesterol, systolic blood pressure, and diabetes mellitus, the risk for stroke was increased in persons who reported sleeping greater than 8 hours at night compared with persons who slept between 6 and 8 hours (relative risk [RR] = 1.5, 95% confidence interval [CI] = 1.1 to 2.0). Daytime somnolence was also associated with stroke incidence (RR = 1.4; 95% CI = 1.1 to 1.8). Persons who reported both greater than 8 hours of sleep and daytime somnolence were at the greatest risk for stroke (RR = 1.9, 95% CI = 1.2 to 3.1). Similar results were also found for coronary heart disease, although the results did not reach statistical significance in the multivariate adjusted model. Conclusions: Habitual sleep patterns have significant effects on the risk for stroke. C1 CTR DIS CONTROL & PREVENT,CARDIOVASC HLTH STUDIES BRANCH,ATLANTA,GA 30341. EMORY UNIV,SCH MED,DEPT NEUROL,SLEEP DISORDERS CTR,ATLANTA,GA 30322. NR 71 TC 180 Z9 185 U1 1 U2 8 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0028-3878 J9 NEUROLOGY JI Neurology PD APR PY 1997 VL 48 IS 4 BP 904 EP 911 PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA WU327 UT WOS:A1997WU32700020 PM 9109875 ER PT J AU Atrash, HK Strauss, LT Kendrick, JS Skjeldestad, FE Ahn, YW AF Atrash, HK Strauss, LT Kendrick, JS Skjeldestad, FE Ahn, YW TI The relation between induced abortion and ectopic pregnancy SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID RISK-FACTORS; REPRODUCTION AB Objective: To determine whether having had one or more induced abortions increases a woman's risk of having an ectopic pregnancy. Methods: We conducted a case-control study of all women admitted to a major metropolitan hospital in Georgia with a surgical diagnosis of ectopic pregnancy during the period of October 1988 to August 1990. Controls were randomly selected from women seeking an induced abortion or delivering an infant at the same hospital. After exclusions, this analysis included 182 cases and 1056 controls. Stratified analysis and unconditional logistic regression were used to control for confounding and to estimate the relative risks. Results: Approximately 90% of eases and controls were non-Hispanic, black women; 34% of the cases and 36% of the controls reported a history of induced abortion. The crude odds ratio for having an ectopic pregnancy associated with a history of induced abortion was 0.9 (95% confidence interval 0.6, 1.3). The odds ratio remained the same after adjusting for selected confounding variables and stratifying by the number of induced abortions, gestational age at the time of abortion, place where the abortion was performed, and the woman's report of medical complications of the abortion. Conclusion: We found no evidence that having one or more induced abortions increases a woman's risk of having an ectopic pregnancy. (C) 1997 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. UNIV TRONDHEIM HOSP,DEPT GYNECOL & OBSTET,TRONDHEIM,NORWAY. EMORY UNIV,SCH MED,DEPT GYNECOL & OBSTET,ATLANTA,GA. NR 24 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 SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD APR PY 1997 VL 89 IS 4 BP 512 EP 518 DI 10.1016/S0029-7844(97)00050-1 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WP923 UT WOS:A1997WP92300005 PM 9083304 ER PT J AU Hillis, SD Marchbanks, PA Tylor, LR Peterson, HB AF Hillis, SD Marchbanks, PA Tylor, LR Peterson, HB TI Tubal sterilization and long-term risk of hysterectomy: Findings from the United States Collaborative Review of Sterilization SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID WOMEN AB Objective: To estimate the long-term probability of hysterectomy after sterilization according to demographic and clinical characteristics before the procedure. Methods: We used a prospective, multi-center cohort study of 10,698 women undergoing tubal sterilization to examine the cumulative probability of hysterectomy up to 14 years after sterilization. Independent risk factors for subsequent hysterectomy were examined using the life-table approach and the Cox proportional hazards model. Results: The cumulative probability of undergoing hysterectomy 14 years after sterilization was 17%. The highest long-term cumulative probabilities of hysterectomy occurred among women who, at the time of sterilization, reported a history of endometriosis (35%) or were older than 30 years and reported prolonged bleeding during menses (46%). Multivariate modeling demonstrated an independently increased risk of hysterectomy among women who, at the time of tubal sterilization, reported a history of heavy menstrual flow (relative risk [RR] 1.4; 95% confidence interval [CI] 1.1, 1.7), severe menstrual pain (RR 1.3; 95% CI 1.1, 1.6), bleeding of more than 7 days during menstrual cycles (RR 1.8; 95% CI 1.1, 2.8), pelvic inflammatory disease (RR 1.3; 95% CI 1.04, 1.7), ovarian cysts (RR 1.6; 95% CI 1.2, 2.0), endometriosis (RR 2.5; 95% CI 1.7, 3.9), or uterine leiomyomata (RR 2.7; 95% CI 2.0, 3.7). Conclusions: Although women with gynecologic disorders before tubal sterilization were at greater risk of hysterectomy during the 14 years after sterilization than were women without these disorders, the majority of sterilized women in both categories did not undergo subsequent hysterectomy. (C) 1997 by The American College of Obstetricians and Gynecologists. RP Hillis, SD (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV REPROD HLTH,MS K34,ATLANTA,GA 30341, USA. NR 24 TC 15 Z9 15 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD APR PY 1997 VL 89 IS 4 BP 609 EP 614 DI 10.1016/S0029-7844(97)00053-7 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WP923 UT WOS:A1997WP92300023 PM 9083322 ER PT J AU Sim, M Dick, R Russo, J Bernard, B Grubb, P Krieg, E Mueller, C McCammon, C AF Sim, M Dick, R Russo, J Bernard, B Grubb, P Krieg, E Mueller, C McCammon, C TI Are aluminium potroom workers at increased risk of neurological disorders? SO OCCUPATIONAL AND ENVIRONMENTAL MEDICINE LA English DT Article DE aluminium smelting; neurological function; tremor; incoordination ID MEASUREMENT SYSTEM; URINARY-EXCRETION; EXPOSURE; WELDERS; SMELTER AB Objective-To determine whether long term potroom workers in an aluminium smelter are at increased risk of neurological disorders. Methods-Cross sectional study of 63 current and former aluminium potroom workers first employed before 1970 and with at least 10 years of service. A group of 37 cast house and carbon plant workers with similar durations of employment and starting dates in the same smelter were used as controls. The prevalence of neurological symptoms was ascertained by questionnaire. Objective tests of tremor in both upper and lower limbs, postural stability, reaction time, and vocabulary were conducted. All subjects were examined by a neurologist. Results-No significant differences in age, race, or education were found between the two groups. Although the potroom group had higher prevalences for all but one of the neurological symptoms, only three odds ratios (ORs) were significantly increased; for incoordination (OR 10.6), difficulty buttoning (OR 6.2), and depression (OR 6.2). Tests of arm or hand and leg tremor in both the visible and non-visible frequencies did not show any significant differences between the two groups. Testing of postural stability showed no definitive pattern of neurologically meaningful differences between the groups. There were no significant differences between the two groups in reaction time, vocabulary score, or clinical neurological assessment. Conclusions-The objective measures of neurological function provided little support for the finding of increased neurological symptom prevalences in the potroom workers, although increased symptoms may be an indicator of early, subtle neurological changes. The results provide no firm basis for concluding that neurological effects among long term potroom workers are related to the working environment, in particular aluminium exposure, in potrooms. These findings should be treated with caution due to the low participation of former workers and the possibility of information bias in the potroom group. C1 NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDI,CINCINNATI,OH 45226. NIOSH,DIV BIOMED & BEHAV SCI,CINCINNATI,OH 45226. UNIV MELBOURNE,DEPT EPIDEMIOL & PREVENT MED,MELBOURNE,VIC,AUSTRALIA. NR 21 TC 17 Z9 17 U1 0 U2 1 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON, ENGLAND WC1H 9JR SN 1351-0711 J9 OCCUP ENVIRON MED JI Occup. Environ. Med. PD APR PY 1997 VL 54 IS 4 BP 229 EP 235 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WR293 UT WOS:A1997WR29300003 PM 9166127 ER PT J AU Howe, DK Vodkin, MH Novak, RJ Visvesvara, G McLaughlin, GL AF Howe, DK Vodkin, MH Novak, RJ Visvesvara, G McLaughlin, GL TI Identification of two genetic markers that distinguish pathogenic and nonpathogenic strains of Acanthamoeba spp SO PARASITOLOGY RESEARCH LA English DT Article ID RESTRICTION ENZYME ANALYSIS; POLYMERASE CHAIN-REACTION; MITOCHONDRIAL-DNA; GENUS ACANTHAMOEBA; ARBITRARY PRIMERS; ISOENZYME; POLYMORPHISMS; CASTELLANII; TAXONOMY; PROFILES AB Species-level identification of Acanthamoeba isolates is difficult and gives little or no indication of the isolate's pathogenicity. We identified two amplification-based genetic markers that were highly correlated with pathogenicity in Acanthamoeba spp. One marker, designed to amplify a 485-bp fragment of the small-subunit ribosomal RNA gene (ssrDNA), was preferentially amplified from the nonpathogenic strains; amplifications from the pathogenic strains yielded anomalous fragments of 650 and 900 bp. A second marker was developed on the basis of the anomalous 650-bp fragment. Primers to this sequence preferentially amplified a noncoding locus (called Ac6) only from the pathogenic strains. These two genetic markers may be useful for identification of pathogenic Acanthamoeba spp. strains. C1 INDIANA UNIV,SCH MED,DEPT PATHOL,INDIANAPOLIS,IN 46202. INDIANA UNIV,SCH MED,LAB MED,INDIANAPOLIS,IN 46202. WASHINGTON UNIV,SCH MED,DEPT MOL MICROBIOL,ST LOUIS,MO 63110. ILLINOIS NAT HIST SURVEY,CTR ECON ENTOMOL,CHAMPAIGN,IL 61820. CTR DIS CONTROL,CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30333. FU NEI NIH HHS [R01 EYO8205] NR 24 TC 23 Z9 25 U1 0 U2 2 PU SPRINGER VERLAG PI NEW YORK PA 175 FIFTH AVE, NEW YORK, NY 10010 SN 0044-3255 J9 PARASITOL RES JI Parasitol. Res. PD APR PY 1997 VL 83 IS 4 BP 345 EP 348 DI 10.1007/s004360050259 PG 4 WC Parasitology SC Parasitology GA WW194 UT WOS:A1997WW19400005 PM 9134555 ER PT J AU Pool, V Chen, R Rhodes, P AF Pool, V Chen, R Rhodes, P TI Indications for measles-mumps-rubella vaccination in a child with prior thrombocytopenia purpura SO PEDIATRIC INFECTIOUS DISEASE JOURNAL LA English DT Letter DE congenital rubella syndrome; measles-mumps-rubella vaccine; rubella; thrombocytopenia; vaccine adverse events RP Pool, V (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 9 TC 4 Z9 4 U1 0 U2 0 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 0891-3668 J9 PEDIATR INFECT DIS J JI Pediatr. Infect. Dis. J. PD APR PY 1997 VL 16 IS 4 BP 423 EP 424 PG 2 WC Immunology; Infectious Diseases; Pediatrics SC Immunology; Infectious Diseases; Pediatrics GA WU185 UT WOS:A1997WU18500021 PM 9109153 ER PT J AU Lobato, MN Vugia, DJ Frieden, IJ AF Lobato, MN Vugia, DJ Frieden, IJ TI Tinea capitis in California children: A population-based study of a growing epidemic SO PEDIATRICS LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) CY SEP 17-22, 1995 CL SAN FRANCISCO, CA SP Amer Soc Microbiol DE tinea capitis; griseofulvin; Trichophyton tonsurans; children ID TRICHOPHYTON-TONSURANS AB Objectives. To describe trends in tinea capitis incidence among California children and to determine subpopulations at increased risk. Design. Retrospective population-based study. Setting. California, 1984 through 1993. Population. Children <10 years of age enrolled in Medi-Cal. Outcome Measures. California Medi-Cal provider data for first-time prescriptions of oral griseofulvin suspension were used to estimate annual incidence of tinea capitis and calculate risk ratios. Results. From 1984 through 1993, the incident rate for prescriptions of oral griseofulvin suspension increased by 84.2% for all children, 140.4% for white children, and 209.7% for African-American children. In 1993, incidence rates (per 10 000 enrolled) were 252.1 claimants for African-American children, 23.1 for white, 17.5 for Hispanic, and 14.3 for Asian/Pacific Islander. The highest rate by location was San Francisco County (172.2). In age groups <5 years and 5 to 9 years, African-American children were 13.1 and 17.6 times more likely to be prescribed griseofulvin than Hispanic children. Since 1987, incidence rates for children 5 to 9 years of age were higher compared with children ages <5 years. Conclusions. Tinea capitis is epidemic among California children with higher rates in the northern counties studied. African-American children are the most affected by this epidemic; however, white children have also experienced increased rates. C1 CTR DIS CONTROL & PREVENT,PREVENT MED RESIDENCY,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. CALIF DEPT HLTH SERV,DIV COMMUNICABLE DIS CONTROL,BERKELEY,CA 94704. UNIV CALIF SAN FRANCISCO,DEPT DERMATOL & PEDIAT,SAN FRANCISCO,CA 94143. OI Frieden, Ilona/0000-0001-7305-5940 NR 25 TC 49 Z9 50 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD APR PY 1997 VL 99 IS 4 BP 551 EP 554 DI 10.1542/peds.99.4.551 PG 4 WC Pediatrics SC Pediatrics GA WQ802 UT WOS:A1997WQ80200009 PM 9093297 ER PT J AU Schuchat, A Halsey, NA AF Schuchat, A Halsey, NA TI Penicillin at birth can help prevent early-onset group B streptococcal disease - Reply SO PEDIATRICS LA English DT Letter ID RISK-FACTORS C1 JOHNS HOPKINS UNIV,DEPT INT HLTH,DIV DIS CONTROL,AAP COMM INFECT DIS,BALTIMORE,MD 21205. RP Schuchat, A (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,CHILDHOOD & RESP DIS BRANCH,ATLANTA,GA 30333, USA. NR 9 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD APR PY 1997 VL 99 IS 4 BP 652 EP 652 PG 1 WC Pediatrics SC Pediatrics GA WQ802 UT WOS:A1997WQ80200050 ER PT J AU Moore, CA Khoury, MJ Liu, YC AF Moore, CA Khoury, MJ Liu, YC TI Does light-to-moderate alcohol consumption during pregnancy increase the risk for renal anomalies among offspring? SO PEDIATRICS LA English DT Article DE renal anomalies; renal agenesis; prenatal ethanol exposure; multiple congenital anomalies ID ETHANOL EXPOSURE; BIRTH-DEFECTS; FETAL GROWTH; MICE; MALFORMATIONS; PATHOGENESIS; EMBRYOPATHY; CIGARETTE; SMOKING; TRACT AB Objective. To determine the association between light-to-moderate prenatal alc Methods. Data from the population-based Atlanta Birth Defects Case-Control Study were used to examine the association between selected renal anomalies and self-reported maternal alcohol consumption during the period from 1 month before through 3 months after conception. Case infants were ascertained by a population-based birth defects registry with active case ascertainment; the case group consisted of 158 infants, born during 1968 through 1980 to metropolitan Atlanta residents, in whom these renal anomalies had been diagnosed. Two control groups were used. One had 3029 infants without birth defects, and the other had 4633 infants with birth defects exclusive of the urinary tract who were born during the same period. Results. Overall, there was a moderate association between renal anomalies and moderate prenatal alcohol exposure (odds ratio, 1.5; 95% confidence interval, 1.0 to 2.3). When the renal anomalies were subclassified, moderate prenatal alcohol exposure was significantly associated only with renal agenesis or hypoplasia (odds ratio, 2.5; 95% confidence interval, 1.2 to 5.1), and within this group only infants with bilateral defects and other major anomalies in addition to renal agenesis or hypoplasia had significantly elevated risks. There were no significant associations between reported light consumption and any category of the selected renal anomalies. No conclusions could be reached for reported heavy consumption because of sparse data. Adjustments for potential confounding factors did not alter these results. Conclusion. This study suggests that moderate alcohol consumption during pregnancy may increase a woman's risk of giving birth to a child with renal agenesis or hypoplasia. RP Moore, CA (reprint author), CTR DIS CONTROL & PREVENT, NATL CTR ENVIRONM HLTH, DIV BIRTH DEFECTS & DEV DISABILITIES, ATLANTA, GA 30341 USA. NR 37 TC 16 Z9 18 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD APR PY 1997 VL 99 IS 4 BP art. no. EP e11 DI 10.1542/peds.99.4.e11 PG 5 WC Pediatrics SC Pediatrics GA WQ802 UT WOS:A1997WQ80200026 PM 9099786 ER PT J AU Ogden, CL Troiano, RP Briefel, RR Kuczmarski, RJ Flegal, M Johnson, CL AF Ogden, CL Troiano, RP Briefel, RR Kuczmarski, RJ Flegal, M Johnson, CL TI Prevalence of overweight among preschool children in the United States, 1971 through 1994 SO PEDIATRICS LA English DT Article DE overweight; anthropometry; preschool children ID INTERNATIONAL GROWTH REFERENCE; NUTRITION EXAMINATION SURVEYS; PHYSICAL-ACTIVITY; NATIONAL-HEALTH; ANTHROPOMETRIC MEASUREMENTS; BODY-COMPOSITION; YOUNG-CHILDREN; SHORT STATURE; WEIGHT; OBESITY AB Objective. To examine the prevalence of overweight among US preschool children 2 months through 5 years of age between the years 1971 through 1974 and 1988 through 1994. Design. Nationally representative cross-sectional surveys with a physical examination, including measurement of stature, length, and weight. Between 1200 and 7500 children younger than 6 years were examined in each of four different surveys during 1971 through 1974 (first National Health and Nutrition Examination Survey [NHANES I]), 1976 through 1980 (NHANES II), 1982 through 1984 (Hispanic Health and Nutrition Examination Survey), and 1988 through 1994 (NHANES III). Results. The prevalence of overweight increased among some sex and age groups of preschool children between 1971 through 1974 and 1988 through 1994. More than 10% of 4- and 5-year-old girls were overweight in 1988 through 1994 compared with 5.8% in 1971 through 1974. However, there was no change during this period in the prevalence of overweight among 1- and 2- to 3-year-old children. During 1988 through 1994, the prevalence of overweight among children 2 months through 5 years of age was consistently higher in girls than boys. Mexican-American children had a higher prevalence of overweight than non-Hispanic black and non-Hispanic white children. These results parallel what has been reported for older children and adults in the United States. Conclusion. These results show that in the last 20 years the prevalence of overweight has increased among 4- and 5-year-old children but not among younger children. These findings suggest that efforts to prevent overweight, including encouragement of physical activity and improved diets, should begin in early childhood. RP Ogden, CL (reprint author), CTR DIS CONTROL & PREVENT, DIV HLTH EXAMINAT STAT, NATL CTR HLTH STAT, EPIDEM INTELLIGENCE SERV, HYATTSVILLE, MD 20782 USA. NR 59 TC 181 Z9 183 U1 0 U2 6 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD APR PY 1997 VL 99 IS 4 BP art. no. EP e1 DI 10.1542/peds.99.4.e1 PG 7 WC Pediatrics SC Pediatrics GA WQ802 UT WOS:A1997WQ80200016 PM 9099776 ER PT J AU Robin, LF Beller, M Middaugh, JP AF Robin, LF Beller, M Middaugh, JP TI Statewide assessment of lead poisoning and exposure risk among children receiving Medicaid Services in Alaska SO PEDIATRICS LA English DT Article DE lead poisoning; child health services; mass screening; government regulations; Medicaid ID QUESTIONNAIRE; POPULATION; HEALTH AB Objective. Lead poisoning is a well-recognized public health concern for children living in the United States. In 1992, Health Care Financing Administration (HCFA) regulations required lead poisoning risk assessment and blood lead testing for all Medicaid-enrolled children ages 6 months to 6 years. This study estimated the prevalence of blood lead levels (BLLs) 10 mu g/dL (0.48 mu mol/L) and the performance of risk assessment questions among children receiving Medicaid services in Alaska. Design. Measurement of venous BLLs in a statewide sample of children and risk assessment using a questionnaire modified from HCFA sample questions. Setting. Eight urban areas and 25 rural villages throughout Alaska. Patients. Nine hundred sixty-seven children enrolled in Medicaid, representing a 6% sample of 6-month- to 6-year-old Alaska children enrolled in Medicaid. Outcome Measure(s). Determination of BLL and responses to verbal-risk assessment questions. Results. BLLs ranged from <1 mu g/dL (<0.048 mu mol/L) to 21 mu g/dL (1.01 mu mol/L) (median, 2.0 mu g/dL or 0.096 mu mol/L). The geometric mean BLLs for rural and urban children were 2.2 mu g/dL (0.106 mu mol/L) and 1.5 mu g/dL (0.072 mu mol/L), respectively. Six (0.6%) children had a BLL 10 mu g/dL; only one child had a BLL 10 mu g/dL (11 mu g/dL or 0.53 mu mol/L) on retesting. Children whose parents responded positively to at least one risk factor question were more likely to have a BLL 10 mu g/dL (prevalence ratio = 3.1; 95% confidence interval = 0.4 to 26.6); the predictive value of a positive response was <1%. Conclusions. In this population, the prevalence of lead exposure was very low (0.6%); only one child tested (0.1%) maintained a BLL 10 mu g/dL on confirmatory testing; no children were identified who needed individual medical or environmental management for lead exposure. Universal lead screening for Medicaid-enrolled children is not an effective use of public health resources in Alaska. Our findings identify an example of the importance in considering local and regional differences when formulating screening recommendations and regulations, and continually reevaluating the usefulness of federal regulations. C1 ALASKA DEPT HLTH & SOCIAL SERV, EPIDEMIOL SECT, ANCHORAGE, AK 99524 USA. CTR DIS CONTROL & PREVENT, EPIDEM INTELLIGENCE SERV, ATLANTA, GA USA. NR 32 TC 7 Z9 8 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD APR PY 1997 VL 99 IS 4 BP art. no. EP e9 DI 10.1542/peds.99.4.e9 PG 6 WC Pediatrics SC Pediatrics GA WQ802 UT WOS:A1997WQ80200024 PM 9099784 ER PT J AU Durvasula, RV Gumbs, A Panackal, A Kruglov, O Aksoy, S Merrifield, RB Richards, FF Beard, CB AF Durvasula, RV Gumbs, A Panackal, A Kruglov, O Aksoy, S Merrifield, RB Richards, FF Beard, CB TI Prevention of insect-borne disease: An approach using transgenic symbiotic bacteria SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID TRYPANOSOMA-CRUZI; ESCHERICHIA-COLI; CHAGAS-DISEASE; VECTOR; TRANSFORMATION; IMMUNITY; PROTEINS AB Expression of molecules with antiparasitic activity by genetically transformed symbiotic bacteria of disease-transmitting insects may serve as a powerful approach to control cer tain arthropod-borne diseases. The endosymbiont of the Chagas disease vector, Rhodnius prolixus, has been transformed to express cecropin A, a peptide lethal to the parasite, Trypanosoma cruzi. In insects carrying the transformed bacteria, cecropin A expression results in elimination or reduction in number of T. cruzi. A method has been devised to spread the transgenic bacteria to populations of R. prolixus. in a manner that mimics their natural coprophagous route of symbiont acquisition. C1 ROCKEFELLER UNIV,NEW YORK,NY 10021. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30341. RP Durvasula, RV (reprint author), YALE UNIV,SCH MED,333 CEDAR ST,NEW HAVEN,CT 06520, USA. OI Panackal, Anil/0000-0001-5524-668X; Aksoy, Serap/0000-0001-9941-143X FU NIAID NIH HHS [AI-08614] NR 21 TC 166 Z9 181 U1 1 U2 26 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD APR 1 PY 1997 VL 94 IS 7 BP 3274 EP 3278 DI 10.1073/pnas.94.7.3274 PG 5 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA WR930 UT WOS:A1997WR93000095 PM 9096383 ER PT J AU Garnett, GP Aral, SO Hoyle, DV Cates, W Anderson, RM AF Garnett, GP Aral, SO Hoyle, DV Cates, W Anderson, RM TI The natural history of syphilis - Implications for the transmission dynamics and control of infection SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID EPIDEMIOLOGY; HIV; PATTERNS; SPREAD AB Background: Syphilis remains a significant cause of morbidity in many developing countries and in some areas within North America and Europe. Mathematical models of the transmission dynamics of sexually transmitted infections have provided insights of relevance both to the interpretation of observed epidemiological patterns and to the design of control programs. Their use for the study of syphilis has been limited to date. Goals and Study Design: The authors investigated the transmission dynamics of syphilis against a template based on the natural history of infection in individual patients with the aim of (1) identifying gaps in our understanding of the biology of infection, and (2) providing insights of relevance to the design of control policies. Results: Analyses reveal that Treponema pallidum has a moderate to high probability of transmission during contact between susceptible and infectious sexual partners. This, combined with questions over the existence of any immunity to reinfection, helps to ensure the long-term persistence of syphilis within ''core'' activity groups, Patterns of treatment in North America are shown to have significantly altered the relative frequency of individuals in the different stages of disease. Conclusions: The analyses emphasize the benefits to be gained from treating infected people early in the primary stage of infection to reduce the effective period during which infected people can transmit to others, This form of treatment is beneficial for both the individual and the community, Treatment has greatly altered the incidence of different disease stages, but the full implications of treatment depend on whether immunity is present. C1 CTR DIS CONTROL & PREVENT,DIV STD & HIV PREVENT,ATLANTA,GA. FAMILY HLTH INT,RES TRIANGLE PK,NC 27709. RP Garnett, GP (reprint author), UNIV OXFORD,DEPT ZOOL,CTR EPIDEMIOL INFECT DIS,WELLCOME TRUST,S PARKS RD,OXFORD OX1 3PS,ENGLAND. RI Garnett, Geoffrey/A-9312-2008 FU Wellcome Trust NR 39 TC 97 Z9 104 U1 2 U2 15 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD APR PY 1997 VL 24 IS 4 BP 185 EP 200 DI 10.1097/00007435-199704000-00002 PG 16 WC Infectious Diseases SC Infectious Diseases GA WR390 UT WOS:A1997WR39000002 PM 9101629 ER PT J AU Blank, S McDonnell, DD Rubin, SR Neal, JJ Brome, MW Masterson, MB Greenspan, JR AF Blank, S McDonnell, DD Rubin, SR Neal, JJ Brome, MW Masterson, MB Greenspan, JR TI New approaches to syphilis control - Finding opportunities for syphilis treatment and congenital syphilis prevention in a women's correctional setting SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID NEW-YORK-CITY; COCAINE USE; PROSTITUTION; ASSOCIATION; EPIDEMIC AB Background: With prostitution and drugs the most common reasons for arrest among New York City (NYC) women, female arrestees are at high risk for acquiring syphilis and delivering congenitally infected babies, Despite routine syphilis screening of all NYC;inmates, many are released before the need for treatment is recognized, and once released, few could be found for treatment. Goals: To improve syphilis treatment rates among female correctional inmates in NYC. Study Design: At a women's correctional health clinic, on-site, rapid, qualitative nontreponemal syphilis testing (STAT rapid plasma reagin [RPR]) and on-line access to the local syphilis case registry were introduced to supplement the usual admission medical evaluation, Treatment decisions made using the authors' jail protocol were compared with treatment criteria used in NYC's sexually transmitted disease (STD) clinics, Patients consisted of a consecutive sample of 685 remandees admitted one or more times during the day shift, March 24, 1993, to July 31, 1993, who had a full complement of mandatory admission medical tests, Using the study protocol, syphilis treatment decisions were made and needed treatment was furnished at the end of the admission medical evaluation, The main outcome measures were correct identification and treatment of syphilis in this population, compared with standard NYC Department of Health (DOH) STD clinic practice, as well. as the effect of the jail protocol on pregnancy outcomes and need to treat offspring for congenital syphilis. Results: Compared with NYC DOH STD clinic practice, the study protocol was 95% sensitive and 88% specific in arriving at appropriate treatment for syphilis, Treatment at the end of the admission medical evaluation increased syphilis treatment rates from 7% to 84% of women with indications for treatment and to 88% of pregnant women with indications for treatment, Prospective follow-up for birth outcomes revealed no spontaneous abortions and eight live births, Seven of the eight did not need congenital syphilis treatment because their mothers were adequately treated while incarcerated. Conclusions: Qualitative (or STAT) RPR testing and access to DOH syphilis case registry data provide prompt and accurate diagnostic information that can lead to an overall increase in the number of inmates appropriately treated (with a minimum amount of overtreatment) in a women's correctional facility, This protocol may be applicable in other high-risk, transient populations. C1 NEW YORK CITY DEPT HLTH,DIV CORRECT HLTH,NEW YORK,NY 10013. CTR DIS CONTROL & PREVENT,DIV STD PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA. RP Blank, S (reprint author), NEW YORK CITY DEPT HLTH,BUR STD CONTROL,125 WORTH ST,BOX 73,ROOM 207,NEW YORK,NY 10013, USA. NR 22 TC 48 Z9 48 U1 0 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD APR PY 1997 VL 24 IS 4 BP 218 EP 226 DI 10.1097/00007435-199704000-00006 PG 9 WC Infectious Diseases SC Infectious Diseases GA WR390 UT WOS:A1997WR39000006 PM 9101633 ER PT J AU Gillum, RF Sempos, CT AF Gillum, RF Sempos, CT TI Erythrocyte sedimentation rate and stroke incidence in the NHANES I epidemiologic follow-up study SO STROKE LA English DT Letter C1 NHLBI,BETHESDA,MD 20892. RP Gillum, RF (reprint author), CTR DIS CONTROL & PREVENT,HYATTSVILLE,MD, USA. NR 6 TC 3 Z9 3 U1 0 U2 0 PU AMER HEART ASSOC PI DALLAS PA 7272 GREENVILLE AVENUE, DALLAS, TX 75231-4596 SN 0039-2499 J9 STROKE JI Stroke PD APR PY 1997 VL 28 IS 4 BP 873 EP 874 PG 2 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA WR454 UT WOS:A1997WR45400039 PM 9099211 ER PT J AU Reed, RC LouisWileman, V Cosmai, EV Fang, S Jue, DL Wohlhueter, RM Hunter, RL Lal, AA AF Reed, RC LouisWileman, V Cosmai, EV Fang, S Jue, DL Wohlhueter, RM Hunter, RL Lal, AA TI Multiple antigen constructs (MACs): Induction of sterile immunity against sporozoite stage of rodent malaria parasites, Plasmodium berghei and Plasmodium yoelii SO VACCINE LA English DT Article DE malaria; Plasmodium berghei; Plasmodium yoelii; sporozoite-stage vaccine; circumsporozoite ID CIRCUMSPOROZOITE PROTEIN; COPOLYMER ADJUVANTS; PEPTIDE VACCINE; ANTIBODIES AB We prepared multiple antigen constructs (MACs) using circumsporozoite (CS) protein-based B-epitopes from Plasmodium berghei, (PPPPNPND)(2) and Plasmodium yoelii, (QGPGAP)(3)QG, along with a P. berghei T-helper epitope KQIRDSITEEWS. Mice were immunized with individual MACs in oil-in-water or water-in-oil vehicles containing block copolymer (P1005) and detoxified RaLPS (RaLPS) as well as other adjuvants. Sporozoite challenge results demonstrated that MACs in adjuvant could induce antibodies capable of active and passive protection. Water-in-oil vaccines induced the highest level of protection in mice immunized with either P. berghei and P. yoelii MACs. In a study aimed at co-eliciting immunity against P. berghei and P. yoelii, three immunizations with MACs induced protective antibodies against P. berghei but not P. yoelii parasite challenge. Therefore, it can be concluded that individually MACs are capable of inducing strong and protective immune responses to either species of rodent malaria, and that protection can be passively transferred. When MAC formulations were used together as a combined vaccine, P. berghei MACs induced a strong protective antibody response while P. yoelii MACs induced a weaker nonprotective response. (C) 1997 Elsevier Science Ltd. C1 CTR DIS CONTROL & PREVENT,BIOTECHNOL CORE FACIL BRANCH,DIV PARASIT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,IMMUNOL BRANCH,DIV PARASIT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30341. RP Reed, RC (reprint author), EMORY UNIV,DEPT PATHOL & LAB MED,ATLANTA,GA 30322, USA. FU NIAID NIH HHS [AI31064] NR 13 TC 17 Z9 18 U1 0 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, OXON, ENGLAND OX5 1GB SN 0264-410X J9 VACCINE JI Vaccine PD APR PY 1997 VL 15 IS 5 BP 482 EP 488 DI 10.1016/S0264-410X(96)00301-5 PG 7 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA WW956 UT WOS:A1997WW95600006 PM 9160515 ER PT J AU Grosse, G Staib, F Rapp, J Rang, H Heise, W Kaufman, L AF Grosse, G Staib, F Rapp, J Rang, H Heise, W Kaufman, L TI Pathological and epidemiological aspects of skin lesions in histoplasmosis - Observations in an AIDS patient and badgers outside endemic areas of histoplasmosis SO ZENTRALBLATT FUR BAKTERIOLOGIE-INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY VIROLOGY PARASITOLOGY AND INFECTIOUS DISEASES LA English DT Article ID FOX VULPES-VULPES; CAPSULATUM; INFECTION AB As a consequence of HIV infection, histoplasmosis is increasingly occurring as an opportunistic infection with a systemic course outside histoplasmosis-endemic areas, e. g. in Europe. Accordingly, questions concerning the epidemiology of this mycosis arise. Two incidents involving histoplasmosis in man and badgers with prevailing involvement of the skin encouraged us to review the pathogenesis and epidemiology of this mycosis in Germany, where so far Histoplasma capsulatum has not been endemic. With a view to prevention, attention is drawn to the avoidance of microfoci of H. capsulatum in the newly introduced concept of biowaste and its composting plants in countries with modern waste management. C1 STAATLICHES TIERARZTLICHES UNTERSUCHUNGSAMT,AULENDORF,GERMANY. TIERHYGIEN INST,FREIBURG,GERMANY. AUGUSTE VIKTORIA KRANKENHAUS,INNERE KLIN 2,BERLIN,GERMANY. CTR DIS CONTROL & PREVENT,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA. RP Grosse, G (reprint author), AUGUSTE VIKTORIA KRANKENHAUS,INST PATHOL,RUBENSSTR 125,D-12157 BERLIN,GERMANY. NR 30 TC 8 Z9 8 U1 0 U2 0 PU GUSTAV FISCHER VERLAG PI JENA PA VILLENGANG 2, D-07745 JENA, GERMANY SN 0934-8840 J9 ZBL BAKT-INT J MED M JI Zent.bl. Bakteriol.-Int. J. Med. Microbiol. Virol. Parasitol. Infect. Dis. PD APR PY 1997 VL 285 IS 4 BP 531 EP 539 PG 9 WC Microbiology; Virology SC Microbiology; Virology GA WW888 UT WOS:A1997WW88800009 PM 9144915 ER PT J AU Ridzon, R Gallagher, K Ciesielski, C Mast, EE Ginsberg, MB Robertson, BJ Luo, CC DeMaria, A AF Ridzon, R Gallagher, K Ciesielski, C Mast, EE Ginsberg, MB Robertson, BJ Luo, CC DeMaria, A TI Simultaneous transmission of human immunodeficiency virus and hepatitis C virus from a needle-stick injury SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID HEALTH-CARE WORKERS; OCCUPATIONAL EXPOSURES; INFANT TRANSMISSION; NATURAL-HISTORY; INFECTION; BLOOD; RISK; IDENTIFICATION; ANTIBODY C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,EPIDEM INTELLIGENCE SERV,DIV FIELD EPIDEMIOL,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HEPATITIS BRANCH,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HIV LAB INVESTIGAT BRANCH,ATLANTA,GA 30333. MASSACHUSETTS DEPT PUBL HLTH,BUR COMMUNICABLE DIS CONTROL,BOSTON,MA. NEPONSET VALLEY HLTH SYST,NORWOOD,MA. NR 27 TC 98 Z9 99 U1 0 U2 2 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 27 PY 1997 VL 336 IS 13 BP 919 EP 922 DI 10.1056/NEJM199703273361304 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WP832 UT WOS:A1997WP83200004 PM 9070472 ER PT J AU Looker, AC Dallman, PR Carroll, MD Gunter, EW Johnson, CL AF Looker, AC Dallman, PR Carroll, MD Gunter, EW Johnson, CL TI Prevalence of iron deficiency in the United States SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID DECLINING PREVALENCE; ANEMIA; POPULATION; NHANES AB Objective.-To determine the prevalence of iron deficiency and iron deficiency anemia in the US population. Design.-Nationally representative cross-sectional health examination survey that included venous blood measurements of iron status. Main Outcome Measures.-Iron deficiency, defined as having an abnormal value for at least 2 of 3 laboratory tests of iron status (erythrocyte protoporphyrin, transferrin saturation, or serum ferritin); and iron deficiency anemia, defined as iron deficiency plus low hemoglobin. Participants.-A total of 24 894 persons aged 1 year and older examined in the third National Health and Nutrition Examination Survey (1988-1994). Results.-Nine percent of toddlers aged 1 to 2 years and 9% to 11% of adolescent girls and women of childbearing age were iron deficient; of these, iron deficiency anemia was found in 3% and 2% to 5%, respectively. These prevalences correspond to approximately 700 000 toddlers and 7.8 million women with iron deficiency; of these, approximately 240 000 toddlers and 3.3 million women have iron deficiency anemia. Iron deficiency occurred in no more than 7% of older children or those older than 50 years, and in no more than 1% of teenage boys and young men. Among women of childbearing age, iron deficiency was more likely in those who are minority, low income, and multiparous. Conclusion.-Iron deficiency and iron deficiency anemia are still relatively common in toddlers, adolescent girls, and women of childbearing age. C1 UNIV CALIF SAN FRANCISCO,SCH MED,DEPT PEDIAT,SAN FRANCISCO,CA 94143. CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV ENVIRONM HLTH LAB SCI,ATLANTA,GA. RP Looker, AC (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR HLTH STAT,DIV HLTH EXAMINAT STAT,6525 BELCREST RD,HYATTSVILLE,MD 20782, USA. NR 26 TC 716 Z9 737 U1 4 U2 42 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 26 PY 1997 VL 277 IS 12 BP 973 EP 976 DI 10.1001/jama.277.12.973 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WN992 UT WOS:A1997WN99200031 PM 9091669 ER PT J AU Godoy, P Diaz, JM Alvarez, P Madrigal, N Ibarra, J Jemenez, M Rullan, J AF Godoy, P Diaz, JM Alvarez, P Madrigal, N Ibarra, J Jemenez, M Rullan, J TI Outbreak of tuberculosis: The importance of time of exposure versus the proximity to the source of infection SO MEDICINA CLINICA LA Spanish DT Article ID NEW-YORK-CITY; MYCOBACTERIUM-TUBERCULOSIS; RESISTANT TUBERCULOSIS; SCHOOL OUTBREAK; TRANSMISSION; SUSCEPTIBILITY; EPIDEMIOLOGY; HOMELESS; CONTACTS; CHILDREN AB BACKGROUND: The polymorphic length restriction fragment technique (PLRF) complements epidemiologic investigations. The aim of this study was to present an outbreak of tuberculosis in which the risk factors of infection and disease were studied. PATIENTS AND METHODS: A descriptive study was carried out in cases of tuberculosis. The isolated strains of Mycobacterium tuberculosis were typed by the PLRF technique, A study of the prevalence of infection was carried out among the 61 classmates of two classrooms (A and B) which the index case attended. An historical cohort study was thereafter performed among the cases with infection. The association of the dependent variable (infection or tuberculosis disease) with the remaining variables was determined by the odds ratio (OR). RESULTS: The incidence of disease was 9.8% (6/61). The strains isolated in 5 patients presented the same PLRF pattern. The prevalence study detected 28 infections (45.9%). Five cases (17.9%) were detected on the second tuberculin test. By multivariate analysis showed that the hours of exposure (1.8-3.2 hours, OR = 2.0; > 3.2 hours; OR = 10.2) were the risk factor for infection. The BCG vaccine, the intensity of the reaction to the tuberculin test and age could be associated with the risk of disease. CONCLUSIONS: The focus of the outbreak was confirmed by the PLRF technique. The importance of repeating the tuberculin test in whom the test was negative on the first test is of note. To evaluate the risk of infection the time of exposure is more important than the proximity to the index case. C1 INST SALUD CARLOS III,CTR NACL EPIDEMIOL,PROGRAMA EPIDEMIOL APLICADA CAMPO,LA MANCHA,SPAIN. JUNTA COMUNIDADES CASTILLA,DELEGAC PROV SANIDAD CUENCA,LA MANCHA,SPAIN. INST SALUD CARLOS III,CNMVIS,MADRID,SPAIN. CTR SALUD MOTILLA PALANCAR,CUENCA,SPAIN. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RI Godoy, Pere/A-7662-2010 NR 42 TC 7 Z9 8 U1 2 U2 2 PU EDICIONES DOYMA S/A PI BARCELONA PA TRAV DE GRACIA 17-21, 08021 BARCELONA, SPAIN SN 0025-7753 J9 MED CLIN-BARCELONA JI Med. Clin. PD MAR 22 PY 1997 VL 108 IS 11 BP 414 EP 418 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WQ066 UT WOS:A1997WQ06600004 PM 9213638 ER PT J AU Brace, NE Zimmerman, HP Potterat, JJ Muth, SQ Muth, JB Maldonado, TS Rothenberg, RB AF Brace, NE Zimmerman, HP Potterat, JJ Muth, SQ Muth, JB Maldonado, TS Rothenberg, RB TI Community-based HIV prevention in presumably underserved populations - July-September 1995 (Reprinted from MMWR, vol 46, pg 152-155, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID INTRAVENOUS-DRUG-USERS; SEROPREVALENCE; INFECTION; RISK C1 EMORY UNIV,SCH MED,DEPT FAMILY & PREVENT MED,ATLANTA,GA. CDC,DIV HIV AIDS PREVENT INTERVENT RES & SUPPORT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA 30333. RP Brace, NE (reprint author), EL PASO CTY DEPT HLTH & ENVIRONM,COLORADO SPRINGS,CO 80909, USA. RI Potterat, John/B-4680-2009 NR 11 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 19 PY 1997 VL 277 IS 11 BP 876 EP 877 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WM774 UT WOS:A1997WM77400013 ER PT J AU Kaye, K Nivin, B Munsiff, S Fujiwara, PI AF Kaye, K Nivin, B Munsiff, S Fujiwara, PI TI Laboratory errors and the misdiagnosis of tuberculosis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Kaye, K (reprint author), NEW YORK CITY DEPT HLTH,NEW YORK,NY 10013, USA. NR 1 TC 1 Z9 1 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 19 PY 1997 VL 277 IS 11 BP 882 EP 882 DI 10.1001/jama.277.11.882 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WM774 UT WOS:A1997WM77400022 PM 9062321 ER PT J AU Schneider, E Hajjeh, RA Spiegel, RA Jibson, RW Harp, EL Marshall, GA Gunn, RA McNeil, MM Pinner, RW Baron, RC Burger, RC Hutwagner, LC Crump, C Kaufman, L Reef, SE Feldman, GM Pappagianis, D Werner, SB AF Schneider, E Hajjeh, RA Spiegel, RA Jibson, RW Harp, EL Marshall, GA Gunn, RA McNeil, MM Pinner, RW Baron, RC Burger, RC Hutwagner, LC Crump, C Kaufman, L Reef, SE Feldman, GM Pappagianis, D Werner, SB TI A coccidioidomycosis outbreak following the Northridge, Calif, earthquake SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article AB Objective.-To describe a coccidioidomycosis outbreak in Ventura County following the January 1994 earthquake, centered in Northridge, Calif, and to identify factors that increased the risk for acquiring acute coccidioidomycosis infection. Design.-Epidemic investigation, population-based skin test survey, and case-control study. Setting.-Ventura County, California. Results.-In Ventura County, between January 24 and March 15, 1994, 203 outbreak-associated coccidioidomycosis cases, including 3 fatalities, were identified (attack rate [AR], 30 cases per 100 000 population). The majority of cases (56%) and the highest AR (114 per 100 000 population) occurred in the town of Simi Valley, a community located at the base of a mountain range that experienced numerous landslides associated with the earthquake. Disease onset for cases peaked 2 weeks after the earthquake. The AR was 2.8 times greater for persons 40 years of age and older than for younger persons (relative risk, 2.8; 95% confidence interval [CI], 2.1-3.7; P<.001). Environmental data indicated that large dust clouds, generated by landslides following the earthquake and strong aftershocks in the Santa Susana Mountains north of Simi Valley, were dispersed into nearby valleys by northeast winds. Simi Valley case-control study data indicated that physically being in a dust cloud (odds ratio, 3.0; 95% CI, 1.6-5.4; P<.001) and time spent in a dust cloud (P<.001) significantly increased the risk for being diagnosed with acute coccidioidomycosis. Conclusions.-Both the location and timing of cases strongly suggest that the coccidioidomycosis outbreak in Ventura County was caused when arthrospores were spread in dust clouds generated by the earthquake. This is the first report of a coccidioidomycosis outbreak following an earthquake. Public and physician awareness, especially in endemic areas following similar dust cloud-generating events, may result in prevention and early recognition of acute coccidioidomycosis. C1 EPIDEM INTELLIGENCE SERV,COMMUNITY DIS CONTROL,DEPT HLTH SERV,SAN DIEGO,CA. CTR DIS CONTROL & PREVENT,DEPT FIELD EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. CDC,EPIDEM INTELLIGENCE SERV,DIV BACTERIAL & MYCOT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. DEPT INTERIOR,CENT REG GEOL HAZARDS TEAM,US GEOL SURVEY,GOLDEN,CO. DEPT INTERIOR,US GEOL SURVEY,MENLO PK,CA. CDC,DIV STD HIV PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA 30333. DEPT HLTH SERV,COMMUNITY DIS CONTROL,SAN DIEGO,CA. CDC,OFF DIRECTOR,NATL CTR INFECT DIS,ATLANTA,GA 30333. CDC,DEPT FIELD EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. CDC,EMERGENCY RESPONSE COORDINAT GRP,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333. VENTURA CTY PUBL HLTH,HLTH OFF,VENTURA,CA. UNIV CALIF DAVIS,SCH MED,DEPT MED MICROBIOL & IMMUNOL,SACRAMENTO,CA 95817. CALIF DEPT HLTH SERV,DIV COMMUNICABLE DIS CONTROL,BERKELEY,CA 94704. NR 29 TC 101 Z9 102 U1 1 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 19 PY 1997 VL 277 IS 11 BP 904 EP 908 DI 10.1001/jama.277.11.904 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WM774 UT WOS:A1997WM77400034 PM 9062329 ER PT J AU Kuhn, L Abrams, EJ Matheson, PB Thomas, PA Lambert, G Bamji, M Greenberg, B Steketee, RW Thea, DM Beatrice, ST Chiasson, MA DeBernardo, E Hutchison, S McVeigh, K Oleszko, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Cruz, N Floyd, J FoyeSousou, V Jessop, DJ Macias, L Ng, D Nelson, K Rios, J Pliner, V Rosenbluth, L Hodge, R Tadros, H Weedon, J Young, S Zhang, ZR Courtland, R Daligadu, M Hoover, W Lopez, D Pollack, H Krasinski, K Belmore, A Champion, S Freedland, C Lovich, S Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Jackson, L Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V AF Kuhn, L Abrams, EJ Matheson, PB Thomas, PA Lambert, G Bamji, M Greenberg, B Steketee, RW Thea, DM Beatrice, ST Chiasson, MA DeBernardo, E Hutchison, S McVeigh, K Oleszko, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Cruz, N Floyd, J FoyeSousou, V Jessop, DJ Macias, L Ng, D Nelson, K Rios, J Pliner, V Rosenbluth, L Hodge, R Tadros, H Weedon, J Young, S Zhang, ZR Courtland, R Daligadu, M Hoover, W Lopez, D Pollack, H Krasinski, K Belmore, A Champion, S Freedland, C Lovich, S Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Jackson, L Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V TI Timing of maternal-infant HIV transmission: Associations between intrapartum factors and early polymerase chain reaction results SO AIDS LA English DT Article DE maternal-infant HIV transmission; timing; mode of delivery; rupture of membranes; preterm delivery; intrauterine growth retardation; polymerase chain reaction ID HUMAN-IMMUNODEFICIENCY-VIRUS; PERINATAL TRANSMISSION; VERTICAL TRANSMISSION; INFECTION; DELIVERY; TYPE-1; BIRTH; RISK; ZIDOVUDINE; PREDICTORS AB Objective: To investigate the hypothesis that labour and delivery events, perinatal characteristics, and maternal factors are only associated with intrapartum HIV transmission, and not with intrauterine HIV transmission. Methods: In the New York City Perinatal HIV Transmission Collaborative Study 276 infants of HIV-infected women were followed prospectively and had results of early polymerase chain reaction (PCR) tests available. Among infected children, intrauterine infection was presumed if HIV DNA was detected by PCR in samples collected from children aged less than or equal to 3 days, and intrapartum infection was presumed if HIV DNA was not detected in these early samples. The proportion of infants with presumed intrauterine and intrapartum infections were compared by selected intrapartum, perinatal and maternal characteristics. Results: Presumed intrapartum infection was found in 7% of infants delivered by Cesarean section and, among infants delivered vaginally, those with longer duration of membrane rupture (> 4 h) were significantly more likely to have presumed intrapartum HIV infection (22%) than those with shorter duration (9%; P = 0.02). There were no differences in presumed intrauterine HIV infection by mode of delivery or longer duration of membrane rupture. infants born preterm and small for gestational age had significantly higher risks of presumed intrapartum infection, but only those who were small for gestational age had higher risks of intrauterine infection. Conclusion: Our results support the notion that selected intrapartum conditions, long duration of membrane rupture prior to delivery in particular, are independent risk factors for maternal-infant transmission, and suggest that preterm infants may be especially vulnerable to intrapartum HIV exposure. C1 COLUMBIA UNIV COLL PHYS & SURG,HARLEM HOSP CTR,NEW YORK,NY 10032. MED & HLTH RES ASSOCIAT NEW YORK CITY,NEW YORK,NY. NEW YORK CITY DEPT HLTH,NEW YORK,NY 10013. BRONX LEBANON HOSP CTR,NEW YORK,NY. METROPOLITAN HOSP,NEW YORK,NY. MONTEFIORE HOSP,NEW YORK,NY. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Kuhn, L (reprint author), COLUMBIA UNIV,GERTRUDE H SERGIEVSKY CTR,630 W 168TH ST,UNIT 16,NEW YORK,NY 10032, USA. FU PHS HHS [U64 CCU 200937] NR 25 TC 69 Z9 71 U1 0 U2 1 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR 15 PY 1997 VL 11 IS 4 BP 429 EP 435 DI 10.1097/00002030-199704000-00005 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WN618 UT WOS:A1997WN61800005 PM 9084789 ER PT J AU Thea, DM Steketee, RW Pliner, V Bornschlegel, K Brown, T Orloff, S Matheson, PB Abrams, EJ Bamji, M Lambert, G Schoenbaum, EA Thomas, PA Heagarty, M Kalish, ML Beatrice, ST Chiasson, MA DeBernado, E Hutchison, S McVeigh, K Oleszko, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Cruz, N Floyd, J FoyeSousou, V Jessop, DJ Macias, L Ng, D Nelson, K Rios, J Rosenbluth, L Hodge, R Tadros, H Weedon, J Young, S Zhang, ZR Courtland, R Daligadu, M Hoover, W Lopez, D Pollack, H Krasinski, K Belmore, A Champion, S Freedland, C Lovich, S Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Jackson, L Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V Grimm, KT Crane, M Campbell, P Davila, S Dobrosycki, J Grant, D Hand, I Harish, Z Harris, A Nieves, M Soloman, L Steiner, A Wiznia, A Greenberg, B Sivapalasingham, M Naccarato, M Brooks, G Nicholson, M Mayers, M Garba, S Ou, CY Moore, J Rogers, M Schable, C Shaffer, N Simonds, RJ Straus, W AF Thea, DM Steketee, RW Pliner, V Bornschlegel, K Brown, T Orloff, S Matheson, PB Abrams, EJ Bamji, M Lambert, G Schoenbaum, EA Thomas, PA Heagarty, M Kalish, ML Beatrice, ST Chiasson, MA DeBernado, E Hutchison, S McVeigh, K Oleszko, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Cruz, N Floyd, J FoyeSousou, V Jessop, DJ Macias, L Ng, D Nelson, K Rios, J Rosenbluth, L Hodge, R Tadros, H Weedon, J Young, S Zhang, ZR Courtland, R Daligadu, M Hoover, W Lopez, D Pollack, H Krasinski, K Belmore, A Champion, S Freedland, C Lovich, S Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Jackson, L Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V Grimm, KT Crane, M Campbell, P Davila, S Dobrosycki, J Grant, D Hand, I Harish, Z Harris, A Nieves, M Soloman, L Steiner, A Wiznia, A Greenberg, B Sivapalasingham, M Naccarato, M Brooks, G Nicholson, M Mayers, M Garba, S Ou, CY Moore, J Rogers, M Schable, C Shaffer, N Simonds, RJ Straus, W TI The effect of maternal viral load on the risk of perinatal transmission of HIV-1 SO AIDS LA English DT Article DE perinatal transmission; HIV-1; viral load; nucleic acid sequence-based amplification; children ID HUMAN-IMMUNODEFICIENCY-VIRUS; POLYMERASE CHAIN-REACTION; STANDARD VACUTAINER TUBES; TYPE-1 HIV-1; P24 ANTIGEN; INFECTION; PLASMA; RNA; AMPLIFICATION; QUANTITATION AB Objective: To determine the effect of maternal viral load at delivery on the risk of perinatal transmission of HIV-1. Design: A nested case-control study within a prospectively followed cohort of HIV-1-infected pregnant women and their infants. Setting: The mullicenter New York City Perinatal HIV Transmission Collaborative Study. Participants: Fifty-one women who gave birth to HIV-1-infected infants were frequency-matched within CD4+ cell count quintiles with 54 non-transmitting mothers. Main outcome measures: Maternal quantity of HIV-1 viral RNA was assayed in plasma obtained near delivery using the nucleic acid sequence-based amplification assay system. Results: Viral RNA was detected in 73 (70%) out of 105 women and the median viral load was 16 000 RNA copies/ml in transmitters and 6600 in non-transmitters (P < 0.01). When adjusted for maternal CD4+ count near delivery, women with measurable viral load were nearly sixfold more likely to transmit HIV-1 than women with viral load below detection [adjusted odds ratio (AOR), 5.8; 95% confidence interval (CI), 2.2-15.5]. The odds ratio for perinatal transmission of log(10) viral load, adjusted for CD4 count was 2.7 (95% CI, 1.5-5.1). When stratified by the stage of HIV-1 disease, the only group with significant association between log(10) viral load and transmission were AIDS-free women with CD4+ count > 500 x 10(6)/l (AOR, 9.1; 95% CI, 2.6-31.5). Conclusions: High maternal viral load increases the likelihood of perinatal transmission of HIV-1 in women without AIDS and advanced immunosuppression. HIV-1-infected pregnant women without advanced disease, shown by others to have the lowest risk of perinatal transmission, may benefit the most from efforts to identify and decrease viral load at delivery. C1 MED & HLTH RES ASSOCIAT,NEW YORK,NY. NEW YORK CITY DEPT HLTH,NEW YORK,NY 10013. CTR DIS CONTROL & PREVENT,ATLANTA,GA. HARLEM HOSP MED CTR,NEW YORK,NY. METROPOLITAN HOSP,NEW YORK,NY. BRONX LEBANON HOSP CTR,BRONX,NY. ALBERT EINSTEIN COLL MED,BRONX,NY 10467. FU PHS HHS [U64 CCU 20093] NR 39 TC 78 Z9 82 U1 0 U2 3 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR 15 PY 1997 VL 11 IS 4 BP 437 EP 444 DI 10.1097/00002030-199704000-00006 PG 8 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WN618 UT WOS:A1997WN61800006 PM 9084790 ER PT J AU Brett, KM Madans, JH AF Brett, KM Madans, JH TI Use of postmenopausal hormone replacement therapy: Estimates from a nationally representative cohort study SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE cohort studies; estrogen replacement therapy; menopause; risk factors ID ESTROGEN USE; NONCONTRACEPTIVE ESTROGENS; ENDOMETRIAL CARCINOMA; UNITED-STATES; HEART-DISEASE; RISK-FACTORS; FOLLOW-UP; WOMEN; MORTALITY; PATTERNS AB The objective of this study was to describe trends in the use of hormone replacement therapy (HRT) in the United States by demographic, life-style, and heart disease risk factors. Data were obtained from the Epidemiologic Followup Study to the First National Health and Nutrition Examination Survey, a nationally representative cohort followed from the mid-1970s until 1992, A total of 5,602 women who had become menopausal by their last follow-up interview were included. An estimated 45% of the cohort of menopausal US women 25-74 years of age in the early 1970s used HRT for at least one month and 20% continued use for 5 or more years. Between 1987 and 1992, as the younger members of the cohort became menopausal, the proportion of this cohort who had ever used HRT and used it for 5 or more years increased by 32% and 54%, respectively. A higher probability of HRT use was found among women who were white, who were more highly educated, and who lived in the West, or who had experienced a surgical menopause. Women who were overweight or who abstained from alcohol were less likely to use HRT, These data support the hypothesis that HRT use is associated with sociodemographic factors, and that women tend to discontinue use within several years. C1 NATL CTR HLTH STAT,CDC,OFF VITAL & HLTH STAT SYST,HYATTSVILLE,MD 20782. RP Brett, KM (reprint author), NATL CTR HLTH STAT,DIV EPIDEMIOL,6525 BELCREST RD,ROOM 730,HYATTSVILLE,MD 20782, USA. NR 39 TC 189 Z9 189 U1 0 U2 2 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD MAR 15 PY 1997 VL 145 IS 6 BP 536 EP 545 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WM321 UT WOS:A1997WM32100010 PM 9063344 ER PT J AU Swerdlow, DL Griffin, PM AF Swerdlow, DL Griffin, PM TI Duration of faecal shedding of Escherichia coli O157:H7 among children in day-care centres SO LANCET LA English DT Editorial Material ID HEMOLYTIC-UREMIC SYNDROME RP Swerdlow, DL (reprint author), CTR DIS CONTROL & PREVENT,FOODBOME & DIARRHOEAL DIS BRANCH,ATLANTA,GA 30333, USA. NR 10 TC 25 Z9 27 U1 0 U2 1 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD MAR 15 PY 1997 VL 349 IS 9054 BP 745 EP 746 DI 10.1016/S0140-6736(05)60196-1 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WN124 UT WOS:A1997WN12400005 PM 9074570 ER PT J AU Smith, PJ Thompson, TJ Jereb, JA AF Smith, PJ Thompson, TJ Jereb, JA TI A model for interval-censored tuberculosis outbreak data SO STATISTICS IN MEDICINE LA English DT Article ID HAZARD FUNCTION; NONPARAMETRIC-ESTIMATION; LOGISTIC-REGRESSION; SURVIVAL ANALYSIS; WORKERS; DIAGNOSTICS; AIDS AB As the incidence of tuberculosis (TB) has increased in the United States, occupationally acquired TB has increased among the health care workers (HCWs). This paper describes a model developed in response to the needs of an outbreak of multidrug-resistant TB. One of the goals of the outbreak investigation was to estimate the risk of tuberculin skin test (TST) conversion as a function of HCW job type and the period during which persons were employed over the study period. TST conversions were evaluated at periodic examinations and data are interval-censored. We present a generalized linear model that extends Efron's survival model for censored survival data to the case of interval-censored data. (C) 1997 by John Wiley & Sons, Ltd. C1 CTR DIS CONTROL & PREVENT, DIV TB TRANSLAT K10, ATLANTA, GA 30333 USA. RP CTR DIS CONTROL & PREVENT, DIV TB ELIMINAT E10, 1600 CLIFTON RD NE, ATLANTA, GA 30333 USA. NR 32 TC 13 Z9 13 U1 0 U2 1 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0277-6715 EI 1097-0258 J9 STAT MED JI Stat. Med. PD MAR 15 PY 1997 VL 16 IS 5 BP 485 EP 496 PG 12 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 WN574 UT WOS:A1997WN57400001 PM 9089957 ER PT J AU Alter, MJ Gallagher, M Morris, TT Moyer, LA Meeks, EL Krawczynski, K Kim, JP Margolis, HS AF Alter, MJ Gallagher, M Morris, TT Moyer, LA Meeks, EL Krawczynski, K Kim, JP Margolis, HS TI Acute non-A-E hepatitis in the United States and the role of hepatitis G virus infection SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID NON-B HEPATITIS; POSTTRANSFUSION HEPATITIS; C-HEPATITIS AB Background Little is known about the relation of the newly discovered hepatitis G virus (HGV) to the cause and clinical course of acute and chronic viral hepatitis. Methods We selected patients from a surveillance study of acute viral hepatitis in four U.S. counties who had acute disease during 1985 to 1986 or 1991 to 1995. Serum samples were tested for HGV RNA by the polymerase chain reaction. Results HGV RNA was detected in 4 of 45 patients with a diagnosis of non-A-E hepatitis (9 percent), 23 of 116 patients with hepatitis C (20 percent), 25 of 100 patients with hepatitis A (25 percent), and 32 of 100 patients with hepatitis B (32 percent) (P<0.05 for the comparison of hepatitis B with hepatitis non-A-E or C). The clinical characteristics of the acute illness were similar for patients with HGV alone and those with hepatitis A, B, or C with or without HGV infection. During a follow-up period of one to nine years, chronic hepatitis did not develop in any of the patients with HGV alone, but 75 percent were persistently positive for HGV RNA, as were 87 percent of those with both hepatitis C and HGV infection. The rates of chronic hepatitis were similar in patients with hepatitis C alone (60 percent) and those with both hepatitis C and HGV infection (61 percent). Conclusions The evidence from this surveillance study does not implicate HGV as an etiologic agent of non-A-E hepatitis. Persistent infection with HGV was common, but it did not lead to chronic disease and did not affect the clinical course in patients with hepatitis A, B, or C. (C) 1997, Massachusetts Medical Society. C1 GENELABS TECHNOL,REDWOOD CITY,CA. RP Alter, MJ (reprint author), CTR DIS CONTROL & PREVENT,HEPATITIS BRANCH,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 24 TC 365 Z9 365 U1 0 U2 3 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 13 PY 1997 VL 336 IS 11 BP 741 EP 746 DI 10.1056/NEJM199703133361101 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WM640 UT WOS:A1997WM64000001 PM 9052651 ER PT J AU Peterson, HB Xia, ZS Hughes, JM Wilcox, LS Tylor, LR Trussell, J AF Peterson, HB Xia, ZS Hughes, JM Wilcox, LS Tylor, LR Trussell, J TI The risk of ectopic pregnancy after tubal sterilization SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID FEMALE STERILIZATION; LAPAROSCOPIC STERILIZATION; FAILURES AB Background Tubal sterilization is an increasingly common method of contraception in the United States. Although pregnancy after sterilization is uncommon, it can occur and may be ectopic. We used data from the U.S. Collaborative Review of Sterilization to estimate the risk of ectopic pregnancy in women who had undergone the common types of tubal sterilization. Methods A total of 10,685 women undergoing tubal sterilization were followed in a multicenter, prospective cohort study. We intended to follow all the women for 5 years by means of annual telephone interviews; for women enrolled early in the study, we attempted an additional follow-up telephone interview 8 to 14 years after sterilization. To assess the risk of ectopic pregnancy in these women, we used cumulative life-table probabilities and proportional-hazards analysis. Results There were 47 ectopic pregnancies in the 10,685 women; the 10-year cumulative probability of ectopic pregnancy for all methods of tubal sterilization combined was 7.3 per 1000 procedures. The cumulative probability varied substantially according to the method of sterilization and the woman's age at the time of sterilization. Women sterilized by bipolar tubal coagulation before the age of 30 years had a probability of ectopic pregnancy that was 27 times as high as that among women of similar age who underwent postpartum partial salpingectomy (31.9 vs. 1.2 ectopic pregnancies per 1000 procedures). The annual rate of ectopic pregnancy for all methods combined in the 4th through 10th years after sterilization was no lower than that in the first 3 years. Conclusions A history of tubal sterilization does not rule out the possibility of ectopic pregnancy, even many years after the procedure. (C) 1997, Massachusetts Medical Society. C1 PRINCETON UNIV,OFF POPULAT RES,PRINCETON,NJ 08544. RP Peterson, HB (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV REPROD HLTH,ATLANTA,GA 30341, USA. FU NICHD NIH HHS [3-Y02-HD41075-10] NR 17 TC 94 Z9 97 U1 0 U2 1 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD MAR 13 PY 1997 VL 336 IS 11 BP 762 EP 767 DI 10.1056/NEJM199703133361104 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WM640 UT WOS:A1997WM64000004 PM 9052654 ER PT J AU Mshar, PA Dembek, ZF Cartter, ML Hadler, JL Fiorentino, TR Marcus, RA McGuire, J Shiffrin, MA Lewis, A Feuss, J VanDyke, J Toly, M Cambridge, M Guzewich, J Keithly, J Dziewulski, D BraunHowland, E Ackman, D Smith, P Coates, J Ferrara, J AF Mshar, PA Dembek, ZF Cartter, ML Hadler, JL Fiorentino, TR Marcus, RA McGuire, J Shiffrin, MA Lewis, A Feuss, J VanDyke, J Toly, M Cambridge, M Guzewich, J Keithly, J Dziewulski, D BraunHowland, E Ackman, D Smith, P Coates, J Ferrara, J TI Outbreaks of Escherichia coli O157:H7 infection and cryptosporidiosis associated with drinking unpasteurized apple cider - Connecticut and New York, October 1996 (Reprinted from MMWR, vol 46, pg 5-8, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID SURVIVAL C1 YALE UNIV, SCH MED, NEW HAVEN, CT USA. CORTLAND CTY DEPT HLTH, CORTLAND, NY USA. NEW YORK STATE DEPT HLTH, ALBANY, NY 12237 USA. CDC, STATE BR, DIV APPL PUBL HLTH & TRAINING, EPIDEMIOL PROGRAM OFF, ATLANTA, GA 30333 USA. CDC, NATL CTR INFECT DIS, DIV PARASIT DIS, ATLANTA, GA 30333 USA. CDC, DIV BACTERIAL & MYCOT DIS, FOODBORNE & DIARRHEAL DIS BRANCH, ATLANTA, GA 30333 USA. NEW YORK STATE AGR & MARKETS, ALBANY, NY 12235 USA. RP Mshar, PA (reprint author), CONNECTICUT DEPT PUBL HLTH & ADDICT SERV, HARTFORD, CT 06106 USA. NR 11 TC 16 Z9 16 U1 1 U2 5 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60654-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 12 PY 1997 VL 277 IS 10 BP 781 EP 782 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WM082 UT WOS:A1997WM08200011 ER PT J AU NeumannHaefelin, D Schweizer, M AF NeumannHaefelin, D Schweizer, M TI Nonhuman primate spumavirus infections among persons with occupational exposure - United States, 1996 (Reprinted from MMWR, vol 46, pg 129-131, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 CDC,OFF DEPUTY DIRECTOR HIV,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP NeumannHaefelin, D (reprint author), UNIV FREIBURG,RETROVIRUS DIS BRANCH,DIV AIDS STD & TB LAB RES,HUGSTETTER STR 55,FREIBURG,GERMANY. NR 1 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 12 PY 1997 VL 277 IS 10 BP 783 EP 785 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA WM082 UT WOS:A1997WM08200012 ER PT J AU Lewander, W Wine, H Carnevale, R Lindenmayer, J Harvey, E HallWalker, C Lambright, L Manzo, E AF Lewander, W Wine, H Carnevale, R Lindenmayer, J Harvey, E HallWalker, C Lambright, L Manzo, E TI Ingestion of cigarettes and cigarette butts by children - Rhode Island, January 1994 July 1996 (Reprinted from MMWR, vol 46, pg 125-128, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 RHODE ISL POISON CONTROL CTR,PROVIDENCE,RI. BROWN UNIV,DEPT COMMUNITY HLTH,PROVIDENCE,RI 02912. RHODE ISL DEPT HLTH,OFF SMOKING & HLTH,PROVIDENCE,RI 02908. CDC,DIV ADULT & COMMUNITY HLTH,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA 30333. RP Lewander, W (reprint author), RHODE ISL HOSP,PROVIDENCE,RI 02903, 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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 12 PY 1997 VL 277 IS 10 BP 785 EP 786 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WM082 UT WOS:A1997WM08200014 ER PT J AU Fujiwara, PI Cook, SV Rutherford, CM Crawford, JT Glickman, SE Kreiswirth, BN Sachdev, PS Osahan, SS Ebrahimzadeh, A Frieden, TR AF Fujiwara, PI Cook, SV Rutherford, CM Crawford, JT Glickman, SE Kreiswirth, BN Sachdev, PS Osahan, SS Ebrahimzadeh, A Frieden, TR TI A continuing survey of drug-resistant tuberculosis, New York City, April 1994 SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; HIV-INFECTED PATIENTS; HEALTH-CARE WORKERS; MYCOBACTERIUM-TUBERCULOSIS; NOSOCOMIAL TRANSMISSION; UNITED-STATES; EMERGENCE; THERAPY; KOREA AB Background: A 1991 survey showed high levels of drug resistance among tuberculosis patients in New York, NY. As a result, the tuberculosis control program was strengthened, including expanded use of directly observed therapy and improved infection control. Methods: We collected isolates from every patient in New York City with a positive culture for Mycobacterium tuberculosis during April 1994; results were compared with those in the April 1991 survey. Results: From 1991 to 1994, the number of patients decreased from 466 to 332 patients. The percentage with isolates resistant to 1 or more antituberculosis drugs decreased from 33% to 24% (P<.01); with isolates resistant to at least isoniazid decreased from 26% to 18% (P<.05); and with isolates resistant to both isoniazid and rifampin decreased from 19% to 13% (P<.05). The number of patients with isolates resistant to both isoniazid and rifampin decreased by more than 50%. Among never previously treated patients, the percentage with resistance to 1 or more drugs decreased from 22% in 1991 to 13% in 1994 (P<.05). The number of patients with consistently positive culture results for more than 4 months decreased from 130 to 44. A history of antituberculosis treatment was the strongest predictor of drug resistance (odds ratio=3.1; P<.001). Human immunodeficiency virus infection was associated with drug resistance among patients who never had been treated for tuberculosis. Conclusions: Drug-resistant tuberculosis declined significantly in New York City from 1991 to 1994. Measures to control and prevent tuberculosis were associated with a 29% decrease in the proportion of drug resistance and a 52% decrease in the number of patients with multidrug-resistant tuberculosis. C1 NEW YORK CITY DEPT HLTH,NEW YORK,NY 10013. CTR DIS CONTROL & PREVENT,DIV TB ELIMINAT,NATL CTR HIV STD & TB PREVENT,NATL CTR INFECT DIS,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,DIV AIDS STD & TB LAB RES,NATL CTR INFECT DIS,ATLANTA,GA 30333. PUBL HLTH RES INST,NEW YORK,NY. NR 30 TC 55 Z9 57 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD MAR 10 PY 1997 VL 157 IS 5 BP 531 EP 536 DI 10.1001/archinte.157.5.531 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WL862 UT WOS:A1997WL86200010 PM 9066457 ER PT J AU Hershey, J Burrus, B Marcussen, V Notter, J Watson, K Wolford, R Shaffner, RE Barrett, E Woolard, D Branch, L Hackler, R Rouse, B Gibson, L Jenkins, S Rullan, J Miller, G Curran, S AF Hershey, J Burrus, B Marcussen, V Notter, J Watson, K Wolford, R Shaffner, RE Barrett, E Woolard, D Branch, L Hackler, R Rouse, B Gibson, L Jenkins, S Rullan, J Miller, G Curran, S TI Legionnaires disease associated with a whirlpool spa display - Virginia, September-October 1996 (Reprinted from MMWR, vol 46, pg 83-86, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID OUTBREAK C1 CARILION GILES MEM HOSP,PEARISBURG,VA. CARIL RADFORD COMMUNITY HOSP,RADFORD,VA. COLUMBIA LEWIS GALE HOSP,SALEM,VA. COLUMBIA MONTGOMERY REG HOSP,BLACKSBURG,VA. DEPT VET AFFAIRS MED CTR,SALEM,VA. VIRGINIA DEPT HLTH,RICHMOND,VA 23218. DIV CONSOLIDATED LAB SVCS,RICHMOND,VA. CDC,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,CHILDHOOD & RESP DIS BRANCH,LAB CORP AMER,ATLANTA,GA 30333. CDC,STATE BR,DIV APPL PUBL HLTH TRAINING,ATLANTA,GA 30333. RP Hershey, J (reprint author), NEW RIVER HLTH DIST,RADFORD,VA 24142, 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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD MAR 5 PY 1997 VL 277 IS 9 BP 705 EP 706 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WK026 UT WOS:A1997WK02600012 ER PT J AU Greenberg, BL Semba, RD Vink, PE Farley, JJ Sivapalasingam, M Steketee, RW Thea, DM Schoenbaum, EE AF Greenberg, BL Semba, RD Vink, PE Farley, JJ Sivapalasingam, M Steketee, RW Thea, DM Schoenbaum, EE TI Vitamin A deficiency and maternal-infant transmission of HIV in two metropolitan areas in the United States SO AIDS LA English DT Article DE vitamin A; retinol; perinatal transmission; HIV ID HUMAN-IMMUNODEFICIENCY-VIRUS; TO-CHILD TRANSMISSION; A-DEFICIENCY; TYPE-1 HIV-1; INFECTION; WOMEN; ASSOCIATION; PREDICTORS; MOTHERS; RWANDA AB Objective: To determine whether vitamin A deficiency is associated with maternal-infant HIV transmission among HIV-infected pregnant women in two United States cities. Methods: Third trimester serum vitamin A levels were evaluated using high performance liquid chromatography in 133 HIV-infected women who delivered livebirths during May 1986 to May 1994 and whose infants had known HIV infection status. Results: Sixteen per cent (seven out of 44) of the transmitting mothers and 6% (five out of 89) of the non-transmitting mothers had severe vitamin A deficiency (<0.70 mu mol/l; P = 0.05). Maternal-infant transmission was also associated with prematurity <37 weeks gestation (P = 0.02), and Cesarean section delivery (P = 0.04), CD4 percentage (P = 0.03) and marginally associated with duration of membrane rupture of greater than or equal to 4 h (P = 0.06) by univariate analysis. In a multivariate logistic regression model, severe vitamin A deficiency [adjusted odds ratio (AOR), 5.05; 95% confidence interval (CI), 1.20-21.24], Cesarean section delivery (AOR, 3.75; 95% CI, 1.10-12.87), and prematurity (AOR, 2.25; 95% CI, 1.22-4.13) were associated with transmission after adjusting for CD4+ percentage, and duration of membrane rupture. Conclusion: Increased risk of maternal-infant transmission was associated with severe vitamin A deficiency among non-breastfeeding women in these cohorts from the United States. C1 JOHNS HOPKINS SCH MED,DEPT OPHTHALMOL,BALTIMORE,MD. UNIV MARYLAND,SCH MED,DEPT PEDIAT,BALTIMORE,MD 21201. CTR DIS CONTROL & PREVENT,ATLANTA,GA. MED & HLTH RES ASSOC,MATERNAL INFANT HIV TRANSMISS STUDY,NEW YORK,NY. MONTEFIORE MED CTR,ALBERT EINSTEIN COLL MED,DEPT MED,BRONX,NY 10467. RP Greenberg, BL (reprint author), MONTEFIORE MED CTR,AIDS RES PROGRAM,DEPT EPIDEMIOL & SOCIAL MED,ALBERT EINSTEIN COLL MED,BRONX,NY 10467, USA. FU NICHD NIH HHS [HD32247]; PHS HHS [U64/CCU207228-05, U64/CCU306825-05] NR 40 TC 67 Z9 69 U1 0 U2 1 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR PY 1997 VL 11 IS 3 BP 325 EP 332 DI 10.1097/00002030-199703110-00010 PG 8 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WK692 UT WOS:A1997WK69200009 PM 9147424 ER PT J AU Pinkerton, SD Holtgrave, DR Valdiserri, RO AF Pinkerton, SD Holtgrave, DR Valdiserri, RO TI Cost-effectiveness of HIV-prevention skills training for men who have sex with men SO AIDS LA English DT Article DE cost analysis; cost-effectiveness; HIV; prevention; risk behaviors; homosexuality ID RISK-REDUCTION INTERVENTIONS; HUMAN-IMMUNODEFICIENCY-VIRUS; INJECTING DRUG-USERS; AIDS PREVENTION; BISEXUAL MEN; INFECTION; MODEL; WOMEN; ADOLESCENTS; BEHAVIORS AB Objective: A previous study empirically compared the effects of two HIV-prevention interventions for men who have sex with men: (i) a safer sex lecture, and (ii) the same lecture coupled with a 1.5 h skills-training group session. The skills-training intervention led to a significant increase in condom use at 12-month follow-up, compared with the lecture-only condition. The current study retrospectively assesses the incremental cost-effectiveness of skills training to determine whether it is worth the extra cost to add this component to an HIV-prevention intervention that would otherwise consist of a safer sex lecture only. Design: Standard techniques of incremental cost-utility analysis were employed. Methods: A societal perspective and a 5% discount rate were used. Cost categories assessed included: staff salary, fringe benefits, quality assurance, session materials, client transportation, client time valuation, and costs shared with other programs. A Bernoulli-process model of HIV transmission was used to estimate the number of HIV infections averted by the skills-training intervention component. For each infection averted, the discounted medical costs and quality-adjusted life years (QALY) saved were estimated. One- and multi-way sensitivity analyses were performed to assess the robustness of base-case results to changes in modeling assumptions. Results: Under base-case assumptions, the incremental cost of the skills training was less than $13,000 (or about $40 per person). The discounted medical costs averted by incrementally preventing HIV infections were over $170 000; more than 21 discounted QALY were saved. The cost per QALY saved was negative, indicating cost-savings. These results are robust to changes in most modeling assumptions. However, the model is moderately sensitive to changes in the per-contact risk of HIV transmission. Conclusions: Under most reasonable assumptions, the incremental costs of the skills training were outweighed by the medical costs saved. Thus, not only is skills training effective in reducing risky behavior, it is also cost-saving. C1 CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA. RP Pinkerton, SD (reprint author), MED COLL WISCONSIN,DEPT PSYCHIAT & BEHAV MED,CTR AIDS INTERVENT RES,1249 N FRANKLIN PL,MILWAUKEE,WI 53202, USA. FU NIMH NIH HHS [P30-MH52776, R01-MH55440] NR 53 TC 43 Z9 43 U1 2 U2 3 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR PY 1997 VL 11 IS 3 BP 347 EP 357 DI 10.1097/00002030-199703110-00013 PG 11 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WK692 UT WOS:A1997WK69200012 PM 9147427 ER PT J AU Boyer, CB Barrett, DC Peterman, TA Bolan, G AF Boyer, CB Barrett, DC Peterman, TA Bolan, G TI Sexually transmitted disease (STD) and HIV risk in heterosexual adults attending a public STD clinic evaluation of a randomized controlled behavioral risk-reduction intervention trial SO AIDS LA English DT Article DE sexually transmitted disease; HIV prevention; education; behavioral intervention; risk reduction; AIDS risk-reduction model ID AIDS; ADOLESCENTS; SKILLS AB Objective: To evaluate the efficacy of a cognitive/behavioral skills-building intervention to prevent sexually transmitted diseases (STD) in high-risk heterosexual adults. Design: A randomized controlled trial with assessments at baseline, and at 3 and 5 months. Setting: San Francisco STD Clinic. Patients: A total of 399 patients were randomly assigned to a four-session, individual, multi-component, cognitive/behavioral intervention (n = 199), or a brief standardized counseling session offered to all patients (n = 200). Intervention: Based on the AIDS Risk-Reduction Model, the aims of the intervention were to increase prevention knowledge, reduce high-risk psychosocial factors, and build decision-making and communication skills to modify sexual behaviors. Main outcome measures: The primary outcome of interest was STD. The secondary outcome was number of risky sexual activities. Results: There were no differences between the intervention (13%) and control (11%) groups in their acquisition of STD. Among men, condom use increased more at 3 months in the intervention group than the control group (56.8 versus 42.3%; P < 0.05). In addition, the mean number of sexual partners without condom use was lower in the intervention group than in the control group at 5 months (0.6 versus 0.9; P < 0.01). Conclusions: The results suggest that a cognitive/behavioral, skills-building intervention consisting of individual, multiple sessions and follow-up assessments can be implemented and evaluated with high-risk heterosexually active adults attending public STD clinics. Our intervention did not have a significant impact on STD, although it had some impact on behavior in men, but not in women. C1 UNIV CALIF SAN FRANCISCO,CTR AIDS PREVENT STUDIES,SAN FRANCISCO,CA. CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. DEPT PUBL HLTH,SAN FRANCISCO,CA. RP Boyer, CB (reprint author), UNIV CALIF SAN FRANCISCO,DEPT PEDIAT,DIV ADOLESCENT MED,400 PARNASSUS AVE,BOX 0503,SAN FRANCISCO,CA 94143, USA. FU PHS HHS [H25-CCH904371, R30-CCR90153] NR 20 TC 77 Z9 77 U1 0 U2 4 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR PY 1997 VL 11 IS 3 BP 359 EP 367 DI 10.1097/00002030-199703110-00014 PG 9 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WK692 UT WOS:A1997WK69200013 PM 9147428 ER PT J AU Stetler, HC Granade, TC Nunez, CA Meza, R Terrell, S Amador, L George, JR AF Stetler, HC Granade, TC Nunez, CA Meza, R Terrell, S Amador, L George, JR TI Field evaluation of rapid HIV serologic tests for screening and confirming HIV-1 infection in Honduras SO AIDS LA English DT Article DE HIV-1 antibody; alternative confirmatory strategies; Honduras; rapid serological assays ID IMMUNODEFICIENCY-VIRUS TYPE-1; ANTIBODY; ASSAYS; STRATEGY; AFRICA; COST AB Objective: To determine the ability of simple, rapid tests to identify HIV-1 antibody-positive specimens in field settings using-the World Health Organization's (WHO) alternative testing strategies. Design: Three-phase evaluation of simple, rapid assays using banked specimens and prospectively collected serum specimens at regional hospitals and rural clinics. Methods: Seven tests (Retrocell, Genie, HIVCHEK, SUDS HIV-1, Testpack, Serodia HIV-1, and HIV-1/2 RTD) were evaluated and results compared with standard enzyme immunoassay (EIA) and Western blot results (phase 1). Further evaluation consisted of prospective testing of routine specimens al regional (phase 2; n = 900) and rural, peripheral laboratories (phase 3; n = 1266) throughout Honduras with selected assays. Results: Sensitivity and specificity were calculated for each assay and combination of assays for each phase to evaluate the effectiveness of the WHO alternative testing strategies. All tests. in all phases were >99% sensitive after correcting for technical errors, with two exceptions (SUDS, phase 1; HIVCHEK, phase 3). In phase 3, where the testing algorithm was diagnostic, several combinations of assays were 100% sensitive and specific using WHO strategy II or III. For the Honduras Ministry of Health, the combination of Retrocell and Genie was found to be equally sensitive, more specific (no indeterminate results), and less expensive than EIA/Western blot. Conclusion: Combinations of rapid, simple HIV antibody assays provide sensitivity and specificity performance comparable to EIA/Western blot. Application of these combinations in the WHO alternative testing strategies provides an inexpensive and effective method of determining HIV status. Assay combinations using these strategies can be easily performed in small, rural laboratories and have been implemented in routine HIV screening in Honduras. C1 CTR DIS CONTROL & PREVENT,DIV AIDS SEXUALLY TRANSMITTED DIS & TB LAB RES,NATL CTR INFECT DIS,ATLANTA,GA 30333. MINIST HLTH,TEGUCIGALPA,HONDURAS. US AGCY INT DEV,TEGUCIGALPA,HONDURAS. NR 19 TC 67 Z9 70 U1 1 U2 1 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD MAR PY 1997 VL 11 IS 3 BP 369 EP 375 DI 10.1097/00002030-199703110-00015 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WK692 UT WOS:A1997WK69200014 PM 9147429 ER PT J AU Esche, CA Groff, JH AF Esche, CA Groff, JH TI Proficiency analytical testing (PAT) program (November 30, 1996) SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Editorial Material RP Esche, CA (reprint author), NIOSH,DEPT HLTH & HUMAN SERV,CTR DIS CONTROL & PREVENT,US PUBL HLTH SERV,DIV PHYS SCI & ENGN,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 SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD MAR PY 1997 VL 58 IS 3 BP 184 EP 185 PG 2 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WN132 UT WOS:A1997WN13200004 PM 9075308 ER PT J AU Spencer, AB Estill, CF McCammon, JB Mickelsen, RL Johnston, OE AF Spencer, AB Estill, CF McCammon, JB Mickelsen, RL Johnston, OE TI Control of ethyl methacrylate exposures during the application of artificial fingernails SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article; Proceedings Paper CT American-Industrial-Hygiene-Association Conference and Exposition CY MAY 21-27, 1994 CL ANAHEIM, CA SP Amer Ind Hyg Assoc DE cosmetologists; cosmetology; ethyl methacrylate; ventilation ID VAPORS AB In 1990 six cases of physician-diagnosed occupational asthma in cosmetologists working with artificial fingernails prompted the Colorado Department of Health to request the assistance of National Institute for Occupational Safety and Health (NIOSH) researchers in the evaluation and control of nail salon technician exposure. A commercially available recirculating downdraft table with charcoal filters was purchased and evaluated. Researchers from NIOSH made modifications to the table that included increasing the downdraft air volume; enlarging the plenum for more consistent airflow rates at the face of the table; removing the charcoal filters while incorporating a ventilation system to the outdoors; and putting an extension around the duct leading to the perforated plate at the downdraft face of the table. An evaluation was performed using the following two configurations: the modified table with the downdraft ventilation on (vented) and without the downdraft ventilation on (unvented). Each of the two configurations, was sampled for 3 days in random order. Testing included the use of XAD-2 solid sorbent tubes for determining ethyl methacrylate and methyl methacrylate concentrations. Relative concentrations of organics were examined and used to analyze work practices. The geometric mean ethyl methacrylate exposure for personal breathing zone samples when using the modified table for approximately 6 hours was 0.6 ppm, when using the unventilated conventional table, the geometric mean exposure was 8.7 ppm. The difference in the values is statistically significant (p=0.0045). Methyl methacrylate concentrations were nondetectable on all sorbent tubes. C1 COLORADO DEPT HLTH,DENVER,CO 80222. RP Spencer, AB (reprint author), NIOSH,US DEPT HLTH & HUMAN SERV,PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226, USA. NR 15 TC 19 Z9 19 U1 0 U2 2 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD MAR PY 1997 VL 58 IS 3 BP 214 EP 218 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WN132 UT WOS:A1997WN13200008 PM 9075312 ER PT J AU Abell, MT Kennedy, ER AF Abell, MT Kennedy, ER TI A computer program to promote understanding of the monitoring method evaluation guidelines used at NIOSH SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article DE airborne toxic substances; computer programs; NIOSH accuracy criterion AB A computer-based training program has been devised to promote better understanding of the recently revised National Institute for Occupational Safely and Health (NIOSH) test guidelines applicable to methods requiring on-site sample collection and laboratory sample analysis of airborne toxic substances. A statistics section explains the basis of the NIOSH accuracy criterion (NAC); an experiments section provides details on the evaluation experiments; and a calculations section calculates method statistics based on data entered by the user. The statistics section graphically explains concepts such as the NAT and limit of detection, allowing the user to experiment with some parameters to see how the results are affected. This section also provides background material to show how some of the performance criteria evolved. The experiments section provides a summary of the experiments used to generate the data for method evaluation. The calculations section has several screens that work like customized spreadsheets for the entry of data collected during the laboratory evaluation of a method. A separate screen then calculates the precision (relative standard deviation) of analytical results at each of four concentrations, tests to see if the precision values are statistically homogeneous, and combines the homogeneous data for calculation of the relative standard deviation, it does the same for bias, and combines the precision with method bias to arrive at an estimate of method accuracy. Other screens in the calculations section facilitate the determination of method limit of detection and sample storage stability. RP Abell, MT (reprint author), NIOSH,DEPT HLTH & HUMAN SERV,US PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,DIV PHYS SCI & ENGN,CINCINNATI,OH 45226, USA. NR 10 TC 3 Z9 3 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD MAR PY 1997 VL 58 IS 3 BP 236 EP 241 DI 10.1202/0002-8894(1997)058<0236:ACPTPU>2.0.CO;2 PG 6 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WN132 UT WOS:A1997WN13200011 PM 9075315 ER PT J AU White, MC Etzel, RA Olson, DR Goldstein, IF AF White, MC Etzel, RA Olson, DR Goldstein, IF TI Reexamination of epidemic asthma in New Orleans, Louisiana, in relation to the presence of soy at the harbor SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE air pollutants, environmental; asthma; disease outbreaks; soybeans ID OUTBREAKS; VISITS; DUST AB Epidemic asthma occurred in New Orleans, Louisiana, in the 1950s and 1960s, but its causes were never fully understood. Subsequently, similar outbreaks of epidemic asthma in Barcelona, Spain, were shown to be caused by the release of soy dust at the harbor. To investigate whether airborne soy dust may have contributed to epidemic asthma in New Orleans, the authors examined historical data on vessel cargo from the New Orleans harbor together with data on emergency department visits for asthma, for the period from 1957 through 1968. Days on which there were 64 or more visits for asthma were twice as likely to have occurred on days when a vessel carrying soy was at the harbor (odds ratio (OR) = 2.3, 95% confidence interval (CI) 1.5-3.3), The association was stronger when the maximum wind speed was less than 12 miles/hour (19.3 km/hour) (OR = 4.0, 95% Cl 2.1-7.7) and strongest when wind speeds were low and the prevailing winds were from the south or southwest, the direction of two grain elevators from the hospital (OR = 6.7, 95% Cl 1.5-46.7), Various temporal and climatic factors that had been associated with the occurrence of asthma outbreaks did not appear to be important confounding factors. The association was specific to soy cargo; no association was observed between asthma-epidemic days and the presence of either wheat or corn in vessels at the harbor. The results of this analysis provide further evidence that ambient soy dust is very asthmogenic and that asthma morbidity in a community can be influenced by exposures in the ambient atmosphere. C1 CTR DIS CONTROL & PREVENT,DIV ENVIRONM HAZARDS & HLTH EFFECTS,NATL CTR ENVIRONM HLTH,ATLANTA,GA. COLUMBIA UNIV,SCH PUBL HLTH,DIV EPIDEMIOL,NEW YORK,NY. RI White, Mary /C-9242-2012 OI White, Mary /0000-0002-9826-3962 NR 33 TC 31 Z9 31 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD MAR 1 PY 1997 VL 145 IS 5 BP 432 EP 438 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WJ513 UT WOS:A1997WJ51300006 PM 9048517 ER PT J AU Hayes, RB Klein, S Suruda, A Schulte, P Boeniger, M Stewart, P Livingston, GK Oesch, F AF Hayes, RB Klein, S Suruda, A Schulte, P Boeniger, M Stewart, P Livingston, GK Oesch, F TI O-6-alkylguanine DNA alkyltransferase activity in student embalmers SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE formaldehyde; occupational exposure; DNA repair; embalming ID PERIPHERAL-BLOOD LYMPHOCYTES; O6-ALKYLGUANINE-DNA ALKYLTRANSFERASE; REPAIR CAPACITIES; FORMALDEHYDE; CELLS; METHYLTRANSFERASE; INHIBITION; EXPOSURE; DAMAGE AB O-6-Alkylguanine-DNA alkyltransferase (AGT) activity was assessed in peripheral blood lymphocytes among 23 mortuary science students before and after 9 weeks in a laboratory course in techniques of embalming. Formaldehyde exposure was established by environmental monitoring. The average air concentration of formaldehyde during embalming was about 1.5 ppm. At the pre-exposure sampling, baseline DNA repair capacity tended to be reduced in subjects who reported a prior history of embalming (p = 0.08). From pre- to post-exposure, 17 subjects decreased in DNA repair capacity, while only 6 increased (p < 0.05). Analysis of variance, including adjustment for age, sex, and smoking status, confirmed these findings. Among the eight subjects who had no embalming experience during the 90 days before study, seven had decreased and one had increased AGT activity during the period of study (p < 0.05). For those with prior embalming experience, 10 subjects decreased in AGT activity, while 5 increased (p < 0.05). Although the major chemical exposure in embalming practice was to formaldehyde, no clear link was established between amount of formaldehyde exposure and AGT activity. (C) 1997 Wiley-Liss, Inc. C1 UNIV MAINZ,INST TOXICOL,D-6500 MAINZ,GERMANY. NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDI,CINCINNATI,OH 45226. UNIV CINCINNATI,SCH MED,DEPT ENVIRONM HLTH SCI,CINCINNATI,OH. RP Hayes, RB (reprint author), NCI,ENVIRONM EPIDEMIOL BRANCH,BETHESDA,MD 20892, USA. NR 27 TC 8 Z9 10 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD MAR PY 1997 VL 31 IS 3 BP 361 EP 365 DI 10.1002/(SICI)1097-0274(199703)31:3<361::AID-AJIM13>3.0.CO;2-Z PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WK699 UT WOS:A1997WK69900013 PM 9055960 ER PT J AU Cordero, JF Orenstein, WA AF Cordero, JF Orenstein, WA TI The future of immunization registries SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID MISSED OPPORTUNITIES; VACCINATION AB The first smallpox vaccine given 200 years ago by Edward Jenner marked the beginning of an unparalleled approach to disease prevention. Because of vaccines, smallpox has been eradicated, polio eradication is close to becoming a reality, and eliminating measles is a realistic goal for the Americas by the Year 2000. Provisional data from 1995 indicate that the United States had the lowest number of cases of vaccine-preventable diseases ever reported for seven diseases, and vaccine coverage levels are now the highest ever recorded in the United States. Yet, today about a million 2-year-old children in the United States need one or more doses of vaccines to be fully protected. Local and state immunization registries will become the cornerstone of our future immunization delivery system that will assure that every child is immunized on schedule. When the registries become fully functional, all children will be enrolled from birth. Parents can be reminded automatically when immunizations are due and can be recalled when they are overdue. Providers will easily determine the immunization needs of their patients, old or new at the time of each visit, wherever a child interacts with the health care system, be it a doctor's office, public health clinic, emergency room, or elsewhere. Programs like the one for Women, Infants, and Children (WIC) will have access to accurate immunization records. Changes in immunization schedules can be rapidly incorporated into software and disseminated. No longer will immunization assessments at the office level have to be done manually. Public health officials will have a simple, quick, inexpensive method to assess immunization coverage in their communities, and to identify groups at risk for underimmunization. Local registries can be interconnected, and information on immunization coverage can be shared with local and state agencies. This can expedite and lower the cost of monitoring immunization coverage at every level. Much progress has occurred in making immunization registries a reality. Much more needs to be done, and there are still critical barriers to overcome. Nevertheless, the progress, as detailed in this supplement, is dramatic and gives us great hope for the future, a future in which more and more infectious diseases will be conquered through the use of more and better vaccines delivered to the populations in need through an efficient system facilitated by immunization information systems. RP Cordero, JF (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,DEPT HLTH & HUMAN SERV,1600 CLIFTON RD,E05,ATLANTA,GA 30333, USA. NR 17 TC 4 Z9 4 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAR-APR PY 1997 VL 13 IS 2 SU S BP 122 EP 124 PG 3 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA WR990 UT WOS:A1997WR99000026 ER PT J AU Escobedo, LG Giles, WH Anda, RF AF Escobedo, LG Giles, WH Anda, RF TI Socioeconomic status, race, and death from coronary heart disease SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; SUDDEN-DEATH; RISK-FACTORS; CARDIOVASCULAR-DISEASE; RACIAL-DIFFERENCES; MORTALITY-RATES; UNITED-STATES; BLACK; RESPONDENTS; INFORMATION AB Introduction: Data to assess factors associated with differences in coronary heart disease mortality between Caucasians and African Americans are limited. We assessed risks for sudden, nonsudden, and other coronary death between Caucasians and African Americans in relation to known risk factors for coronary disease and socioeconomic status. Methods: We analyzed data from the 1986 National Mortality Followback Survey, the 1985 National Health Interview Survey, and the U.S. Bureau of the Census. Logistic regression methods were used to create multivariate models to assess the relationship of socioeconomic status and other known modifiable risk factors to death from each of the three coronary diseases for Caucasians and African Americans separately. Results: In an age- and gender-adjusted analysis of data on men 25-44 years old and women 25-54 years old, African Americans had about twice the risk for sudden, nonsudden, or other coronary death as did Caucasians. Adjusted risks for coronary death for Caucasians associated with modifiable risk factors (cigarette smoking, body weight, diabetes, and hypertension) either resembled or were slightly greater than those for African Americans. Half or more of all excess risks for African Americans in multivariate models could be explained by socioeconomic status. About 18% of excess sudden coronary death risk could be further explained by known modifiable coronary heart disease risk factors. Conclusions: Broad public health efforts are needed to address these causes of excess mortality. Medical Subject Headings (MeSH): coronary heart disease, mortality, race, surveys, socioeconomic status, African Americans. C1 CTR DIS CONTROL,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,CARDIOVASC HLTH STUDIES BRANCH,ATLANTA,GA 30333. NR 34 TC 28 Z9 28 U1 0 U2 2 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD MAR-APR PY 1997 VL 13 IS 2 BP 123 EP 130 PG 8 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA WR009 UT WOS:A1997WR00900011 PM 9088449 ER PT J AU ElHashimy, MM Aubert, RE Alich, K Warram, JH Harrigan, BA Herman, WH AF ElHashimy, MM Aubert, RE Alich, K Warram, JH Harrigan, BA Herman, WH TI Strategies to improve the reporting of legal blindness in Massachusetts SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article AB Objectives. Registration practices were evaluated as the initial phase of a validation study of the Register of the Massachusetts Commission for the Blind. Methods. Massachusetts eye care providers were surveyed to determine factors associated with nonreporting of legal blindness to the commission. Results. Among ophthalmologists, factors associated with nonreporting were small practice size and practicing for 5 years or less in Massachusetts. Among optometrists, factors included small practice size and unawareness of the Massachusetts reporting law. Conclusions. Information should be disseminated to eye care providers, legally blind patients, and the public to ensure registration and sustain it. C1 MASSACHUSETTS DEPT PUBL HLTH,DIABET CONTROL PROGRAM,BOSTON,MA 02108. PRUDENTIAL CTR HLTH CARE RES,ATLANTA,GA. JOSLIN DIABET CTR,EPIDEMIOL & GENET SECT,BOSTON,MA 02215. MASSACHUSETTS COMMIS BLIND,BOSTON,MA. CTR DIS CONTROL & PREVENT,DIV DIABET TRANSLAT,ATLANTA,GA. NR 10 TC 2 Z9 2 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAR PY 1997 VL 87 IS 3 BP 425 EP 428 DI 10.2105/AJPH.87.3.425 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WR017 UT WOS:A1997WR01700020 PM 9096546 ER PT J AU Grabbe, L Demi, A Camann, MA Potter, L AF Grabbe, L Demi, A Camann, MA Potter, L TI The health status of elderly persons in the last year of life: A comparison of deaths by suicide, injury, and natural causes SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID CANCER-PATIENTS; RISK AB Objectives. This study identified health status variables related to suicide by elderly persons and compared the health status of suicide decedents with natural death and injury decedents. Methods. Data were obtained from the 1986 National Mortality Followback Survey. Results. When other variables were controlled for, suicide decedents were significantly more likely than injury decedents to have a history of cancer (odds ratio [OR] = 51.94), moderate (OR = 29.37) or heavy (OR = 22.87) alcohol use, and mental or emotional disorder (OR = 10.91) and to be White (OR = 18.54) and male (OR = 9.12). Conclusions. The findings indicate that a history of cancer should be considered as a risk for suicide in the elderly. C1 GEORGIA STATE UNIV,SCH NURSING,ATLANTA,GA 30302. KENNESAW STATE COLL,KENNESAW,GA. CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 19 TC 38 Z9 38 U1 0 U2 3 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAR PY 1997 VL 87 IS 3 BP 434 EP 437 DI 10.2105/AJPH.87.3.434 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WR017 UT WOS:A1997WR01700022 PM 9096548 ER PT J AU Greife, AL Goldenhar, LM Fruend, E Stock, A Halperin, W AF Greife, AL Goldenhar, LM Fruend, E Stock, A Halperin, W TI Carbon monoxide poisoning from gasoline-powered engines: Risk perception among Midwest flood victims SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter C1 NIOSH,CINCINNATI,OH 45226. NR 5 TC 7 Z9 7 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD MAR PY 1997 VL 87 IS 3 BP 466 EP 467 DI 10.2105/AJPH.87.3.466 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WR017 UT WOS:A1997WR01700032 PM 9096558 ER PT J AU Mills, JN Ksiazek, TG Ellis, BA Rollin, PE Nichol, ST Yates, TL Gannon, WL Levy, CE Engelthaler, DM Davis, T Tanda, DT Frampton, JW Nichols, CR Peters, CJ Childs, JE AF Mills, JN Ksiazek, TG Ellis, BA Rollin, PE Nichol, ST Yates, TL Gannon, WL Levy, CE Engelthaler, DM Davis, T Tanda, DT Frampton, JW Nichols, CR Peters, CJ Childs, JE TI Patterns of association with host and habitat: Antibody reactive with Sin Nombre virus in small mammals in the major biotic communities of the southwestern United States SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID ARGENTINE HEMORRHAGIC-FEVER; GENETIC IDENTIFICATION; ETIOLOGIC AGENT; RODENT RESERVOIR; JUNIN VIRUS; HANTAVIRUS; INFECTION; POPULATIONS; PREVALENCE; OUTBREAK AB The distribution and prevalence of antibody reactive with Sin Nombre virus were determined in mammals in biotic communities of the southwestern United States. Small mammals (n = 3,069) of 69 species were trapped in nine communities from lower Sonoran desert to alpine tundra. Antibody was found in rodents from all communities (overall prevalence = 6.3%); prevalence was lowest at the altitudinal and climatic extremes (0.4% in desert and 2.0% in alpine tundra). Antibody occurred in 11% of 928 deer mice, 20% of 355 brush mice, 23% of 35 western harvest mice, and 12% of 24 Mexican voles. No infected deer mice were found in desert habitat; prevalence varied from 4% in chaparral to 17% in pinyon-juniper. Brush mice were frequently infected in chaparral and montane forest (25%). Seropositivity was higher in males and in heavier animals, suggesting horizontal transmission among adult males. Decreasing prevalence with age among the youngest deer mice suggests that infected dams confer passive immunity to pups. C1 JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT MOL MICROBIOL & IMMUNOL,BALTIMORE,MD 21205. UNIV NEW MEXICO,DEPT BIOL,MUSEUM SW BIOL,ALBUQUERQUE,NM 87131. ARIZONA DEPT HLTH SERV,VECTOR BORNE & ZOONOT DIS SECT,PHOENIX,AZ 85015. COLORADO DEPT PUBL HLTH & ENVIRONM,DENVER,CO 80222. UTAH DEPT HLTH,BUR EPIDEMIOL,SALT LAKE CITY,UT 84116. RP Mills, JN (reprint author), CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,VIRAL & RICKETTSIAL ZOONOSES BRANCH,ATLANTA,GA 30333, USA. RI Childs, James/B-4002-2012 NR 39 TC 156 Z9 159 U1 0 U2 8 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD MAR PY 1997 VL 56 IS 3 BP 273 EP 284 PG 12 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WW087 UT WOS:A1997WW08700005 PM 9129529 ER PT J AU Kolbe, LJ Collins, J Cortese, P AF Kolbe, LJ Collins, J Cortese, P TI Building the capacity of schools to improve the health of the nation - A call for assistance from psychologists SO AMERICAN PSYCHOLOGIST LA English DT Article ID HIV-INFECTION; ADOLESCENTS; EDUCATION; PROGRAM AB During the past several years, about two dozen major reports have called for the nation to reconceive and regenerate its school health programs. Proposals to reform health, education, and social services have included means to improve such programs. This article (a) identifies the leading causes of mortality and morbidity in the United States, (b) delineates 6 categories of behavior established during youth that contribute to these causes, (c) outlines ways in which a modem school health program might prevent such behaviors and address critical health and social problems among students, (d) describes practical research and development strategies that are being established to help schools implement effective school health programs, and (e) suggests how psychologists might help improve these programs. RP Kolbe, LJ (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV ADOLESCENT & SCH HLTH,ATLANTA,GA 30341, USA. NR 64 TC 45 Z9 46 U1 0 U2 2 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD MAR PY 1997 VL 52 IS 3 BP 256 EP 265 PG 10 WC Psychology, Multidisciplinary SC Psychology GA WM099 UT WOS:A1997WM09900007 PM 9104091 ER PT J AU Khine, HH Corddry, DH Kettrick, RG Martin, TM McCloskey, JJ Rose, JB Theroux, MC Zagnoev, M AF Khine, HH Corddry, DH Kettrick, RG Martin, TM McCloskey, JJ Rose, JB Theroux, MC Zagnoev, M TI Comparison of cuffed and uncuffed endotracheal tubes in young children during general anesthesia SO ANESTHESIOLOGY LA English DT Article DE anesthesia, endotracheal tube, formula, fresh gas flow, operating room contamination, nitrous oxide, pediatric, cuffed endotracheal tube AB Background: Uncuffed endotracheal tubes are routinely used in young children. This study tests a formula for selecting appropriately sized cuffed endotracheal tubes and compares the use of cuffed versus uncuffed endotracheal tubes for patients whose lungs are mechanically ventilated during anesthesia. Methods: Full-term newborns and children (n = 488) through 8 yr of age who required general anesthesia and tracheal intubation were assigned randomly to receive either a cuffed tube sized by a new formula [size(mm internal diameter) = (age/4) + 3], or an uncuffed tube sized by the modified Cole's formula [size(mm internal diameter) = (age/4) + 4]. The number of intubations required to achieve an appropriately sized tube, the need to use more than 21 . min(-1) fresh gas flow, the concentration of nitrous oxide in the operating room, and the incidence of croup were compared. Results: Cuffed tubes selected by our formula were appropriate for 99% of patients, Uncuffed tubes selected by Cole's formula were appropriate for 77% of patients (P < 0.001). The lungs of patients with cuffed tubes were adequately ventilated with 2 1 . min(-1) fresh gas flow, whereas 11% of those with uncuffed tubes needed greater fresh gas flow (P < 0.001), Ambient nitrous oxide concentration exceeded 25 parts per million in 37% of cases with uncuffed tubes and in 0% of cases with cuffed tubes (P < 0.001). Three patients in each group were treated for croup symptoms (1.2% cuffed; 1.3% uncuffed). Conclusions Our formula for cuffed tube selection is appropriate for young children. Advantages of cuffed endotracheal tubes include avoidance of repeated laryngoscopy, use of low fresh gas flow, and reduction of the concentration of anesthetics detectable in the operating room. We conclude that cuffed endotracheal tubes may be used routinely during controlled ventilation in full-term newborns and children during anesthesia. C1 THOMAS JEFFERSON UNIV,JEFFERSON MED COLL,PHILADELPHIA,PA 19107. NEMOURS CHILDREN CLIN,JACKSONVILLE,FL. LONG BEACH MEM HOSP,LONG BEACH,CA. CTR DIS CONTROL & PREVENT,US DEPT HLTH & HUMAN SERV,ATLANTA,GA. RP Khine, HH (reprint author), DUPONT HOSP CHILDREN,EDITORIAL SERV,DEPT ANESTHESIOL & CRIT CARE,1600 ROCKLAND RD,WILMINGTON,DE 19899, USA. NR 13 TC 194 Z9 198 U1 0 U2 2 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0003-3022 J9 ANESTHESIOLOGY JI Anesthesiology PD MAR PY 1997 VL 86 IS 3 BP 627 EP 631 DI 10.1097/00000542-199703000-00015 PG 5 WC Anesthesiology SC Anesthesiology GA WM546 UT WOS:A1997WM54600017 PM 9066329 ER PT J AU Ives, TJ Manzewitsch, P Regnery, RL Butts, JD Kebede, M AF Ives, TJ Manzewitsch, P Regnery, RL Butts, JD Kebede, M TI In vitro susceptibilities of Bartonella henselae, B-quintana, B-elizabethae, Rickettsia rickettsii, R-conorii, R-akari, and R-prowazekii to macrolide antibiotics as determined by immunofluorescent-antibody analysis of infected vero cell monolayers SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID CAT-SCRATCH DISEASE; HUMAN POLYMORPHONUCLEAR LEUKOCYTES; HUMAN-IMMUNODEFICIENCY-VIRUS; TISSUE-CULTURE CELLS; ROCHALIMAEA-HENSELAE; SPOTTED-FEVER; BACILLARY ANGIOMATOSIS; SP-NOV; INVITRO; CLARITHROMYCIN AB The in vitro susceptibilities of Bartonella (Rochalimaea) henselae, B. quintana, B, elizabethae, Rickettsia akari, R. conorii, R, prowazekii, and R, rickettsii to different concentrations of azithromycin, clarithromycin, dirithromycin, erythromycin, and roxithromycin in Vero cell cultures were evaluated, Bartonella and Rickettsia spp. were allowed to initiate infection of the antibiotic-free Vero cell monolayers, which were maintained in 16-chamber microscope slides in the absence of antibiotics at 32 degrees C in a CO2-enriched atmosphere, The monolayers were then incubated for 3 h to allow for initial host cell intracellular penetration by infecting species. After inoculation, inocula were replaced and tested with media containing 12 different concentrations of each antibiotic in replicate (10 wells of each antibiotic dilution) for each species, and the monolayers were reincubated, Tetracycline served as the control, Growth status of Bartonella spp. and Rickettsia spp, was determined by evaluation of immunofluorescent staining bacilli, Five days later, when antibiotic-free, control-infected cell monolayers demonstrated significant fluorescence, media were removed for all cell monolayers, the monolayers were fixed, and all specimens were stained with standard indirect immunofluorescent antibody reagents, Fluorescent foci were enumerated by counting such foci on random fields visualized with an epifluorescence microscope, The extent of antibiotic-induced focus inhibition was recorded for each dilution of antibiotic and compared with that of an antibiotic-negative control, Effective antibiotic dilution endpoints for inhibition of Bartonella and Rickettsia proliferation, as judged by absence of increase of significant fluorescence (as compared with no-growth controls), were enumerated by determining the number of cell culture chambers at various antibiotic dilutions that were negative or positive for significant Bartonella- or Rickettsia-specific fluorescence. All of the macrolide agents tested were readily active against all three Bartonella organisms, and azithromycin, clarithromycin, and roxithromycin may have potential in the treatment of Rickettsia infections, Animal model-based clinical trials are warranted to define the specific treatment role of the newer macrolide antibiotics. C1 UNIV N CAROLINA,SCH PHARM,DEPT FAMILY MED,CHAPEL HILL,NC 27599. CTR DIS CONTROL & PREVENT,VIRAL & RICKETTSIAL BRANCH,ATLANTA,GA. UNIV N CAROLINA HOSP,DEPT PHARM,CHAPEL HILL,NC. RP Ives, TJ (reprint author), UNIV N CAROLINA,SCH MED,DEPT FAMILY MED,CAMPUS BOX 7595,CHAPEL HILL,NC 27599, USA. NR 45 TC 42 Z9 45 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD MAR PY 1997 VL 41 IS 3 BP 578 EP 582 PG 5 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA WL111 UT WOS:A1997WL11100015 PM 9055996 ER PT J AU Rasheed, JK Jay, C Metchock, B Berkowitz, F Weigel, L Crellin, J Steward, C Hill, B Medeiros, AA Tenover, FC AF Rasheed, JK Jay, C Metchock, B Berkowitz, F Weigel, L Crellin, J Steward, C Hill, B Medeiros, AA Tenover, FC TI Evolution of extended-spectrum beta-lactam resistance (SHV-8) in a strain of Escherichia coli during multiple episodes of bacteremia SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID SELECTIVE CEFTAZIDIME RESISTANCE; FIELD GEL-ELECTROPHORESIS; KLEBSIELLA-PNEUMONIAE; NUCLEOTIDE-SEQUENCE; 3RD-GENERATION CEPHALOSPORINS; MOLECULAR CHARACTERIZATION; CEFOTAXIME RESISTANCE; PLASMID; GENE; ENTEROBACTERIACEAE AB Nine isolates of Escherichia coli were recovered from seven blood cultures over a period of 3 months from a 19-month-old female with aplastic anemia. Initial isolates were susceptible to extended-spectrum cephalosporins, including ceftazidime (MIC, less than or equal to 0.25 mu g/ml), but gradually became resistant to this drug (MICs, greater than or equal to 128 mu g/ml) and other cephalosporins and the monobactam aztreonam. Molecular typing methods, including plasmid profile analysis, pulsed-field gel electrophoresis, and arbitrarily primed PCR, indicated that the nine isolates were derived from a common ancestor. Dot blot hybridization and PCR analysis of total bacterial DNA using bla(SHV)- and bla(TEM)-specific DNA probes and primers identified the presence of a bla(TEM) beta-lactamase gene in all of the isolates and a bla(SHV) gene in the isolates with elevated ceftazidime MICs. Isoelectric focusing analysis of crude lysates showed that all nine isolates contained an enzyme with a pi of 5.4 corresponding to the TEM-1 beta-lactamase, and those isolates containing an SHV-type beta-lactamase demonstrated an additional band with a pi of 7.6. The first of the ceftazidime-resistant isolates appeared to hyperproduce the SHV enzyme compared to the other resistant isolates. DNA sequencing revealed a bla(SHV-1) gene in the first ceftazidine-resistant isolate and a novel bla(SHV) gene, bla(SHV-8), with an Asp-to-Asn substitution at amino acid position 179 in the remaining four isolates. Three of the ceftazidime-resistant isolates also showed a change in porin profile. The patient had received multiple courses of antimicrobial agents during her illness, including multiple courses of ceftazidime. This collection of blood isolates from the same patient appears to represent the in vivo evolution of resistance under selective pressure of treatment with various cephalosporins. C1 CTR DIS CONTROL & PREVENT,NOSOCOMIAL PATHOGENS LAB BRANCH G08,ATLANTA,GA 30333. BIOMERIEUX SA,LA BALME GROTTES,FRANCE. EMORY UNIV,SCH MED,ATLANTA,GA 30329. MIRIAM HOSP,PROVIDENCE,RI 02906. NR 54 TC 178 Z9 195 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD MAR PY 1997 VL 41 IS 3 BP 647 EP 653 PG 7 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA WL111 UT WOS:A1997WL11100027 PM 9056008 ER PT J AU Mosley, D Komatsu, K Vaz, V Vertz, D England, B Ampel, NM AF Mosley, D Komatsu, K Vaz, V Vertz, D England, B Ampel, NM TI Coccidioidomycosis - Arizona, 1990-1995 (Reprinted from MMWR, vol 45, pg 1069, 1996) SO ARCHIVES OF DERMATOLOGY LA English DT Reprint C1 UNIV ARIZONA,TUCSON,AZ 85721. VET AFFAIRS MED CTR,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,SURVEILL BRANCH,DIV HIV-AIDS PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,CHILDHOOD & RESPIRAT BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. RP Mosley, D (reprint author), ARIZONA DEPT HLTH SERV,TUCSON,AZ 85721, 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 SN 0003-987X J9 ARCH DERMATOL JI Arch. Dermatol. PD MAR PY 1997 VL 133 IS 3 BP 403 EP 404 PG 2 WC Dermatology SC Dermatology GA WN865 UT WOS:A1997WN86500031 ER PT J AU Bannerman, TL Rhoden, DL McAllister, SK Miller, JM Wilson, LA AF Bannerman, TL Rhoden, DL McAllister, SK Miller, JM Wilson, LA TI The source of coagulase-negative staphylococci in the endophthalmitis vitrectomy study - A comparison of eyelid and intraocular isolates using pulsed-field gel electrophoresis SO ARCHIVES OF OPHTHALMOLOGY LA English DT Article ID ACUTE POSTOPERATIVE ENDOPHTHALMITIS; IDENTIFICATION AB Objective: To determine the species distribution of coagulase-negative staphylococci (CoNS) inpatients with endophthalmitis and to ascertain whether the patient's own flora was a major source of postoperative endophthalmitis following cataract extraction. Methods: In a 4-year multicenter prospective study, 524 bacterial isolates were submitted from 225 Endophthalmitis Vitrectomy Study patients. From the 524 isolates, 250 represented CoNS cultured from the anterior chamber, the vitreous, or both of the 225 patients. Where possible, paired isolates from an individual patient's eyelid and intraocular compartment(s) were studied by pulsed-field gel electrophoresis, an established molecular strain-typing technique. Results: From all sites the most frequently isolated CoNS were Staphylococcus epidermidis (81.9%) and Staphylococcus lugdunensis (5.9%). Where analysis was possible, eyelid isolates were indistinguishable from intraocular isolates in 71 (67.7%) of 105 comparisons. Non-S epidermidis CoNS caused postoperative endophthalmitis in 5 patients. Four of the 5 had postoperative endophthalmitis caused by S lugdunensis and 1 by Staphylococcus haemolyticus. Conclusions: Coagulase-negative staphylococci from the patient's periocular skin flora play a significant role in causing intraocular infections, and non-S epidermidis CoNS play a small but significant role. These results reinforce the necessity to follow stringent surgical site preparation prior to eye surgery. C1 CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,ATLANTA,GA. EMORY UNIV,SCH MED,CTR EYE,ATLANTA,GA. RI Bannerman, Tammy/E-2694-2011 FU NEI NIH HHS [EY08151, EY08150, EY08210] NR 14 TC 111 Z9 126 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9950 J9 ARCH OPHTHALMOL-CHIC JI Arch. Ophthalmol. PD MAR PY 1997 VL 115 IS 3 BP 357 EP 361 PG 5 WC Ophthalmology SC Ophthalmology GA WN485 UT WOS:A1997WN48500008 PM 9076208 ER PT J AU Thacker, SB AF Thacker, SB TI Lessons in technology diffusion: The electronic fetal monitoring experience SO BIRTH-ISSUES IN PERINATAL CARE LA English DT Editorial Material RP Thacker, SB (reprint author), CTR DIS CONTROL & PREVENT,EPIDEMIOL PROGRAM OFF,1600 CLIFTON RD NE,MS-C08,ATLANTA,GA 30333, USA. NR 13 TC 6 Z9 6 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 SN 0730-7659 J9 BIRTH-ISS PERINAT C JI Birth-Issue Perinat. Care PD MAR PY 1997 VL 24 IS 1 BP 58 EP 60 PG 3 WC Nursing; Obstetrics & Gynecology; Pediatrics SC Nursing; Obstetrics & Gynecology; Pediatrics GA WT018 UT WOS:A1997WT01800010 PM 9271969 ER PT J AU Woods, TC Roberts, BD Butera, ST Folks, TM AF Woods, TC Roberts, BD Butera, ST Folks, TM TI Loss of inducible virus in CD45RA naive cells after human immunodeficiency virus-1 entry accounts for preferential viral replication in CD45RO memory cells SO BLOOD LA English DT Article ID T-CELLS; LYMPHOCYTES-T; HIV-1 INFECTION; SELECTIVE LOSS; ACTIVATION; EXPRESSION; SUBSETS; INDIVIDUALS; INCREASE; ANTIGEN AB Controversy exists concerning the preferential infection and replication of human immunodeficiency virus-1 (HIV-1) within naive (CD45RA(+)) and memory (CD45RO(+)) subsets of CD4(+) lymphocytes. To explore the susceptibility of these subsets to HIV-1 infection, we purified CD45RA(+)/CD4(+) (RA) and CD45RO(+)/CD4(+) (RO) cells from normal donors and subjected them to a novel monokine activation culture scheme. Following HIV-1 infection and interleukin-2 (IL-2) induction, viral production measured on day 13 was 19-fold greater in Ho cultures compared with HA cultures. Il-2-stimulated proliferation in uninfected control cultures was equivalent. To explore the mechanisms by which RA cells were reduced in viral production capacity, RA and Ho cells were exposed to HIV-1 followed by treatment with trypsin, and then phytohemagglutinin antigen (PHA)-stimulated at days 4, 7, and 10 postinfection, HIV-1 production in day 4 postinfection RA and RO cultures was analogous, indicating that viral fusion and entry had occurred in both cell types. However, whereas similarly treated day 7 and 10 postinfection RO cultures produced virus, HIV-1 was markedly reduced or lost in the corresponding RA cultures. These results suggest that a temporally labile postfusion HIV-1 complex exists in unstimulated RA cells that requires cellular activation signals beyond that provided by IL-2 alone for productive infection. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV AIDS STD & TB LAB RES,RETROVIRUS DIS BRANCH,ATLANTA,GA. NR 32 TC 80 Z9 80 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0006-4971 J9 BLOOD JI Blood PD MAR 1 PY 1997 VL 89 IS 5 BP 1635 EP 1641 PG 7 WC Hematology SC Hematology GA WK477 UT WOS:A1997WK47700021 PM 9057646 ER PT J AU Tepper, A Burt, S Piacitelli, L Patterson, DG AF Tepper, A Burt, S Piacitelli, L Patterson, DG TI Serum levels of polychlorinated dibenzo-p-dioxins and dibenzofurans in pulp and paper mill workers SO CHEMOSPHERE LA English DT Article; Proceedings Paper CT 15th International Symposium on Chlorinated Dioxins, PCB and Related Compounds CY AUG 21-25, 1995 CL EDMONTON, CANADA ID MASS-SPECTROMETRIC ANALYSIS; VIETNAM VETERANS; ADIPOSE-TISSUE; AGENT ORANGE; NEW-HAMPSHIRE; HUMAN-BLOOD; MORTALITY; INDUSTRY; 2,3,7,8-TETRACHLORODIBENZO-P-DIOXIN; 2,3,7,8-TCDD AB Serum levels of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) among 46 long-term workers at a pulp and paper mill were compared to the levels in 16 community residents who never worked at the mill. Overall, there were no appreciable differences among the three exposure groups (community resident, low-exposure-potential worker, high-exposure-potential worker) for specific PCDDs or PCDFs. Neither exposure group nor duration in high-exposure-potential-jobs was related to total toxic equivalents (I-TEQ). Serum levels of PCDDs and PCDFs in this study generally were within the range previously reported for persons with no known occupational exposure. Published by Elsevier Science Ltd. C1 CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30341. RP Tepper, A (reprint author), NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDI,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 40 TC 12 Z9 15 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0045-6535 J9 CHEMOSPHERE JI Chemosphere PD MAR-APR PY 1997 VL 34 IS 5-7 BP 1587 EP 1603 DI 10.1016/S0045-6535(97)00455-4 PG 17 WC Environmental Sciences SC Environmental Sciences & Ecology GA WR677 UT WOS:A1997WR67700060 PM 9134690 ER PT J AU Embil, J Warren, P Yakrus, M Stark, R Corne, S Forrest, D Hershfield, E AF Embil, J Warren, P Yakrus, M Stark, R Corne, S Forrest, D Hershfield, E TI Pulmonary illness associated with exposure to Mycobacterium-avium complex in hot tub water - Hypersensitivity pneumonitis or infection? SO CHEST LA English DT Article DE atypical pneumonia; hot tub, water; hypersensitivity pneumonitis; Mycobacterium avium complex ID EXTRINSIC ALLERGIC ALVEOLITIS; HUMIDIFIER LUNG; NONTUBERCULOUS MYCOBACTERIA; INTRACELLULARE; FEVER; COLONIZATION; EPIDEMIOLOGY; DIAGNOSIS; WHIRLPOOL; DISEASE AB Background: Mycobacterium avium complex is common in water. When aerosolized, it is frequently inhaled but rarely causes illness in healthy people. Hypersensitivity pneumonitis to inhaled aerosols has been described; these aerosols are from several sources of water. The pneumonitis forms are collectively known as humidifier lung; the responsible agent in the water remains uncertain. Purpose: To report five cases of respiratory illness in healthy subjects using hot tubs contaminated with M avium complex. Design: Descriptive case reports. Setting: Consultations in two teaching hospitals. Patients: Five healthy people developed respiratory illnesses characterized by bronchitis, fever, and ''flu-like'' symptoms after using a hot tub. Acute exacerbations of their illness developed within hours of heavy use of the hot tubs. Investigations: A chest radiograph and sputum culture in all, BAL in one, CT scan and lung biopsy in another were performed. Culture of the water of the two hot tubs also was done. Results: Chest radiographs showed interstitial infiltrates or a miliary nodular pattern. Cultures of all sputum samples, the lung biopsy specimens, lung lavage and water samples were positive for M avium complex. The lung biopsy specimen revealed noncaseating granulomas. An patients recovered with no treatment for M avium complex. Conclusion: We conclude that the M avium complex in the water was responsible for the pulmonary illnesses. The symptoms and the results of investigations are more suggestive of a hypersensitivity pneumonitis than of an infection, but no serologic proof of an immunologic reaction to the M avium complex or water was obtained. C1 UNIV MANITOBA,DEPT MED,WINNIPEG,MB,CANADA. CTR DIS CONTROL & PREVENT,DIV BACTERIAL & MYCOT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA. UNIV MANITOBA,DEPT PATHOL,WINNIPEG,MB R3T 2N2,CANADA. NR 32 TC 108 Z9 113 U1 0 U2 1 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 SN 0012-3692 J9 CHEST JI Chest PD MAR PY 1997 VL 111 IS 3 BP 813 EP 816 DI 10.1378/chest.111.3.813 PG 4 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA WM946 UT WOS:A1997WM94600047 PM 9118726 ER PT J AU Maslanka, SE Gheesling, LL Libutti, DE Donaldson, KBJ Harakeh, HS Dykes, JK Arhin, FF Devi, SJN Frasch, CE Huang, JC KrizKuzemenska, P Lemmon, RD Lorange, M Peeters, CCAM Quataert, S Tai, JY Carlone, GM Mills, EL Ashton, FE Diepevaen, J Bielecki, J Bybel, M Cloutier, M Poolman, JT AF Maslanka, SE Gheesling, LL Libutti, DE Donaldson, KBJ Harakeh, HS Dykes, JK Arhin, FF Devi, SJN Frasch, CE Huang, JC KrizKuzemenska, P Lemmon, RD Lorange, M Peeters, CCAM Quataert, S Tai, JY Carlone, GM Mills, EL Ashton, FE Diepevaen, J Bielecki, J Bybel, M Cloutier, M Poolman, JT TI Standardization and a multilaboratory comparison of Neisseria meningitidis serogroup A and C serum bactericidal assays SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; CAPSULAR POLYSACCHARIDE; GROUP-A; ANTIBODY; VACCINE; PROTECTION; CHILDREN; EFFICACY; DURATION; AGE AB A standardized serum bactericidal assay (SEA) is required to evaluate the functional activity of antibody produced in response to Neisseria meningitidis serogroup A and C vaccines. We evaluated assay parameters (assay buffer, target strains, growth of target cells, target cell number, complement source and concentration, and methods for growth of surviving bacteria) which may affect the reproducibility of SEA titers. The various assay parameters and specificity of anticapsular antibody to five serogroup A strains (A1, ATCC 13077, F8238, F9205, and F7485) and four serogroup C strains (C11, G7880, G8050, and 1002-90) were evaluated with Centers for Disease Control and Prevention meningococcal quality control sera. The critical assay parameters for the reproducible measurement of SEA titers were found to include the target strain, assay incubation time, and complement. The resulting standardized SEA was used by 10 laboratories to measure functional anticapsular antibody against serogroup A strain F8238 and serogroup C strain C11. In the multilaboratory study, SBA titers were measured in duplicate for 14 pairs of sera (seven adults and seven children) before and after immunization with a quadrivalent polysaccharide (A C, Y, and W-135) vaccine. The standardized SEA was reliable in all laboratories regardless of experience in performing SBAs. For most sera, intralaboratory reproducibility was +/-1 dilution; interlaboratory reproducibility was +/-2 dilutions. The correlation between median titers (interlaboratory) and enzyme-linked immunosorbent assay total antibody concentrations was high for both serogroup A (r = 0.86; P < 0.001; slope 0.5) and serogroup C (n = 0.86; P < 0.001; slope = 0.7). The specified assay, which includes the critical parameters of target strain, incubation time, and complement source, will facilitate interlaboratory comparisons of the functional antibody produced in response to current or developing serogroup A and C meningococcal vaccines. C1 MCGILL UNIV,MONTREAL,PQ H3A 2T5,CANADA. LAB CTR DIS CONTROL,OTTAWA,ON K1A 0L2,CANADA. QUEBEC PUBL HLTH LAB,QUEBEC CITY,PQ,CANADA. US FDA,BETHESDA,MD 20892. NATL PUBL HLTH INST,PRAGUE,CZECH REPUBLIC. CONNAUGHT LABS INC,SWIFTWATER,PA 18370. NATL INST PUBL HLTH & ENVIRONM PROTECT,NL-3720 BA BILTHOVEN,NETHERLANDS. LEDERLE PRAXIS BIOL INC,W HENRIETTA,NY 14586. N AMER VACCINE INC,BELTSVILLE,MD 20705. RP Maslanka, SE (reprint author), CTR DIS CONTROL & PREVENT,CHILDHOOD & RESP DIS BRANCH,NATL CTR INFECT DIS,1600 CLIFTON RD,ATLANTA,GA 30333, USA. RI Krizova, Pavla/M-6120-2015; OI Bielecki, Joanna/0000-0002-1830-4219 NR 40 TC 287 Z9 295 U1 0 U2 4 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD MAR PY 1997 VL 4 IS 2 BP 156 EP 167 PG 12 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WL504 UT WOS:A1997WL50400009 PM 9067649 ER PT J AU OGorman, MRG Gelman, R Folds, J Wilkening, C Spritzler, J Weng, D Landay, A Mandy, F Waxdal, M Monical, C Paxton, H Blum, S Lowell, C Hartz, T Denny, T Douglas, S Nicholson, J Plaeger, S Ward, B SchnitzleinBick, C Kagan, J Livnat, D AF OGorman, MRG Gelman, R Folds, J Wilkening, C Spritzler, J Weng, D Landay, A Mandy, F Waxdal, M Monical, C Paxton, H Blum, S Lowell, C Hartz, T Denny, T Douglas, S Nicholson, J Plaeger, S Ward, B SchnitzleinBick, C Kagan, J Livnat, D TI Inter- and intrainstitutional evaluation of automated volumetric capillary cytometry for the quantitation of CD4- and CD8-positive T lymphocytes in the peripheral blood of persons infected with human immunodeficiency virus SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID FLOW-CYTOMETRY; HIV-INFECTION; COUNTS; ENUMERATION; HEMATOLOGY; IMMUNOASSAY; PRECISION; SUBSETS; PROGRAM AB Volumetric capillary cytometry (VCC) is a new technology that involves the detection and enumeration of dually fluorochrome-labeled cells in a precise volume. We compared the accuracy and precision of VCC with the accuracy and precision of how cytometry and hematology (F&H) for the measurement of the absolute numbers of CD4 and CD8 T cells in the whole blood of patients infected with human immunodeficiency virus. Five laboratories, each with a different F&H system and certified by the National Institute of Allergy and Infectious Diseases flow cytometry proficiency testing program, were shipped aliquots of the same samples from a central site in addition to procuring samples locally. In general, the VCC technology generated CD4 and CD8 T-cell counts which were lower than those obtained with F&H. Intralaboratory variability of replicate CD4 T-cell determinations was similar for both technologies except in the local samples with CD4 counts less than 200/mu l, where the VCC variability was higher than the F&H variability. Interlaboratory variability on replicate CD4 T-cell counts made by VCC was significantly less than that when counts were made by F&H. The VCC instrument has automated CD4 and CD8 T-cell enumeration in whole blood and has consolidated the process to a single platform. Its performance in this evaluation indicates that it may represent a viable alternative to F&H for obtaining absolute T-cell subset counts. C1 NORTHWESTERN UNIV,SCH MED,DEPT PEDIAT,CHICAGO,IL 60614. HARVARD UNIV,SCH PUBL HLTH,BOSTON,MA 02146. UNIV N CAROLINA,CHAPEL HILL,NC 27515. RUSH PRESBYTERIAN ST LUKES MED CTR,CHICAGO,IL 60612. CHILDRENS HOSP PHILADELPHIA,PHILADELPHIA,PA 19104. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. NORTHWESTERN UNIV,SCH MED,EVANSTON,IL 60208. UNIV CALIF LOS ANGELES,LOS ANGELES,CA 90024. US DEPT DEF,WASHINGTON,DC 20305. INDIANA UNIV,BLOOMINGTON,IN 47405. RP OGorman, MRG (reprint author), CHILDRENS MEM HOSP,2300 CHILDRENS PLAZA,CHICAGO,IL 60614, USA. OI Denny, Thomas/0000-0002-7364-8276 NR 23 TC 24 Z9 24 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD MAR PY 1997 VL 4 IS 2 BP 173 EP 179 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WL504 UT WOS:A1997WL50400011 PM 9067651 ER PT J AU Dworkin, MS Anderson, DE Thompson, E Gautom, RK Fritsche, TR AF Dworkin, MS Anderson, DE Thompson, E Gautom, RK Fritsche, TR TI Photo quiz - Relapse of Plasmodium vivax malaria with the presence of microgametes SO CLINICAL INFECTIOUS DISEASES LA English DT Article RP Dworkin, MS (reprint author), CTR DIS CONTROL & PREVENT,MAILSTOP E-47,ATLANTA,GA 30333, USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAR PY 1997 VL 24 IS 3 BP 303 EP & PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK382 UT WOS:A1997WK38200002 PM 9114176 ER PT J AU Musher, DM Groover, JE Reichler, MR Riedo, FX Schwartz, B Watson, DA Baughn, RE Breiman, RF AF Musher, DM Groover, JE Reichler, MR Riedo, FX Schwartz, B Watson, DA Baughn, RE Breiman, RF TI Emergence of antibody to capsular polysaccharides of Streptococcus pneumoniae during outbreaks of pneumonia: Association with nasopharyngeal colonization SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID CELL-WALL POLYSACCHARIDE; VACCINE; INFECTIONS; SEROTYPES; CHILDREN; INFANTS; LIFE AB Antibody to pneumococcal capsular polysaccharides (PPS) of Streptococcus pneumoniae plays a major role in protecting the host against pneumococcal infection. ii variable proportion of healthy adults have antibody to PPS, often in the absence of recognized pneumococcal infection. To determine whether exposure to pneumococci or colonization by pneumococci, or both, stimulates the emergence of antibody to PPS, we studied outbreaks of pneumonia at two military camps, Of the men who were present at a military training camp during an outbreak of pneumonia due to S. pneumoniae serotype 1 but who did not develop pneumonia, 27.8% had IgG antibody to PPS 1, whereas only 3.6% of controls had this antibody. In another outbreak caused by S. pneumoniae serotypes 7F and 8, 35.9% of asymptomatic soldiers who had nasopharyngeal colonization by one of these strains had antibody to the relevant PPS, and another 30.8% who originally did not have antibody developed it within 30 days; thus, 66.7% of these soldiers had antibody to the relevant PPS, These data show that serotype-specific antibody promptly appears following exposure to an outbreak of pneumococcal pneumonia and is probably mediated through acquisition of nasopharyngeal pneumococcal carriage. C1 BAYLOR COLL MED,DEPT MED,HOUSTON,TX 77030. BAYLOR COLL MED,DEPT MICROBIOL IMMUNOL,HOUSTON,TX 77030. CTR DIS CONTROL & PREVENT,RES PATHOGENS BRANCH,ATLANTA,GA. RP Musher, DM (reprint author), DEPT VET AFFAIRS MED CTR,INFECT DIS SECT 111G,MED SERV,ROOM 4B-370,2002 HOLCOMBE BLVD,HOUSTON,TX 77030, USA. NR 26 TC 69 Z9 69 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAR PY 1997 VL 24 IS 3 BP 441 EP 446 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK382 UT WOS:A1997WK38200023 PM 9114197 ER PT J AU Bryan, RT Weber, R Schwartz, DA AF Bryan, RT Weber, R Schwartz, DA TI Microsporidiosis in patients who are not infected with human immunodeficiency virus SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID ENTEROCYTOZOON-BIENEUSI; DIARRHEA; LIVER C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ALBUQUERQUE,NM. EMORY UNIV,SCH MED,DEPT PATHOL,ATLANTA,GA 30322. UNIV SPITAL ZURICH,DEPT MED,DIV INFECT DIS & HOSP EPIDEMIOL,ZURICH,SWITZERLAND. RI Infektiologie, USZ/A-6921-2011; Weber, Rainer/D-5175-2012 NR 11 TC 22 Z9 22 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD MAR PY 1997 VL 24 IS 3 BP 534 EP 535 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK382 UT WOS:A1997WK38200056 PM 9114227 ER PT J AU Davis, YM McCray, E AF Davis, YM McCray, E TI Hospital infection control practices for tuberculosis SO CLINICS IN CHEST MEDICINE LA English DT Article ID RESISTANT MYCOBACTERIUM-TUBERCULOSIS; HEALTH-CARE WORKERS; LENGTH-POLYMORPHISM ANALYSIS; NOSOCOMIAL TRANSMISSION; OUTBREAK; PERSONNEL; EFFICACY; PATIENT; AUTOPSY; UNIT AB Transmission of M. tuberculosis is a recognized risk to patients and healthcare workers in health-care facilities. Transmission is most Likely to occur from patients who have unrecognized pulmonary or laryngeal tuberculosis, are not on effective antituberculosis therapy, and have not been placed in isolation. Several recent tuberculosis outbreaks in health-care facilities, including outbreaks of multidrug-resistant tuberculosis, have heightened concern over nosocomial transmission. The primary goals for an effective tuberculosis infection control plan are early identification, isolation, and effective treatment of persons who have active tuberculosis. Although completely eliminating the risk for transmission of M. tuberculosis in all health-care facilities may not be possible at the present time, adherence to certain fundamental tuberculosis infection control measures should reduce the risk to persons in these settings. RP Davis, YM (reprint author), CTR DIS CONTROL & PREVENT,SURVEILLANCE & EPIDEMIOL BRANCH,DIV TB ELIMINAT,ATLANTA,GA 30333, USA. NR 43 TC 14 Z9 14 U1 1 U2 3 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0272-5231 J9 CLIN CHEST MED JI Clin. Chest Med. PD MAR PY 1997 VL 18 IS 1 BP 19 EP & DI 10.1016/S0272-5231(05)70353-1 PG 16 WC Respiratory System SC Respiratory System GA WR037 UT WOS:A1997WR03700003 PM 9098608 ER PT J AU McCray, E Weinbaum, CM Braden, CR Onorato, IM AF McCray, E Weinbaum, CM Braden, CR Onorato, IM TI The epidemiology of tuberculosis in the United States SO CLINICS IN CHEST MEDICINE LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; DRUG-RESISTANT TUBERCULOSIS; NEW-YORK-CITY; IMMUNE-DEFICIENCY-SYNDROME; DIRECTLY OBSERVED THERAPY; MYCOBACTERIUM-TUBERCULOSIS; NOSOCOMIAL TRANSMISSION; INFECTION; OUTBREAK; RISK AB The epidemiology of tuberculosis (TB) in the United States has changed dramatically since 1985, with increasing TB incidence through 1992, and a reversal in the upward trend beginning in 1993. The increase in TB incidence was attributed to the HIV epidemic, increased immigration from countries with a high prevalence of TB, and decreases in resources available to TB control programs. The decline in TB since 1993 has been attributed to improvement in TB control in the United States, and decreased transmission of TB in congregative settings such as hospitals. The current national decrease trend in TB incidence can be sustained through organized efforts by federal and private agencies and state and local health departments to ensure that all people with TB are identified and treated promptly. RP McCray, E (reprint author), CTR DIS CONTROL & PREVENT,SURVEILLANCE & EPIDEMIOL BRANCH,DIV TB ELIMINAT,ATLANTA,GA 30333, USA. NR 81 TC 37 Z9 39 U1 1 U2 1 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0272-5231 J9 CLIN CHEST MED JI Clin. Chest Med. PD MAR PY 1997 VL 18 IS 1 BP 99 EP & DI 10.1016/S0272-5231(05)70359-2 PG 16 WC Respiratory System SC Respiratory System GA WR037 UT WOS:A1997WR03700009 PM 9098614 ER PT J AU Fujiwara, PI Larkin, C Frieden, TR AF Fujiwara, PI Larkin, C Frieden, TR TI Directly observed therapy in New York city - History, implementation, results, and challenges SO CLINICS IN CHEST MEDICINE LA English DT Article ID DRUG-RESISTANT TUBERCULOSIS AB The history of the New York City Department of Health Bureau of Tuberculosis Control Program, and the events leading to the adoption of widescale directly observed therapy (DOT) in 1992 are described. The organization and role of Department of Health and non-Department of Health directly observed programs are discussed. Details are provided regarding the Department of Health's program: the use of standard treatment and program protocols, the use of incentives and enablers, a profile of the successful DOT worker, the detention program, and other issues. Program, data and outcomes from 1992 through 1995 are presented, along with some of the challenges and questions for the future. C1 CTR DIS CONTROL & PREVENT,DIV TB ELIMINAT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA. RP Fujiwara, PI (reprint author), NEW YORK CITY DEPT HLTH,BUR TB CTR,125 WORTH ST,BOX 74,ROOM 214,NEW YORK,NY 10013, USA. NR 28 TC 58 Z9 60 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0272-5231 J9 CLIN CHEST MED JI Clin. Chest Med. PD MAR PY 1997 VL 18 IS 1 BP 135 EP & DI 10.1016/S0272-5231(05)70363-4 PG 16 WC Respiratory System SC Respiratory System GA WR037 UT WOS:A1997WR03700013 PM 9098618 ER PT J AU Goldenberg, RL Andrews, WW Yuan, AC MacKay, HT StLouis, ME AF Goldenberg, RL Andrews, WW Yuan, AC MacKay, HT StLouis, ME TI Sexually transmitted diseases and adverse outcomes of pregnancy SO CLINICS IN PERINATOLOGY LA English DT Review ID LOW-BIRTH-WEIGHT; SIMPLEX VIRUS-INFECTIONS; CHLAMYDIA-TRACHOMATIS INFECTION; B STREPTOCOCCAL COLONIZATION; CONGENITAL CYTOMEGALOVIRUS-INFECTION; HUMAN-IMMUNODEFICIENCY-VIRUS; EARLY PRETERM LABOR; BACTERIAL VAGINOSIS; UNITED-STATES; RISK-FACTORS AB The effect of sexually transmitted diseases on various adverse outcomes of pregnancy owing to direct fetal and infant infection and increased preterm birth is estimated for the entire population of the United States. The large potential impact of bacterial vaginosis on adverse outcomes through an increased risk of preterm birth is emphasized. This type of analysis may be useful for priority determinations in research and intervention programs. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Goldenberg, RL (reprint author), UNIV ALABAMA,DEPT OBSTET GYNECOL,DIV MATERNAL FETAL MED,CTR OBSTET RES,618 S 20TH ST,BIRMINGHAM,AL 35233, USA. FU PHS HHS [290-92-0055] NR 123 TC 83 Z9 85 U1 3 U2 4 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0095-5108 J9 CLIN PERINATOL JI Clin. Perinatol. PD MAR PY 1997 VL 24 IS 1 BP 23 EP & PG 20 WC Obstetrics & Gynecology; Pediatrics SC Obstetrics & Gynecology; Pediatrics GA WR916 UT WOS:A1997WR91600003 PM 9099500 ER PT J AU YearginAllsopp, M Murphy, CC Cordero, JF Decoufle, P Hollowell, JG AF YearginAllsopp, M Murphy, CC Cordero, JF Decoufle, P Hollowell, JG TI Reported biomedical causes and associated medical conditions for mental retardation among 10-year-old children, metropolitan Atlanta, 1985 to 1987 SO DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY LA English DT Article ID DEVELOPMENTAL-DISABILITIES; PREVALENCE; ETIOLOGY; HANDICAP; RISK AB This report describes biomedical causes of mental retardation(MR) among school-age children and associated medical conditions in children for whom no cause was reported. This study involved 715, 10-year-old children with MR (intelligence quotient [IQ] 70 or less) born between 1975 and 1977. We determined biomedical causes of MR using a hierarchical approach based on the timing of the event (i.e. prenatal, perinatal, or postneonatal). Among children with no identified biomedical cause the occurrence of associated medical conditions was examined, No reported biomedical cause could be found in 78% of children with MR (87% mild, IQ 50 to 70; 57% severe, IQ < 50). Prenatal causes were present in 12%, perinatal causes in 6%, and postneonatal causes in 4%. On the basis of these findings it was concluded that intensive use of public health prevention strategies can reduce the number of children who receive a diagnosis of MR. C1 US DEPT HHS,NATL IMMUNIZATION PROGRAM,OFF DIRECTOR,CTR DIS CONTROL & PREVENT,PUBL HLTH SERV,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,DIV BIRTH DEFECTS & DEV DISABIL,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333. NR 45 TC 74 Z9 80 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 40 WEST 20TH STREET, NEW YORK, NY 10011-4211 SN 0012-1622 J9 DEV MED CHILD NEUROL JI Dev. Med. Child Neurol. PD MAR PY 1997 VL 39 IS 3 BP 142 EP 149 PG 8 WC Clinical Neurology; Pediatrics SC Neurosciences & Neurology; Pediatrics GA WT306 UT WOS:A1997WT30600002 PM 9112961 ER PT J AU Yang, QH Khoury, MJ Olney, RS Mulinare, J AF Yang, QH Khoury, MJ Olney, RS Mulinare, J TI Does periconceptional multivitamin use reduce the risk for limb deficiency in offspring? SO EPIDEMIOLOGY LA English DT Article DE multivitamins; limb deficiency; case-control study; maternal exposure ID NEURAL-TUBE DEFECTS; VITAMIN SUPPLEMENTATION; WESTERN-AUSTRALIA; EARLY-PREGNANCY; DIETARY-FOLATE; BIRTH-DEFECTS; PREVENTION; TRIMESTER AB There is accumulating evidence that periconceptional multivitamin use may prevent the occurrence of some birth defects other than neural tube defects. Using data from the population-based Atlanta Birth Defects Case-Control Study, we investigated the possible association between periconceptional multivitamin use and the occurrence of limb deficiency. We examined the periconceptional use of multivitamins among mothers of 117 babies with nonsyndromic limb deficiency who were liveborn or stillborn to residents of metropolitan Atlanta from 1968 to 1980 and among mothers of 3,029 control babies born without birth defects who were randomly selected through birth certificates. We found that children whose mothers were periconceptional multivitamin users had a lower risk of having a limb deficiency [odds ratio (OR) = 0.47; 95% confidence interval (CI) = 0.23-0.97]. This protective effect, however, was mostly seen for transverse limb deficiency (OR = 0.30; 95% CI = 0.07-1.32) and not for longitudinal deficiency (including preaxial and postaxial deficiencies; OR = 1.03; 95% CI = 0.17-4.30). Adjustment for potential confounding factors did not change these findings. We found a trend of decreasing risk for all transverse limb deficiencies with earlier vitamin use. These data indicate that mothers' periconceptional multivitamin use may reduce the risk for some types of limb deficiency among their offspring. In addition, because we did not find the protective effect for all types of limb deficiency, the data may also indicate causal heterogeneity of limb deficiencies. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30341. RP Yang, QH (reprint author), CTR DIS CONTROL & PREVENT,BIRTH DEFECTS & GENET DIS BRANCH,DIV BIRTH DEFECTS & DEV DISABIL,ATLANTA,GA 30341, USA. NR 30 TC 46 Z9 46 U1 0 U2 4 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD MAR PY 1997 VL 8 IS 2 BP 157 EP 161 DI 10.1097/00001648-199703000-00006 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WK432 UT WOS:A1997WK43200011 PM 9229207 ER PT J AU Escobedo, LG Caspersen, CJ AF Escobedo, LG Caspersen, CJ TI Risk factors for sudden coronary death in the United States SO EPIDEMIOLOGY LA English DT Article DE health surveys; heart disease; mortality; smoking; hypertension; diabetes mellitus; gender ID ACUTE MYOCARDIAL-INFARCTION; HEART-DISEASE MORTALITY; CARDIAC DEATH; EPIDEMIOLOGY; RESPONDENTS; INFORMATION; WOMEN; MEN AB We assessed risk factors for sudden coronary death among persons without a history of coronary heart disease (unexpected sudden coronary death) and persons with a history of coronary heart disease (sudden coronary heart disease death). We analyzed national data to calculate death rates and odds ratios for both types of sudden coronary death. Among modifiable factors that we examined, only cigarette smoking increased risk for unexpected sudden coronary death [odds ratio (OR) = 1.8; 95% confidence interval (CI) = 1.2-2.7]. Diabetes mellitus (OR = 3.8; 95% CI = 2.5-5.8 for women), cigarette smoking (OR = 1.5; 95% CI = 1.0-2.1), and hypertension (OR = 1.4; 95% CI = 1.1-1.9) increased the risk for sudden coronary heart disease death. Etiologic factors for sudden death appear to differ depending on the presence or absence of coronary disease. With preexisting coronary disease, factors associated with chronic coronary disease may elevate sudden death risk; without coronary disease, factors that provoke ventricular arrhythmias may trigger sudden death. C1 CTR DIS CONTROL & PREVENT,CARDIOVASC HLTH STUDIES BRANCH,ATLANTA,GA. RI Caspersen, Carl/B-2494-2009 NR 35 TC 37 Z9 37 U1 0 U2 3 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 1044-3983 J9 EPIDEMIOLOGY JI Epidemiology PD MAR PY 1997 VL 8 IS 2 BP 175 EP 180 DI 10.1097/00001648-199703000-00009 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WK432 UT WOS:A1997WK43200014 PM 9229210 ER PT J AU Nakazawa, M Fantappie, MR Freeman, GL EloiSantos, S Olsen, NJ Kovacs, WJ Secor, WE Colley, DG AF Nakazawa, M Fantappie, MR Freeman, GL EloiSantos, S Olsen, NJ Kovacs, WJ Secor, WE Colley, DG TI Schistosoma mansoni: Susceptibility differences between male and female mice can be mediated by testosterone during early infection SO EXPERIMENTAL PARASITOLOGY LA English DT Article DE Schistosoma mansoni; Schistosomiasis; host gender differences; susceptibility; trematode; testosterone ID C57BL/6 MICE; SEX; RESISTANCE AB In murine Schistosoma mansoni infections, fewer adult worms develop in male than in female mice infected with the same number of cercariae. To evaluate a potential role for testosterone in this phenomenon, testosterone levels were manipulated in groups of CBA/J mice that were then infected and monitored for survival rates, worm burdens, organomegaly, and egg production. By 16 weeks of infection, more than 80% of mice in groups with low levels of testosterone (untreated females, castrated males, or carrier-treated castrates) were dead, while less than 40% of those in groups with high levels of testosterone (sham-castrated males, testosterone-treated castrates, or testosterone-treated female mice) succumbed to infection. The mean number of worms recovered from mice in the low testosterone level groups was comparable among groups, and significantly greater than that from those in high-testosterone-level groups. The degree of organomegaly observed correlated strongly with worm burden, but the number of hepatic eggs per female worm did not differ significantly between groups. When male mice were castrated or sham-castrated 5 weeks after S. mansoni infection, no significant differences in host survival occurred. Furthermore, female mice treated with testosterone demonstrated reduced worm burdens if the testosterone was given 10 days prior to infection but not if the testosterone was given 10 days or 5 weeks after infection. Thus, the host sex bias observed in parallel-infected male and female mice appears to be related to the presence of male gonadal tissue or testosterone early in infection, during the development of immature schistosomules. C1 UNIV FED RIO DE JANEIRO,INST CIENCIAS BIOMED,DEPT BIOQUIM MED,RIO JANEIRO,BRAZIL. UNIV FED MINAS GERAIS,FAC MED,DEPT PROPEDEUT COMPLEMENTAR,BR-30130100 BELO HORIZONT,MG,BRAZIL. VANDERBILT UNIV,SCH MED,DEPT MED,NASHVILLE,TN 37232. RP Nakazawa, M (reprint author), US DEPT HHS,PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,ATLANTA,GA 30341, USA. FU NIAID NIH HHS [AI 11289] NR 16 TC 48 Z9 48 U1 1 U2 5 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0014-4894 J9 EXP PARASITOL JI Exp. Parasitol. PD MAR PY 1997 VL 85 IS 3 BP 233 EP 240 DI 10.1006/expr.1997.4148 PG 8 WC Parasitology SC Parasitology GA WP327 UT WOS:A1997WP32700003 PM 9085920 ER PT J AU Murphy, PA Chen, HP Hauck, GC Wilson, LA AF Murphy, PA Chen, HP Hauck, GC Wilson, LA TI Soybean protein composition and tofu quality SO FOOD TECHNOLOGY LA English DT Article; Proceedings Paper CT IFT Symposium on Storage Proteins in Legumes and Cereals - Characterization, Value-Added Utilization and Improvement at Annual Meeting of Institute-of-Food-Technologists CY JUN 03-07, 1995 CL ANAHEIM, CA SP Inst Food Technologists ID GLOBULAR-PROTEINS; BETA-CONGLYCININ; THERMAL GELATION; MODEL STORAGE; GEL STRENGTH; GLYCININ; VARIETAL; SOYMILK; YIELD C1 CTR DIS CONTROL,ATLANTA,GA 30333. RP Murphy, PA (reprint author), IOWA STATE UNIV,2312 FOOD SCI BLDG,AMES,IA 50011, USA. NR 20 TC 53 Z9 64 U1 2 U2 7 PU INST FOOD TECHNOLOGISTS PI CHICAGO PA SUITE 300 221 N LASALLE ST, CHICAGO, IL 60601-1291 SN 0015-6639 J9 FOOD TECHNOL-CHICAGO JI Food Technol. PD MAR PY 1997 VL 51 IS 3 BP 86 EP & PG 4 WC Food Science & Technology SC Food Science & Technology GA WM465 UT WOS:A1997WM46500024 ER PT J AU Nyame, AK Pilcher, JB Tsang, VCW Cummings, RD AF Nyame, AK Pilcher, JB Tsang, VCW Cummings, RD TI Rodents infected with Schistosoma mansoni produce cytolytic IgG and IgM antibodies to the Lewis x antigen SO GLYCOBIOLOGY LA English DT Article DE Schistosoma mansoni; rodent; IgM; IgG; Lewis x ID LACTO-N-FUCOPENTAOSE; EMBRYONIC ANTIGEN; MONOCLONAL-ANTIBODIES; FUCOSYL-TRANSFERASE; MOLECULAR-CLONING; ELAM-1 LIGAND; EXPRESSION; GENE; MICE; EPITOPES AB Schistosoma mansoni is a blood fluke that produces glycoconjugates containing the Lewis x antigen (Lex) Gal beta 1-->4(Fuc alpha 1-->3) GlcNAc beta 1-->R. However, Le(x) antigen is also normally expressed in many tissues of adult rodents, We now report that mice and hamsters chronically infected with S.mansoni generate high titers of both IgM and IgG antibodies reactive with Le(x) and that no reactivity is present in sera from uninfected animals, Anti-Le(x) antibodies were detected by ELISA using the Le(x)-containing neoglycoprotein lacto-N-fucopentaoseIII-BSA. The IgG in infected animals consists of IgG1, IgG2a, and IgG2b subclasses and binds to Protein A-Sepharose. The sera of infected animals reacts only with Le(x) antigen and has no reactivity toward either Le(a) or sialyl Le(x), The IgM response to Le(x) is detectable at week 2, whereas the IgG response is detectable at weeks 5-6 following infection of mice, The sera of infected mice and hamsters can mediate the complement-dependent cytolysis (CDC) of cells expressing surface Le(x). This cytolytic activity is exclusively effected by the anti-Le(x) antibodies, since their removal from sera by adsorption depletes the sera of CDC activity, Thus, the abundant expression of the Le(x) antigens by the parasite elicits cytolytic antibodies reactive with a host antigen. C1 UNIV OKLAHOMA,HLTH SCI CTR,DEPT BIOCHEM & MOL BIOL,OKLAHOMA CITY,OK 73190. CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,IMMUNOL BRANCH,ATLANTA,GA 30341. FU NIAID NIH HHS [AI26725, AI052590] NR 30 TC 32 Z9 33 U1 0 U2 3 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD, ENGLAND OX2 6DP SN 0959-6658 J9 GLYCOBIOLOGY JI Glycobiology PD MAR PY 1997 VL 7 IS 2 BP 207 EP 215 DI 10.1093/glycob/7.2.207 PG 9 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA WR720 UT WOS:A1997WR72000009 PM 9134427 ER PT J AU Shriber, D AF Shriber, D TI State experience in regulating a changing health care system SO HEALTH AFFAIRS LA English DT Article AB Conversions of nonprofit hospitals, health maintenance organizations (HMOs), and Blue Cross and Blue Shield plans to for-profit status have tremendous social and economic consequences for communities. Although some consensus exists on the legal principles governing hospital conversions, a coherent legal framework for processing many other conversions is often lacking. Rapid changes in the configuration of health plans and providers complicate the situation. Litigation will provide some resolution of the issues but is not an optimal way of making policy. Some state legislatures are stepping into the fray with differing solutions. Currently, the approach of a particular regulator is often the most important determinant of a given conversion. RP Shriber, D (reprint author), CTR DIS CONTROL & PREVENT,WASHINGTON,DC, USA. NR 6 TC 6 Z9 6 U1 0 U2 0 PU PROJECT HOPE-HEALTH AFFAIRS PI SYRACUSE PA PO BOX 8015, SYRACUSE, NY 13217 SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD MAR-APR PY 1997 VL 16 IS 2 BP 48 EP 68 DI 10.1377/hlthaff.16.2.48 PG 21 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA WP292 UT WOS:A1997WP29200005 PM 9086648 ER PT J AU Cardarelli, J Elliott, L Hornung, R Chang, WP AF Cardarelli, J Elliott, L Hornung, R Chang, WP TI Proposed model for estimating dose to inhabitants of Co-60 contaminated buildings SO HEALTH PHYSICS LA English DT Article DE Co-60; epidemiology; dose assessment; modeling, dose assessment AB A model to predict the time weighted exposures to gamma radiation was developed for buildings constructed with structural steel having some contamination from Co-60. Several buildings throughout sixteen city blocks in downtown Taipei were built about ten years ago with this material. These buildings were used for residential, business, and educational purposes with radiation levels ranging from background to five hundred times background. A comprehensive epidemiologic study by the National Yang Ming University Medical School in Taipei is underway to study the effects of this exposure to the building occupants. An evaluation of external radiation exposure was performed using survey instruments and thermoluminescent dosimeters. Exposure data from the survey instruments were used in a computer model developed to calculate cumulative radiation exposure estimates for the epidemiologic research. While the survey instrument data provided radiation levels at a point in time, the thermoluminescent dosimeters were placed in fixed locations and on several volunteers for a period of one month to verify the modeling results. The model itself is a mathematical algorithm that provides estimates with minimum and maximum range values by taking into account differences in the survey data between adults and children, variable occupancy patterns, background radiation, and radioactive decay. Several assumptions (background rates, height adjustment values, and occupancy factors) are easily adjusted to improve the estimated radiation exposures. The model predicted the exposures as measured by the thermoluminescent dosimeters with greater reliability for adults than for children. The differences between the two methods were about 10-15% for the adults and about 60% for the child. This strategy, its advantages, limitations, and its performance against actual thermoluminescent dosimeter measurements are presented. C1 NIOSH, CINCINNATI, OH 45226 USA. NATL YANG MING UNIV, SCH MED, TAIPEI 112, TAIWAN. NR 5 TC 29 Z9 31 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD MAR PY 1997 VL 72 IS 3 BP 351 EP 360 DI 10.1097/00004032-199703000-00002 PG 10 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA WJ338 UT WOS:A1997WJ33800003 PM 9030836 ER PT J AU Loevinsohn, BP Sutter, RW Costales, MO AF Loevinsohn, BP Sutter, RW Costales, MO TI Using cost-effectiveness analysis to evaluate targeting strategies: The case of vitamin A supplementation SO HEALTH POLICY AND PLANNING LA English DT Article AB Given the demonstrated efficacy of vitamin A supplements in reducing childhoood mortality, health officials now have to decide whether ii: would be efficient to target the supplements to high risk children. Decisions about targeting are complex because they depend on a number of factors; the degree of clustering of preventable deaths, the cost of the intervention, the side-effects of the intervention, the cost of identifying the high risk group, and the accuracy of the 'diagnosis' of risk. A cost-effectiveness analysis was used in the Philippines to examine whether vitamin A supplements should be given universally to all children 6-59 months, targeted broadly to children suffering from mild, moderate, or severe malnutrition, or targeted narrowly to pre-schoolers with moderate and severe malnutrition. The first year average cost of the universal approach was US$67.21 per death averted compared to $144.12 and $257.20 for the broad and narrow targeting approaches respectively. When subjected to sensitivity analysis the conclusion about the most cost-effective strategy was robust to changes in underlying assumptions such as the efficacy of supplements, clustering of deaths, and toxicity. Targeting vitamin A supplements to high risk children is not an efficient use of resources. Based on the results of this cost-effectiveness analysis and a consideration of alternate strategies, it is apparent that vitamin A, like immunization, should be provided to all pre-schoolers in the developing world. Issues about targeting public health interventions can usefully be addressed by cost-effectiveness analysis. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. PHILIPPINE DEPT HLTH,MANILA,PHILIPPINES. RP Loevinsohn, BP (reprint author), ASIAN DEV BANK,POB 789,MANILA 0980,PHILIPPINES. NR 16 TC 17 Z9 19 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD, ENGLAND OX2 6DP SN 0268-1080 J9 HEALTH POLICY PLANN JI Health Policy Plan. PD MAR PY 1997 VL 12 IS 1 BP 29 EP 37 DI 10.1093/heapol/12.1.29 PG 9 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA WM799 UT WOS:A1997WM79900003 PM 10166100 ER PT J AU Grant, KA AF Grant, KA TI Electromyography in ergonomics - Kumar,S, Mital,A SO HUMAN FACTORS AND ERGONOMICS IN MANUFACTURING LA English DT Book Review RP Grant, KA (reprint author), NIOSH,CINCINNATI,OH 45226, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI NEW YORK PA 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 1045-2699 J9 HUM FACTOR ERGON MAN JI Hum. Factors Ergon. Manuf. PD SPR PY 1997 VL 7 IS 2 BP 155 EP 156 PG 2 WC Engineering, Manufacturing; Ergonomics SC Engineering GA WM458 UT WOS:A1997WM45800006 ER PT J AU Golde, WT Piesman, J Dolan, MC Kramer, M Hauser, P Lobet, Y Capiau, C Desmons, P Voet, P Dearwester, D Frantz, JC AF Golde, WT Piesman, J Dolan, MC Kramer, M Hauser, P Lobet, Y Capiau, C Desmons, P Voet, P Dearwester, D Frantz, JC TI Reactivity with a specific epitope of outer surface protein A predicts protection from infection with the Lyme disease spirochete, Borrelia burgdorferi SO INFECTION AND IMMUNITY LA English DT Article ID NYMPHAL IXODES-DAMMINI; RECOMBINANT OSPA; MICE; TRANSMISSION; ANTIBODY; IMMUNITY; ATTACHMENT; ANTIGENS; DURATION; TICKS AB The response to recombinant vaccines for Lyme disease was studied to determine serum antibody levels effective in protecting against tick-transmitted infection. Data presented here demonstrate a significant correlation between antibody to an epitope on outer surface protein A (OspA) and protection against infection with Borrelia burgdorferi in canines and mice, A competitive enzyme-linked immunosorbent assay was developed to measure antibody to a site on OspA, defined by monoclonal antibody LA-2, Comparison of LA-2 titers against infection of canines and mice following vaccination and challenge established a predicted value for LA-2 titers, The statistical relationship between serum antibody levels and protection was calculated by logistic regression analysis. The statistical model predicted that an LA-2 titer of 0.32 mu g equivalents (eq) per mi correlated to an 80% predicted probability of protection for both mice and dogs. This value was used to classify mice and dogs as to their protected status at the time of tick exposure, The LA-2 cutoff titer (0.32 mu g eq/ml) correctly classified all dogs (n = 13) and mice (n = 44) that failed to become infected. By contrast, 20 of 22 dogs and 28 of 31 mice with titers of less than 0.32 mu g eq/ml became infected. On the basis of these results, we conclude that an LA-2 titer is a reliable indicator of immune status for estimating immune protection following use of OspA-based vaccines for B. burgdorferi sensu stricto. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,PUBL HLTH SERV,US DEPT HHS,FT COLLINS,CO 80522. UNIV HEIDELBERG,INST IMMUNOL & SEROL,D-6900 HEIDELBERG,GERMANY. SMITHKLINE BEECHAM BIOL,B-1330 RIXENSART,BELGIUM. PFIZER INC,DIV CENT RES,LINCOLN,NE 68501. NR 28 TC 33 Z9 33 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD MAR PY 1997 VL 65 IS 3 BP 882 EP 889 PG 8 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WK953 UT WOS:A1997WK95300006 PM 9038292 ER PT J AU Anderson, RL Carr, JH Bond, WW Favero, MS AF Anderson, RL Carr, JH Bond, WW Favero, MS TI Susceptibility of vancomycin-resistant enterococci to environmental disinfectants SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 95th Annual Meeting of the American-Society-for-Microbiology CY MAY 21-25, 1995 CL WASHINGTON, DC SP Amer Soc Microbiol ID INTENSIVE-CARE UNIT; STAPHYLOCOCCUS-AUREUS; BACTERICIDAL ACTIVITY; POVIDONE-IODINE; FAECIUM; ANTISEPTICS; OUTBREAK; GENTAMICIN; INFECTIONS; FAECALIS AB OBJECTIVE: To determine the susceptibilities of vancomycin-resistant and -sensitive enterococci (VRE and VSE) to various concentrations of commonly used, commercial, hospital-grade disinfectants. DESIGN: A microbial suspension test using inocula of 10(8) cells per mL in a disinfectant test dilution was used to determine inactivation kinetics of the test strains. In each test, 1-mL aliquots were removed from the cell-disinfectant mixtures at 15 and 30 seconds and then at 1-minute intervals for 5 minutes and neutralized. Appropriate serial dilutions were plated on agar medium for enumeration of survivors. RESULTS: VRE and VSE challenge inocula (in the absence of any additional protein or serum challenge) were below the limit of detection (5 colony-forming units/mL) after 15 seconds' exposure to the manufacturers' suggested use-dilutions of quaternary ammonium, phenolic, or iodophor germicidal detergents. In subsequent tests, when the disinfectants were diluted far beyond the recommended use-dilutions (extended dilution), no differences were demonstrated between the susceptibilities of VRE and VSE. CONCLUSIONS: VRE and VSE are sensitive to a spectrum of commonly used environmental disinfectants and have parallel inactivation rates when challenged with extended dilutions of these products. Our findings did not demonstrate a relationship between antibiotic and germicide resistance. Routine disinfection and housekeeping protocols presently used in hospitals need not be altered due to concerns about the potential for environmentally mediated transmission of antibiotic-resistant microorganisms. RP Anderson, RL (reprint author), CTR DIS CONTROL,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,1600 CLIFTON RD,1-B383,M-S C01,ATLANTA,GA 30333, USA. NR 25 TC 46 Z9 46 U1 0 U2 5 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD MAR PY 1997 VL 18 IS 3 BP 195 EP 199 PG 5 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WP739 UT WOS:A1997WP73900011 PM 9090548 ER PT J AU Rossner, S VanGaal, LF Williamson, DF Svendsen Gorpe Prentice Barranco AF Rossner, S VanGaal, LF Williamson, DF Svendsen Gorpe Prentice Barranco TI Discussion Panel 1: What are the benefits of moderate weight loss? SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Editorial Material C1 KAROLINSKA HOSP,OBES UNIT,S-17176 STOCKHOLM,SWEDEN. CTR DIS CONTROL & PREVENT,DIV DIABET TRANSLAT K10,ATLANTA,GA 30341. UNIV INSTELLING ANTWERP,DEPT ENDOCRINOL,B-2610 WILRIJK,ANTWERP,BELGIUM. NR 0 TC 0 Z9 0 U1 0 U2 0 PU STOCKTON PRESS PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE, HAMPSHIRE, ENGLAND RG21 6XS SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD MAR PY 1997 VL 21 SU 1 BP S20 EP S21 PG 2 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA WQ905 UT WOS:A1997WQ90500006 ER PT J AU Williamson, DF AF Williamson, DF TI Intentional weight loss: Patterns in the general population and its association with morbidity and mortality SO INTERNATIONAL JOURNAL OF OBESITY LA English DT Article; Proceedings Paper CT Satellite Symposium of the 7th European Congress on Obesity CY MAY 14-17, 1996 CL BARCELONA, SPAIN SP Knoll Pharmaceut DE intentional weight loss; longevity; epidemiology ID BODY-WEIGHT; WOMEN; INTERVENTION; VARIABILITY; BENEFITS; SAMPLE; TRIAL; RISK; MEN AB The question of whether intentional weight loss increases the longevity of obese individuals is important, given the high prevalence of obesity and co-morbidities in industrialized countries, and the high prevalence of intentional weight loss in such populations. A number of studies suggest that both weight loss and weight fluctuation are associated with increased mortality. Factors such as smoking status and pre-existing illness, however, have to be considered in relation to these findings. A study controlled for smoking status and pre-existing illness, found that intentional weight loss by overweight, white, US women, consistently reduced mortality in those with obesity related co-morbidities. An Indian study, involving individuals with previous myocardial infarction, found that dietary intervention reduced mortality substantially. Those losing >5kg had the greatest reduction in both total and cardiovascular mortality. In both the above studies, weight loss was approximately 10% of initial body weight. Preliminary evidence suggests that modest intentional weight loss is associated with increased longevity in individuals with co-morbidities. RP Williamson, DF (reprint author), CTR DIS CONTROL & PREVENT,DIV DIABET TRANSLAT K10,4770 BUFORD HWY NE,ATLANTA,GA 30341, USA. NR 21 TC 41 Z9 43 U1 0 U2 1 PU STOCKTON PRESS PI BASINGSTOKE PA HOUNDMILLS, BASINGSTOKE, HAMPSHIRE, ENGLAND RG21 6XS SN 0307-0565 J9 INT J OBESITY JI Int. J. Obes. PD MAR PY 1997 VL 21 SU 1 BP S14 EP S19 PG 6 WC Endocrinology & Metabolism; Nutrition & Dietetics SC Endocrinology & Metabolism; Nutrition & Dietetics GA WQ905 UT WOS:A1997WQ90500005 PM 9130036 ER PT J AU Hammett, TA Ciesielski, CA Bush, TJ Fleming, PL Ward, JW AF Hammett, TA Ciesielski, CA Bush, TJ Fleming, PL Ward, JW TI Impact of the 1993 expanded AIDS surveillance case definition on reporting of persons without HIV risk information SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE AIDS; surveillance; risk ID HUMAN-IMMUNODEFICIENCY-VIRUS; TRANSMISSION AB To evaluate the impact of the 1993 expansion of the acquired immunodeficiency syndrome (AIDS) surveillance definition on reporting of persons with no HIV risk exposure information, we compared persons reported with and without risk in 1992 and 1993. The expanded case definition resulted in a large increase in both the number of persons reported with risk (121% increase) and without risk (167% increase). The changes in demographic characteristics for each group were similar from 1992 to 1993. Persons reported based on immunologic criteria were more likely and persons with pulmonary tuberculosis (PTB) less likely than those meeting the pre-1993 definition criteria to be reported with risk. Many persons with PTB were retrospectively identified from tuberculosis registries that do not systematically include HIV risk information. Ascertainment of risk information continues to be an essential part of AIDS surveillance with >90% of reports including risk exposure. RP Hammett, TA (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,NATL CTR HIV STD TB,MAILSTOP E-47,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 14 TC 8 Z9 8 U1 0 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD MAR 1 PY 1997 VL 14 IS 3 BP 259 EP 262 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WP137 UT WOS:A1997WP13700010 PM 9117459 ER PT J AU Kassler, WJ Meriwether, RA Klimko, TB Peterman, TA Zaidi, A AF Kassler, WJ Meriwether, RA Klimko, TB Peterman, TA Zaidi, A TI Eliminating access to anonymous HIV antibody testing in North Carolina: Effects on HIV testing and partner notification SO JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES AND HUMAN RETROVIROLOGY LA English DT Article DE serodiagnosis; partner notification; prevention and control; anonymous testing; confidentiality; policy ID INFECTION; DISCLOSURE; TIME AB Anonymous HIV testing may attract persons who might otherwise not be tested but may hinder partner notification. We evaluated the effects on North Carolina's HIV testing and partner notification programs of policy changes that eliminated and later restored anonymous testing in 82 counties. We used an interrupted time-series design to compare counties eliminating with counties retaining anonymous testing. We analyzed HIV testing and partner notification data from before, during, and after elimination of anonymous testing. After elimination of anonymous testing in 82 counties, the mean monthly level of testing (+/-SE) increased by 45%, or 548 (+/-123) tests per month, while in 18 counties that retained anonymous testing, there was a 63% increase, or 802 (+/-162) tests per month (p >.05). Among men of all races, testing increased by 16%, or 155 (+/-35) tests per month, in counties that eliminated anonymous testing; and by 51%, or 305 (+/-42) tests per month (p <.05), in counties that retained anonymous testing. After elimination of anonymous testing, both county types experienced similar increases in the rate of partners notified. However, partner notification was more successful if the index patient was tested confidentially; 2.7 times as many partners per index patient were notified and counseled. There was no effect on testing or on partner notification rates following restoration of anonymous testing. Substantial community opposition to eliminating anonymous testing was encountered. The policy change appeared to result in a slight decrease in testing among men and a slight increase in partners notified. Programs considering the elimination of anonymous testing should weigh these potential gains and losses, as well as the impact on relationships between the public health and advocacy communities. C1 DEPT ENVIRONM HLTH & NAT RESOURCES,RALEIGH,NC. CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. RP Kassler, WJ (reprint author), CTR DIS CONTROL,DIV STD PREVENT,MAILSTOP E44,ATLANTA,GA 30333, USA. NR 30 TC 20 Z9 21 U1 1 U2 5 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1077-9450 J9 J ACQ IMMUN DEF SYND JI J. Acquir. Immune Defic. Syndr. Hum. Retrovirol. PD MAR 1 PY 1997 VL 14 IS 3 BP 281 EP 289 PG 9 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WP137 UT WOS:A1997WP13700013 PM 9117462 ER PT J AU Miller, KS Clark, LF Wendell, DA Levin, ML GrayRay, P Velez, CN Webber, MP AF Miller, KS Clark, LF Wendell, DA Levin, ML GrayRay, P Velez, CN Webber, MP TI Adolescent heterosexual experience: A new typology SO JOURNAL OF ADOLESCENT HEALTH LA English DT Article DE adolescence; sexual behavior; interventions; HIV ID HIGH-SCHOOL-STUDENTS; SEXUAL BEHAVIORS; AIDS PREVENTION; HIV-INFECTION; CONDOM USE; SAFER-SEX; RISK; INTERVENTION; CATEGORIES; ATTITUDES AB Purpose: The purpose of this paper is to define a typology that encompasses the full range of adolescent heterosexual behavior; to compare the usefulness of the new typology with that of the traditional dichotomy of ''sexually active''/''sexually inactive'' for understanding sexual behavior among adolescents; and to determine the implications of the new typology for the design and implementation of HIV prevention programs targeting adolescents. Methods: Detailed face-to-face interviews were conducted with a cross-sectional sample of 907 mothers and their adolescents, ages 14-17 years, recruited from public high schools in Alabama, New York, and Puerto Rico. Information from the adolescent survey on precoital sexual behaviors and STD/HIV sexual risk and risk reduction behaviors was examined. A typology of adolescent heterosexual experiences was constructed using four behavioral dimensions. Results: Ninety-nine percent (n = 894) of the sample was classified into one of the five patterns of sexual experience: Delayers, Anticipators, One-timers, Steadies, and Multiples. Among the participants who were not sexually active, precoital behaviors differed significantly between the 22% who anticipated initiating sexual intercourse in the next year (Anticipators) and those who did not (Delayers). Among those traditionally classified as ''sexually active'', One-timers and Steadies were significantly older when they first had penile-vaginal intercourse than those who had multiple partners. One-timers were more likely to use condoms than Steadies or Multiples, and only Multiples reported previous STDs. Conclusion: A typology that defines a range of adolescent heterosexual experiences was developed, and it was possible to classify 99% of our sample. The traditional dichotomy between ''sexually active'' vs. ''not active'' hides important behavioral intentions and sexual practices. These differences must be taken into account in the development and implementation of HIV prevention programs that target adolescents. (C) Society for Adolescent Medicine, 1997. C1 UNIV BIRMINGHAM,SCH PUBL HLTH,BIRMINGHAM,AL. LOUISIANA OFF PUBL HLTH,NEW ORLEANS,LA. MISSISSIPPI STATE UNIV,SOCIAL SCI RES CTR,MISSISSIPPI STATE,MS 39762. UNIV PUERTO RICO,SCH PUBL HLTH,SAN JUAN,PR 00936. MONTEFIORE MED CTR,BRONX,NY 10467. RP Miller, KS (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,NATL CTR HIV STD & TB PREVENT,US PHS,DEPT HHS,ATLANTA,GA 30333, USA. NR 31 TC 48 Z9 49 U1 3 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1054-139X J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD MAR PY 1997 VL 20 IS 3 BP 179 EP 186 DI 10.1016/S1054-139X(96)00182-6 PG 8 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA WM866 UT WOS:A1997WM86600001 PM 9069018 ER PT J AU Hennessy, CH McNeely, EA Whittington, FJ Strasser, DC Archea, CK AF Hennessy, CH McNeely, EA Whittington, FJ Strasser, DC Archea, CK TI Perceptions of physical restraint use and barriers to restraint reduction in a long-term care facility SO JOURNAL OF AGING STUDIES LA English DT Article ID DECISION-MAKING; COMMUNITY AB The use of restraints in nursing homes has been curtailed in the United Stares since the passage in 1987 of federal legislation regulating restraint practices. This study used focus groups with administrators and nursing staff in a skilled nursing facility to examine their views of restraints and perceptions of conditions in the nursing home environment that affect restraint use. Although respondents lacked a shared definition of a ''restraint,'' they did identify contextual factors that in combination with resident characteristics produced situations in which restraint use was justified. Implications of these findings for staff education on restraint reduction are discussed. C1 WESLEY WOODS GERIATR HOSP,ATLANTA,GA. GEORGIA STATE UNIV,ATLANTA,GA 30303. ATLANTA VET AFFAIRS MED CTR,ATLANTA,GA. RP Hennessy, CH (reprint author), CTR DIS CONTROL & PREVENT,HLTH CARE & AGING STUDIES BRANCH,MAILSTOP K-51,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. NR 31 TC 14 Z9 14 U1 0 U2 1 PU JAI PRESS INC PI GREENWICH PA 55 OLD POST RD-#2, PO BOX 1678, GREENWICH, CT 06836-1678 SN 0890-4065 J9 J AGING STUD JI J. Aging Stud. PD SPR PY 1997 VL 11 IS 1 BP 49 EP 62 DI 10.1016/S0890-4065(97)90011-6 PG 14 WC Gerontology SC Geriatrics & Gerontology GA WP626 UT WOS:A1997WP62600004 PM 11774882 ER PT J AU Zhu, KM Levine, RS Brann, EA Baum, MK AF Zhu, KM Levine, RS Brann, EA Baum, MK TI The relationship of hepatitis history and pathological diagnosis of primary liver cancer SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE diagnosis; hepatitis; liver cancer; pathology AB During the analysis of risk factors in relation to primary liver cancer, we noticed an association between the confirmed (as opposed to probable) pathologic diagnosis of liver cancer and a positive history of hepatitis. This report pursues the observation using data from the Selected Cancers Study. Study subjects included 168 men who lived in areas covered by eight cancer registries in the U.S., and were pathologically diagnosed with confirmed or probable primary liver cancer during 1984-1988. The results showed that men with confirmed primary liver cancer were six times more likely to have a hepatitis diagnosed within 3 years before liver cancer detection, compared with those with probable primary liver cancer. Further analyses showed that men with a confirmed primary liver cancer or with a recent hepatitis more likely had a tissue specimen obtained from a surgery, and less likely had one from an aspiration. Upon adjustment for type of specimen, the association between pathological confirmation of primary liver cancer and recent hepatitis persisted. The results raised questions whether recent hepatitis and its pathologic changes influence choice of tissue collecting procedure and ultimate pathological diagnosis of primary liver cancer. Other factors that might be related to the findings also need to be examined in future studies. (C) 1997 Elsevier Science Inc. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30341. UNIV MIAMI,SCH MED,DEPT EPIDEMIOL & PUBL HLTH,MIAMI,FL 33101. RP Zhu, KM (reprint author), MEHARRY MED COLL,SCH MED,DEPT FAMILY & PREVENT MED,1005 DB TODD JR BLVD,NASHVILLE,TN 37208, USA. NR 11 TC 2 Z9 2 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD MAR PY 1997 VL 50 IS 3 BP 297 EP 301 DI 10.1016/S0895-4356(96)00364-2 PG 5 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA WQ592 UT WOS:A1997WQ59200011 PM 9120529 ER PT J AU Brenner, SA Rooney, JA Manzewitsch, P Regnery, RL AF Brenner, SA Rooney, JA Manzewitsch, P Regnery, RL TI Isolation of Bartonella (Rochalimaea) henselae: Effects of methods of blood collection and handling SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID CAT-SCRATCH DISEASE; BACILLARY ANGIOMATOSIS; LYSIS-CENTRIFUGATION; CULTURE SYSTEM; DOMESTIC CAT; BACILLIFORMIS; CELLS; IDENTIFICATION; BACTEREMIA; SPECIMENS AB Bartonella (Rochalimaea) henselae causes cat-scratch disease, bacillary angiomatosis, peliosis hepatis, and fever in humans. B. henselae can be difficult to culture axenically, and as many as 5 weeks may be required before colonies are visible. We compared how different methods of blood collection and handling affect isolation of this pathogen. Blood specimens from B. henselae-infected cats were collected in both EDTA and Isolator blood-lysis tubes and were subsequently plated onto rabbit blood-brain heart infusion agar by using three different schedules: plating immediately, plating after 24 h at 25 degrees C, and plating after 26 days at -65 degrees C. Colonies were counted 14 and 35 days after plating. Blood collected in tubes containing EDTA, frozen at -65 degrees C, and then plated on blood agar yielded a median of 60,000 CFU/ml, compared with 25,333 CFU/ml after collection in the Isolator tubes (P < 0.01). Frozen blood yielded the largest number of B. henselae colonies for any of the schedules tested. These results support previous observations that the Isolator system is more sensitive than tubes containing EDTA for isolation of B. henselae and suggest that, for cat blood, collection in tubes containing EDTA and subsequent freezing may further improve the sensitivity of detection of B. henselae. C1 EMORY UNIV,SCH MED,DIV INFECT DIS,ATLANTA,GA. CTR DIS CONTROL & PREVENT,VIRAL & RICKETTSIAL ZOONOSES BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. HESKA CORP,FT COLLINS,CO. NR 29 TC 46 Z9 47 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 544 EP 547 PG 4 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800002 PM 9041385 ER PT J AU Ando, T Monroe, SS Noel, JS Glass, RI AF Ando, T Monroe, SS Noel, JS Glass, RI TI A one-tube method of reverse Transcription-PCR to efficiently amplify a 3-kilobase region from the RNA polymerase gene to the poly(A) tail of small round-structured viruses (Norwalk-like viruses) SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID HUMAN ENTERIC CALICIVIRIDAE; CHAIN-REACTION; MOLECULAR CHARACTERIZATION; DNA-POLYMERASE; CAPSID PROTEIN; TAQ POLYMERASE; SEQUENCE; GASTROENTERITIS; AMPLIFICATION; EXPRESSION AB Amplification of a 3-kb genome region from the RNA polymerase gene to the 3' poly(A) tail of small round-structured virus (SRSV) by reverse transcription-PCR (RT-PCR) has been difficult to achieve because of a stable secondary structure in a region between the RNA polymerase gene and the 5' end of the second open reading frame. We have developed a one-tube RT-PCR method to efficiently amplify this region. The method comprises three procedures: purification of poly(A)(+) RNA from a starting RNA solution by oligo(dT)(30) covalently linked to latex particles, buffer exchange, and continuous RT and PCR in a single tube containing all reaction components. The key elements of this method are (i) first-strand cDNA synthesis with the Superscript II version of RNase H- Moloney murine leukemia virus reverse transcriptase at 50 degrees C for 10 min by using the RNA-oligo(dT)(30) hybrid on the latex particles as the template and primer, and (ii) PCR by Taq and Pwo DNA polymerases mixed together with a mixture of 12 phased oligo(dT)(25) antisense primers. The detection threshold of the one-tube RT-PCR method was as little as 0.2 ng of the crude RNA used as the source of the template. Using this method, we obtained 3-kb products from 24 SRSV strains previously characterized into four genetic groups. These included 5 P1-A, 4 P1-B, 5 P2-A, and 10 P2-B strains. Because SRSVs have not yet been cultivated in vitro, this novel method should facilitate molecular characterization of SRSVs to provide a firm scientific foundation for improvements and refinements of SRSV diagnostics. RP Ando, T (reprint author), CTR DIS CONTROL & PREVENT,VIRAL GASTROENTERITIS SECT,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333, USA. OI Monroe, Stephan/0000-0002-5424-716X NR 44 TC 36 Z9 38 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 570 EP 577 PG 8 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800008 PM 9041391 ER PT J AU Doellgast, GJ Brown, JE Koufman, JA Hatheway, CL AF Doellgast, GJ Brown, JE Koufman, JA Hatheway, CL TI Sensitive assay for measurement of antibodies to Clostridium botulinum neurotoxins A, B, and E: Use of Hapten-labeled-antibody elution to isolate specific complexes SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; SOLUTION-PHASE COMPLEXES; COAGULATION ASSAY; TOXIN AB The measurement of chicken and human antibodies to Clostridium botulinum neurotoxins A, B, and E was accomplished by affinity isolation of complexes containing these antibodies. By this approach, a mixture of toxin with the test antibody, fluoresceinated antibody, and enzyme (Russell's viper venom factor X activator)-labeled antibody is allowed to form a complex in solution phase. This complex is then bound to a matrix containing antifluorescein antibody. All components not bound to the matrix are washed off, and the complex is isolated intact by elution with fluorescein, which competes with the complex for binding to the antifluorescein matrix. The eluted complex is then bound to a matrix which specifically binds the test antibody (anti-chicken immunoglobulin Y [IgY] or anti-human IgG), and the bound complex is measured by using the enzyme label. Using this approach, we were able to measure as little as 1 ng of specific antibody per mi from affinity-isolated, monospecific chicken antibody preparations and to measure antibody specifically from IgY fractions of monospecific chicken antibody preparations. Human antibodies from subjects immunized with pentavalent toroid preparations were detectable at dilutions as great as 24,300-fold, and undiluted serum from most control subjects showed no measurable antibody. Antibody was also measured in 65 subjects who were receiving preparations of neurotoxin A (BOTOX) for the treatment of spastic disorders. Eighteen of them had toxin-specific antibody reactive with toxin B, and two of them had toxin-specific antibody reactive with toxin A. The two patients having antibody to toxin A were refractory to treatment with this toxin. This approach of isolation of hapten-labeled immune complexes under nondenaturing conditions with hapten is broadly applicable to the specific measurement of antibodies present at very low concentrations in serum. C1 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT OTOLARYNGOL,WINSTON SALEM,NC 27157. ELCATECH INC,WINSTON SALEM,NC 27101. USA,CTR HLTH PROMOT & PREVENT MED,ABERDEEN PROVING GROUND,MD 21010. CTR DIS CONTROL & PREVENT,BOTULISM LAB,ATLANTA,GA 30333. RP Doellgast, GJ (reprint author), WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT BIOCHEM,MED CTR BLVD,WINSTON SALEM,NC 27157, USA. NR 13 TC 21 Z9 23 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 578 EP 583 PG 6 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800009 PM 9041392 ER PT J AU Visvesvara, GS Moura, H KovacsNace, E Wallace, S Eberhard, ML AF Visvesvara, GS Moura, H KovacsNace, E Wallace, S Eberhard, ML TI Uniform staining of Cyclospora oocysts in fecal smears by a modified safranin technique with microwave heating SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID CYANOBACTERIUM-LIKE BODIES; FOREIGN RESIDENTS; DIARRHEA; ORGANISM; TRAVELERS; PATHOGEN; INFECTION; HUMANS; NEPAL; ACID AB Cyclospora, a coccidian protist, is increasingly being identified as an important, newly emerging parasite that causes diarrhea, flatulence, fatigue, and abdominal pain leading to weight loss in immunocompetent persons with or without a recent travel history as well as in patients with AIDS. Modified Kinyoun's acid-fast stain is the most commonly used stain to identify the oocyst of this parasite in fecal smears. Oocysts of Cyclospora stain variably by the modified acid-fast procedure, resulting in the possible misidentification of this parasite. We examined fecal smears stained by six different procedures that included Giemsa,trichrome, chromotrope, Gram-chromotrope, acid-fast, and safranin stains, We report on a safranin-based stain that uniformly stains oocysts of Cyclospora a brilliant reddish orange, provided that the fecal smears are heated in a microwave oven prior to staining, This staining procedure, besides being superior to acid fast staining, is fast, reliable, and easy to perform in most clinical laboratories. RP Visvesvara, GS (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,MS-F-13,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. NR 25 TC 54 Z9 60 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 730 EP 733 PG 4 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800038 PM 9041421 ER PT J AU Sutton, DA Padhye, AA Standard, PG Rinaldi, MG AF Sutton, DA Padhye, AA Standard, PG Rinaldi, MG TI An aberrant variant of Histoplasma capsulatum var capsulatum SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID RAPID IDENTIFICATION; DNA-PROBE AB We studied an aberrant culture of Histoplasma capsulatum var, capsulatum isolated from synovial fluid collected from the right elbow of a patient from Kansas, Colonies on Sabouraud glucose agar and other routine mycological media were glabrous to soft, moist, heaped, deeply folded or convoluted, and orange-brown with a white, irregular margin, Microscopically, hyphae were hyaline, septate, and branched and remained totally devoid of conidiation over a period of 2 years on all mycological media, Conversion to the yeast form was achieved on Pine's medium at 37 degrees C, Colonies at early stages of growth were smooth, moist, pasty, shiny, and orange-brown but soon became wrinkled and slightly raised and produced oval, thin-walled cells measuring 2 to 3 by 3 to 4,5 mu m which multiplied by polar budding, The identity of the isolate was further confirmed by utilizing the Accuprobe DNA probe and the exoantigen test for H, capsulatum var, capsulatum. C1 AUDIE L MURPHY MEM VET ADM MED CTR,SAN ANTONIO,TX 78284. CTR DIS CONTROL,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. RP Sutton, DA (reprint author), UNIV TEXAS,HLTH SCI CTR,DEPT PATHOL,FUNGUS TESTING LAB,7703 FLOYD CURL DR,SAN ANTONIO,TX 78284, USA. NR 14 TC 7 Z9 8 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 734 EP 735 PG 2 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800039 PM 9041422 ER PT J AU Floyd, MM Guthertz, LS Silcox, VA Duffey, PS Jang, Y Desmond, EP Crawford, JT Butler, WR AF Floyd, MM Guthertz, LS Silcox, VA Duffey, PS Jang, Y Desmond, EP Crawford, JT Butler, WR TI Characterization of an SAV organism and proposal of Mycobacterium triplex sp nov (vol 34, pg 2963, 1996) SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Correction, Addition C1 CALIF DEPT HLTH SERV,MICROBIAL DIS LAB,BERKELEY,CA 94704. RP Floyd, MM (reprint author), CTR DIS CONTROL & PREVENT,DIV AIDS STD & TB LAB RES,NATL CTR INFECT 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 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD MAR PY 1997 VL 35 IS 3 BP 802 EP 802 PG 1 WC Microbiology SC Microbiology GA WJ848 UT WOS:A1997WJ84800060 ER PT J AU Demi, A Bakeman, R Moneyham, L Sowell, R Seals, B AF Demi, A Bakeman, R Moneyham, L Sowell, R Seals, B TI Effects of resources and stressors on burden and depression of family members who provide care to an HIV-infected woman SO JOURNAL OF FAMILY PSYCHOLOGY LA English DT Article ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; SOCIAL SUPPORT; HEALTH-CARE; ALZHEIMERS-DISEASE; MENTAL-ILLNESS; AIDS; CAREGIVERS; PREDICTORS; MODEL; ADJUSTMENT AB This article describes the effect of resources and stressors on 156 family members who provided care and support for an HIV-infected woman. Both resources and stressors were related to the family members' perceived burden and depressive mood, and resources did little to buffer the associations between stress and burden and between stress and depression. Together, resources and stressors accounted for 50% of the variance in family members' perceived burden and 21% of the variance in their depressive mood. The only variable important in predicting both burden and depressive mood was the family member's feelings of stigma. These results suggest that efforts should be made to reduce the stigma felt by family members and to help them obtain additional family and community resources to ameliorate the burden of caregiving. C1 GEORGIA STATE UNIV,DEPT PSYCHOL,ATLANTA,GA 30303. EMORY UNIV,DEPT NURSING SYST,ATLANTA,GA 30322. AID ATLANTA INC,ATLANTA,GA. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Demi, A (reprint author), GEORGIA STATE UNIV,SCH NURSING,UNIV PLAZA,ATLANTA,GA 30303, USA. NR 68 TC 21 Z9 22 U1 0 U2 1 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0893-3200 J9 J FAM PSYCHOL JI J. Fam. Psychol. PD MAR PY 1997 VL 11 IS 1 BP 35 EP 48 DI 10.1037//0893-3200.11.1.35 PG 14 WC Psychology, Clinical; Family Studies SC Psychology; Family Studies GA WM847 UT WOS:A1997WM84700004 ER PT J AU Lukashevich, IS Djavani, M Shapiro, K Sanchez, A Ravkov, E Nichol, ST Salvato, MS AF Lukashevich, IS Djavani, M Shapiro, K Sanchez, A Ravkov, E Nichol, ST Salvato, MS TI The Lassa fever virus L gene: Nucleotide sequence, comparison, and precipitation of a predicted 250 kDa protein with monospecific antiserum SO JOURNAL OF GENERAL VIROLOGY LA English DT Article ID PUTATIVE RNA-POLYMERASE; ENCODES AB The large (L) RNA segment of Lassa fever virus (LAS) encodes a putative RNA-dependent RNA polymerase (RdRp or L protein). Similar to other arenaviruses, the LAS L protein is encoded on the genome-complementary strand and is predicted to be 2218 amino acids in length (253 kDa). It has an unusually large non-coding region adjacent to its translation start site. The LAS L protein contains six motifs of conserved amino acids that have been found among arenavirus L proteins and core RdRp of other segmented negative-stranded (SNS) viruses (Arena-, Bunya- and Orthomyxoviridae). Phylogenetic analyses of the RdRp of 20 SNS viruses reveals that arenavirus L proteins represent a distinct cluster divided into LAS-lymphocytic choriomeningitis and Tacaribe-Pichinde virus lineages. Monospecific serum against a synthetic peptide corresponding to the most conserved central domain precipitates a 250 kDa product from LAS and lymphocytic choriomeningitis virus-infected cells. C1 UNIV WISCONSIN,SCH MED,DEPT PATHOL,MADISON,WI 53706. UNIV WISCONSIN,SCH MED,LAB MED,MADISON,WI 53706. CTR DIS CONTROL & PREVENT,SPECIAL PATHOGEN BRANCH,ATLANTA,GA. BELORUSSIAN RES INST EPIDEMIOL & MICROBIOL,MINSK,BYELARUS. FU NIAID NIH HHS [R01 AI032107-03, R01 AI032107] NR 23 TC 51 Z9 52 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 MAR PY 1997 VL 78 BP 547 EP 551 PN 3 PG 5 WC Biotechnology & Applied Microbiology; Virology SC Biotechnology & Applied Microbiology; Virology GA WL178 UT WOS:A1997WL17800007 PM 9049403 ER PT J AU Viazov, S Riffelmann, M Khoudyakov, Y Fields, H Varenholz, C Roggendorf, M AF Viazov, S Riffelmann, M Khoudyakov, Y Fields, H Varenholz, C Roggendorf, M TI Genetic heterogeneity of hepatitis G virus isolates from different parts of the world SO JOURNAL OF GENERAL VIROLOGY LA English DT Article ID C VIRUS; GENOTYPES AB Comparative sequence analysis of a 354 nt fragment of the NS5 region of hepatitis G virus (HGV) isolates was performed to assess two levels of HGV genomic variability: (1) heterogeneity of HGV within an infected individual, and (2) heterogeneity of different HGV isolates. Comparison of nucleotide sequences of DNA clones from two virus isolates demonstrated that in each infected individual HGV is represented by a population of virions with closely related but heterogeneous genomes (quasispecies). Phylogenetic analysis of nucleotide sequences of 42 isolates collected from 14 countries revealed less significant genome variability of HGV as compared to hepatitis C virus. Sequences of all HGV isolates fell into one group of distribution of evolutionary distances. On a phylogenetic tree all HGV sequences segregated into numerous branches. All sequences of isolates from Africa, South and South-East Asia, however, were clustered together and were separated from those of other isolates collected in Europe, North America and Central Asia. C1 UNIV ESSEN GESAMTHSCH,INST VIROL,D-45122 ESSEN,GERMANY. CTR DIS CONTROL,HEPATITIS BRANCH,ATLANTA,GA 30333. UNIV ESSEN GESAMTHSCH,INST HYG & OCCUPAT MED,D-45122 ESSEN,GERMANY. RP Viazov, S (reprint author), DI IVANOVSKII INST VIROL,GAMALEYA ST 16,MOSCOW 123098,RUSSIA. NR 17 TC 52 Z9 55 U1 0 U2 0 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 MAR PY 1997 VL 78 BP 577 EP 581 PN 3 PG 5 WC Biotechnology & Applied Microbiology; Virology SC Biotechnology & Applied Microbiology; Virology GA WL178 UT WOS:A1997WL17800012 PM 9049408 ER PT J AU DeStefano, F Nordstrom, DL Vierkant, RA AF DeStefano, F Nordstrom, DL Vierkant, RA TI Long-term symptom outcomes of carpal tunnel syndrome and its treatment SO JOURNAL OF HAND SURGERY-AMERICAN VOLUME LA English DT Article ID NERVE-CONDUCTION; SURVEILLANCE; PREVALENCE; DEFINITION AB A retrospective follow-up study of a population-based case series was conducted to determine the clinical course and outcomes of carpal tunnel syndrome (CTS). A total of 425 cases first diagnosed between 1979 and 1988 were followed through 1993. Among patients who did not have surgery, median duration of symptoms was between 6 and 9 months, but 22% had symptoms for 8 years or longer. Patients who had surgery were about 6 times more likely to have resolution of their symptoms than were patients who did not have surgery. Patients who had surgery 3 or more years after their initial diagnosis of CTS were less than half as likely to have symptom resolution than were patients who had surgery within 3 years of diagnosis. The results indicate that surgery is a highly effective treatment, but duration of CTS prior to surgery is a key determinant of surgical outcome. RP DeStefano, F (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,MSE61,1600 CLIFTON DR,ATLANTA,GA 30333, USA. OI Vierkant, Robert/0000-0001-6242-5221 FU PHS HHS [U07/CCU507126] NR 33 TC 58 Z9 59 U1 0 U2 3 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 SN 0363-5023 J9 J HAND SURG-AM JI J. Hand Surg.-Am. Vol. PD MAR PY 1997 VL 22A IS 2 BP 200 EP 210 DI 10.1016/S0363-5023(97)80152-9 PG 11 WC Orthopedics; Surgery SC Orthopedics; Surgery GA WQ194 UT WOS:A1997WQ19400003 PM 9195415 ER PT J AU Scaglia, M Sacchi, L Croppo, GP deSilva, A Gatti, S Corona, S Orani, A Bernuzzi, AM Pieniazek, NJ Slemenda, SB Wallace, S Visvesvara, GS AF Scaglia, M Sacchi, L Croppo, GP deSilva, A Gatti, S Corona, S Orani, A Bernuzzi, AM Pieniazek, NJ Slemenda, SB Wallace, S Visvesvara, GS TI Pulmonary microsporidiosis due to Encephalitozoon hellem in a patient with AIDS SO JOURNAL OF INFECTION LA English DT Article ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; INTESTINAL MICROSPORIDIOSIS; N-SP; CULTURE; IDENTIFICATION; INFECTIONS; CUNICULI; URINE AB The microsporidian Encephalitozoon hellem is being reported with increasing frequency in HIV-positive subjects, as an agent of disseminated microsporidiosis without involving the gastrointestinal tract. We describe a case of pulmonary microsporidiosis in a 27-year-old Italian man with AIDS who developed fever, cough, and dyspnea. A chest X-ray showed multiple bilateral pulmonary opacities and mediastinal lymph-node enlargement. Stained smears of bronchoalveolar lavage sediment showed oval structures consistent with microsporidian spores. Viral, bacterial and fungal cultures were repeatedly negative, whereas microsporidia were successfully cultured in human and bovine fibroblast cell lines. Analysis of electron micrographs indicated that the isolate belonged to the genus Encephalitozoon. Based on further immunological, biochemical and molecular studies it was characterized as E. hellem. Even though a temporary improvement with albendazole therapy was noticed the patient deteriorated clinically and died of severe respiratory distress. C1 UNIV PAVIA,DEPT BIOL ANIM,I-27100 PAVIA,ITALY. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA. LECCO HOSP,INFECT DIS UNIT,LECCO,ITALY. RP Scaglia, M (reprint author), UNIV PAVIA,IRCCS SAN MATTEO,INST INFECT DIS,LAB CLIN PARASITOL,I-27100 PAVIA,ITALY. NR 20 TC 17 Z9 17 U1 0 U2 0 PU W B SAUNDERS CO LTD PI LONDON PA 24-28 OVAL RD, LONDON, ENGLAND NW1 7DX SN 0163-4453 J9 J INFECTION JI J. Infect. PD MAR PY 1997 VL 34 IS 2 BP 119 EP 126 DI 10.1016/S0163-4453(97)92414-2 PG 8 WC Infectious Diseases SC Infectious Diseases GA WU014 UT WOS:A1997WU01400005 PM 9138134 ER PT J AU Steffen, R Melling, J Woodall, JP Rollin, PE Lang, RH Luthy, R Waldvogel, A AF Steffen, R Melling, J Woodall, JP Rollin, PE Lang, RH Luthy, R Waldvogel, A TI Preparation for emergency relief after biological warfare SO JOURNAL OF INFECTION LA English DT Article ID ANTHRAX AB Upon invitation by the World Health Organization during the Gulf War a task force ''Scorpio'' independent from the nations involved ill the armed conflict was formed whose task was to determine whether, which and to what extent biological warfare agents had been used. Risk assessment concluded that anthrax and Clostridium botulinum toxin were the major risks. The 21 civilian experts had rapidly to decide on the doctrine of operation, to assemble material which could be used and to be immunized or protected otherwise against the potential risks. Biological warfare agents may be used anywhere any time, be it by terrorists or during open or clandestine hostilities. The general population cannot rely on the military to take care of civilian relief, thus international and national organizations may wish to establish similar task forces basing on the ''Scorpio'' model on a national or regional basis. C1 CTR APPL MICROBIOL,SALISBURY SP4 0JG,WILTS,ENGLAND. NEW YORK STATE DEPT HLTH,NEW YORK,NY. CTR DIS CONTROL & PREVENT,SPECIAL PATHOGENS BRANCH,ATLANTA,GA. UNIV BERN,INST PATHOL,BERN,SWITZERLAND. UNIV ZURICH HOSP,DIV INFECT DIS,CH-8091 ZURICH,SWITZERLAND. UNIV ZURICH,INST VET PATHOL,ZURICH,SWITZERLAND. RP Steffen, R (reprint author), UNIV ZURICH,ISPM,SUMATRASTR 30,CH-8006 ZURICH,SWITZERLAND. RI Infektiologie, USZ/A-6921-2011 NR 12 TC 7 Z9 7 U1 1 U2 3 PU W B SAUNDERS CO LTD PI LONDON PA 24-28 OVAL RD, LONDON, ENGLAND NW1 7DX SN 0163-4453 J9 J INFECTION JI J. Infect. PD MAR PY 1997 VL 34 IS 2 BP 127 EP 132 DI 10.1016/S0163-4453(97)92433-6 PG 6 WC Infectious Diseases SC Infectious Diseases GA WU014 UT WOS:A1997WU01400006 PM 9138135 ER PT J AU Morse, SA Trees, DL Htun, Y Radebe, F Orle, KA Dangor, Y BeckSague, CM Schmid, S Fehler, G Weiss, JB Ballard, RC AF Morse, SA Trees, DL Htun, Y Radebe, F Orle, KA Dangor, Y BeckSague, CM Schmid, S Fehler, G Weiss, JB Ballard, RC TI Comparison of clinical diagnosis and standard laboratory and molecular methods for the diagnosis of genital ulcer disease in lesotho: Association with human immunodeficiency virus infection SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID POLYMERASE CHAIN-REACTION; SEXUALLY-TRANSMITTED DISEASES; HAEMOPHILUS-DUCREYI; HIV-INFECTION; SOUTH-AFRICA; RISK FACTOR; HERPES; PREVALENCE; TYPE-2; DURBAN AB A multiplex polymerase chain reaction (M-PCR) assay for Haemophilus ducreyi, Treponema pallidum, and herpes simplex virus (HSV) was compared with clinical and standard laboratory methods for the diagnosis of genital ulcer disease (GUD) in 105 patients; 36% were human immunodeficiency virus (HIV)-seropositive. Chancroid (80%), syphilis (8%), and genital herpes (8%) were the most frequent diagnoses. H. ducreyi and HSV were isolated from ulcers of 43% and 18% of patients, respectively; in 35%, all cultures were negative and the laboratory diagnosis indeterminate. M-PCR detected H. ducreyi, T. pallidum, and HSV in 56%, 23%, and 26% of patients, respectively; (no definitive diagnosis, 6%). The proportion of patients with more than one agent was 4% by culture and 17% by M-PCR (P = .002). Resolved sensitivities of M-PCR for H. ducreyi and HSV cultures were 95% and 93%, respectively. The sensitivities of H. ducreyi and HSV cultures were 75% and 60%, respectively. HSV, detected in 47% of specimens from HIV-infected versus 16% from HIV-uninfected patients (P < .001), may be emerging as a more frequent cause of GUD. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. S AFRICAN INST MED RES,NATL REFERENCE CTR SEXUALLY TRANSMITTED DIS,ZA-2000 JOHANNESBURG,SOUTH AFRICA. DEPT HLTH,JOHANNESBURG,SOUTH AFRICA. ROCHE MOL SYST,ALAMEDA,CA. RP Morse, SA (reprint author), CTR DIS CONTROL & PREVENT,DIV AIDS,SEXUALLY TRANSMITTED DIS & TB LAB RES,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 43 TC 104 Z9 107 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD MAR PY 1997 VL 175 IS 3 BP 583 EP 589 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK411 UT WOS:A1997WK41100011 PM 9041329 ER PT J AU Griffin, PM Hatheway, CL Rosenbaum, R Sokolow, R AF Griffin, PM Hatheway, CL Rosenbaum, R Sokolow, R TI Endogenous antibody production to botulinum toxin in an adult with intestinal colonization botulism and underlying Crohn's disease SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT Interagency-Botulism-Research-Coordinating-Committee Meeting CY NOV 13-15, 1995 CL CTR DIS CONTROL & PREVENT, ATLANTA, GA SP Interagcy Botulism Res Coordinating Comm HO CTR DIS CONTROL & PREVENT ID CLOSTRIDIUM-BOTULINUM; MICE; SUSCEPTIBILITY AB A patient with obstruction of the terminal ileum from Crohn's disease developed complete paralysis in week 1 of hospitalization. Features initially suggested Guillain-Barre syndrome, but botulinum toxin was identified in serum and stool specimens from week 1 and type A toxin-producing Clostridium botulinum in stool specimens from weeks 3 to 19, confirming botulism due to intestinal colonization. In week 19, the inflamed small bowel was resected, and C. botulinum disappeared from the stool. In week 31, the patient was able to breath without assistance. Testing for an active immune response with neutralizing antibodies to C. botulinum at week 19 was positive; these antibodies remained at a protective level for >1 year. Intestinal colonization botulism, rare in adults, should be considered for patients with descending paralysis, especially those with a preceding alteration in small bowel function. An active immune response to botulinum toxin with production of protective antibodies has not been demonstrated previously in a patient with botulism and may have contributed to this patient's recovery. C1 OREGON CLIN,DIV NEUROL,PORTLAND,OR. OREGON STATE PUBL HLTH LABS,PORTLAND,OR. RP Griffin, PM (reprint author), CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333, USA. NR 27 TC 25 Z9 29 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD MAR PY 1997 VL 175 IS 3 BP 633 EP 637 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK411 UT WOS:A1997WK41100017 PM 9041335 ER PT J AU Wainwright, RB Bulkow, LR Parkinson, AJ Zanis, C McMahon, BJ AF Wainwright, RB Bulkow, LR Parkinson, AJ Zanis, C McMahon, BJ TI Protection provided by hepatitis B vaccine in a Yupik Eskimo population - Results of a 10-year study SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID HOMOSEXUAL MEN; VIRUS-INFECTION; EFFICACY; IMMUNOGENICITY; CHILDREN; DURATION; IMMUNITY; 7-YEAR; TRIAL AB A hepatitis B virus vaccine demonstration project was conducted in southwest Alaska in 1981-1982 to determine the immunogenicity and efficacy of the vaccine, A total of 1630 susceptible persons in the Alaskan Native population were vaccinated with the recommended three-dose regimen of plasma-derived hepatitis B vaccine, and 94% demonstrated antibody to hepatitis B surface antigen (anti-HBs) at levels greater than or equal to 10 mIU/mL. After 10 years of follow-up, 76% of those immunized had anti-HBs levels greater than or equal to 10 mIU. During the 10 years following the first dose of vaccine, 13 study participants developed antibody to hepatitis B core antigen (10 vaccine responders, 3 nonresponders), and none developed sustained HBs positivity or had clinical hepatitis. These data suggest that immunization with hepatitis B vaccine continues to provide high levels of protection from clinical disease for at least 10 years. C1 CTR DIS CONTROL & PREVENT,ARCTIC INVEST PROGRAM,NATL CTR INFECT DIS,PUBL HLTH SERV,US DEPT HHS,ANCHORAGE,AK 99501. INDIAN HLTH SERV,ALASKA NAT MED CTR,ALASKA AREA NAT HLTH SERV,ANCHORAGE,AK. NR 14 TC 122 Z9 126 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD MAR PY 1997 VL 175 IS 3 BP 674 EP 677 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK411 UT WOS:A1997WK41100023 PM 9041341 ER PT J AU Steketee, RW Abrams, EJ Thea, DM Brown, TM Lambert, G Orloff, S Weedon, J Bamji, M Schoenbaum, EE Rapier, J Kalish, ML Beatrice, ST Chiasson, MA Debenardo, E ODonnell, R Oleszki, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Courtland, R Cruz, N Floyd, J FoyeSousou, V Hodge, R Hutchison, S Jackson, L Jessop, DJ Macias, L McVeigh, K Ng, D Nelson, K Rosenbluth, L Tadros, H Young, S Zhang, ZR Daligadu, M Hoover, W Krasinksi, K Lopez, D Pollack, H Rios, J Belmore, A Champion, S Freedland, C Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V Grimm, KT Crane, M Campbell, P Davila, S Dobrosycki, J Grant, D Harish, Z Harris, A Nieves, M Soloman, L Steiner, A Wiznia, A Greenberg, B Sivapalasingham, M Naccarato, M Brooks, G Nicholson, M Mayers, M Schable, C AF Steketee, RW Abrams, EJ Thea, DM Brown, TM Lambert, G Orloff, S Weedon, J Bamji, M Schoenbaum, EE Rapier, J Kalish, ML Beatrice, ST Chiasson, MA Debenardo, E ODonnell, R Oleszki, W Punsalang, A Alford, T Betre, A Cappelli, M Carrasquillio, N Courtland, R Cruz, N Floyd, J FoyeSousou, V Hodge, R Hutchison, S Jackson, L Jessop, DJ Macias, L McVeigh, K Ng, D Nelson, K Rosenbluth, L Tadros, H Young, S Zhang, ZR Daligadu, M Hoover, W Krasinksi, K Lopez, D Pollack, H Rios, J Belmore, A Champion, S Freedland, C Prince, P Rogers, A Suarez, M Chow, J Kaul, A Nachman, S Shah, K Ahmed, S Agustin, E Henriquez, R Sacharzky, E Losub, SI Brotman, R Blanch, S Brutus, J Day, C Hutson, D Rhinehart, W Simon, R Turkell, V Grimm, KT Crane, M Campbell, P Davila, S Dobrosycki, J Grant, D Harish, Z Harris, A Nieves, M Soloman, L Steiner, A Wiznia, A Greenberg, B Sivapalasingham, M Naccarato, M Brooks, G Nicholson, M Mayers, M Schable, C TI Early detection of perinatal human immunodeficiency virus (HIV) type 1 infection using HIV RNA amplification and detection SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT XIth International Conference on AIDS CY JUL 07-13, 1996 CL VANCOUVER, CANADA ID POLYMERASE CHAIN-REACTION; INFANTS BORN; DIAGNOSIS; MOTHERS AB Early diagnosis of perinatally transmitted human immunodeficiency virus type 1 (HIV) infection can guide early interventions. HIV coculture and DNA polymerase chain reaction (DNA-PCR) detect few HIV-infected infants at birth and 90%-100% by age 3 months. Because extracellular HIV RNA may appear soon after infection, a plasma HIV RNA assay was compared with DNA-PCR for early detection of perinatally infected infants. Blood-draw specimens (108) obtained at the same time from 49 HIV-infected infants and 10 specimens from 8 uninfected infants were tested. HIV RNA and DNA-PCR positivity rates were 56% and 33%, respectively, in 36 specimens from 36 infants <28 days of age (binomial test, P = .001). Among 81 specimens obtained after age 14 days, 79 (98%) were positive by HIV RNA testing. No HIV-infected infant specimens were DNA-PCR-positive and HIV RNA-negative. All specimens from 8 uninfected infants were HIV RNA-negative. These results suggest that plasma HIV RNA was detectable earlier and more reliably than HIV DNA in perinatal infection. C1 METROPOLITAN HOSP,NEW YORK,NY. BRONX LEBANON HOSP CTR,BRONX,NY 10456. MONTEFIORE MED CTR,BRONX,NY 10467. HARLEM HOSP MED CTR,MED & HLTH RES ASSOC,NEW YORK,NY. RP Steketee, RW (reprint author), CTR DIS CONTROL & PREVENT,EPIDEMIOL BRANCH,DHAP,NCHSTP,MAILSTOP E-45,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 15 TC 73 Z9 76 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD MAR PY 1997 VL 175 IS 3 BP 707 EP 711 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WK411 UT WOS:A1997WK41100032 PM 9041350 ER PT J AU Lew, RA Hall, HI Nadel, M May, DS Geller, AC Miller, DS Koh, HK AF Lew, RA Hall, HI Nadel, M May, DS Geller, AC Miller, DS Koh, HK TI Factors associated with ever having had screening for skin cancer. SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract C1 BOSTON UNIV,SCH MED,DEPT DERMATOL,BOSTON,MA 02118. CTR DIS CONTROL & PREVENT,BOSTON,MA 02118. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 1997 VL 108 IS 3 BP 5 EP 5 PG 1 WC Dermatology SC Dermatology GA WJ663 UT WOS:A1997WJ66300025 ER PT J AU Burnett, C Lushniak, B McCarthy, W Kaufman, J AF Burnett, C Lushniak, B McCarthy, W Kaufman, J TI Occupational dermatitis causing lost work days SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract C1 NIOSH,CINCINNATI,OH 45226. OI Kaufman, Joel/0000-0003-4174-9037 NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD MAR PY 1997 VL 108 IS 3 BP 11 EP 11 PG 1 WC Dermatology SC Dermatology GA WJ663 UT WOS:A1997WJ66300031 ER PT J AU Dolan, MC Maupin, GO Panella, NA Golde, WT Piesman, J AF Dolan, MC Maupin, GO Panella, NA Golde, WT Piesman, J TI Vector competence of Ixodes scapularis, I-spinipalpis, and Dermacentor andersoni (Acari: Ixodidae) in transmitting Borrelia burgdorferi, the etiologic agent of Lyme disease SO JOURNAL OF MEDICAL ENTOMOLOGY LA English DT Article DE Ixodes scapularis; Ixodes spinipalpis; Dermacentor andersoni; vector competence ID BLACK-LEGGED TICK; AMBLYOMMA-AMERICANUM; SPIROCHETE; DAMMINI; VARIABILIS; PREVALENCE; MAMMALS; WISCONSIN; PACIFICUS; RODENTS AB This report describes the vector competence of 3 ixodid tick species, Ixodes scapularis (Say), I. spinipalpis (Nuttall), and Dermacentor andersoni (Stiles), for Borrelia burgdorferi in Colorado. The study was based on preliminary field work performed in 6 Colorado counties, where rodents and ticks were collected and assayed for the presence of B. burgdorferi. Four of the 6 counties produced 52 rodent and 39 I. spinipalpis isolates of B. burgdorferi. Two B. burgdorferi isolates were tested under laboratory conditions and found to be infective to Imperial Cancer Research Fund (ICRF) outbred mice. The 1st, a low-passage strain originating from New York (B-31, passage 6) was used as a control, and the 2nd was isolated from ear tissue of a Neotoma mexicana (Baird) (Mexican wood rat) that was trapped in Colorado. Larvae of I. scapularis, I. spinipalpis, and D. andersoni were fed on infected mice and cultured in Barbour-Stoner-Kelly media to assay for infection at 1, 2, 3, and 4 wk after repletion. The infection rates in replete larvae were 75, 69, and 8.5%, respectively, whereas transstadial nymphal infection rates were 80, 75, and 0%, respectively. Both I. scapularis and I. spinipalpis were shown to be competent vectors that acquired the infection from the host reservoir mice and subsequently transmitted it to naive mice. Given that I. scapularis are not found in Colorado, I. spinipalpis are restricted to the nests and burrows of rodents, and because of the semiarid environment in Colorado, the risk of human contact with B. burgdorferi appears to be low. RP Dolan, MC (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VECTOR BORNE INFECT DIS,PHS,FT COLLINS,CO 80522, USA. NR 26 TC 36 Z9 38 U1 0 U2 2 PU ENTOMOL SOC AMER PI LANHAM PA 9301 ANNAPOLIS RD, LANHAM, MD 20706 SN 0022-2585 J9 J MED ENTOMOL JI J. Med. Entomol. PD MAR PY 1997 VL 34 IS 2 BP 128 EP 135 PG 8 WC Entomology; Veterinary Sciences SC Entomology; Veterinary Sciences GA WP050 UT WOS:A1997WP05000006 PM 9103755 ER PT J AU Cliff, AD Haggett, P SmallmanRaynor, M Stroup, DF Williamson, GD AF Cliff, AD Haggett, P SmallmanRaynor, M Stroup, DF Williamson, GD TI The importance of long-term records in public health surveillance: The US weekly sanitary reports, 1888-1912, revisited SO JOURNAL OF PUBLIC HEALTH MEDICINE LA English DT Article DE public health surveillance; history; infectious diseases; United States AB Background This paper outlines the ways in which a little-used archive of early public health records may throw light on longer-term trends in international epidemic behaviour and serve as a major source of epidemiological information for historians of urbanization and public health. The Weekly Abstract of Sanitary Reports was the official disease surveillance report of the US Public Health Service and its predecessors, and began to publish urban mortality statistics on a regular basis in 1888. Here, the authors describe the first 25 years of continuous reporting (1888-1912), when the Reports contained not only disease data far US cities, but also records sent back by US consuls based in some 250 cities in many parts of the world. Methods The content of the weekly editions of the Reports was systematically sampled and analysed using graphical techniques and the simple statistical method of running means. Results Relatively complete weekly series of mortality from all causes, and six infectious diseases (diphtheria, enteric or typhoid fever, measles, scarlet fever, tuberculosis and whooping cough) were identified for a total of 100 cities world-wide. Conclusion Reporting coverage for these cities is sufficiently complete that multivariate analysis should be possible to obtain a comparative picture of mortality for many parts of the world, Despite limitations of the data, sources of the type described in this paper form an important comparative database for studying international patterns of mortality. C1 CTR DIS CONTROL & PREVENT,DIV SURVEILLANCE & EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. UNIV NOTTINGHAM,DEPT PUBL HLTH MED & EPIDEMIOL,NOTTINGHAM NG7 2RD,ENGLAND. UNIV NOTTINGHAM,DEPT GEOG,NOTTINGHAM NG7 2RD,ENGLAND. UNIV BRISTOL,DEPT GEOG,BRISTOL BS8 1SS,AVON,ENGLAND. UNIV CAMBRIDGE,DEPT GEOG,CAMBRIDGE CB2 3EN,ENGLAND. FU Wellcome Trust NR 25 TC 11 Z9 11 U1 1 U2 8 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD, ENGLAND OX2 6DP SN 0957-4832 J9 J PUBLIC HEALTH MED JI J. Public Health Med. PD MAR PY 1997 VL 19 IS 1 BP 76 EP 84 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WT332 UT WOS:A1997WT33200015 PM 9138222 ER PT J AU Croft, JB Giles, WH Pollard, RA Casper, ML Anda, RF Livengood, JR AF Croft, JB Giles, WH Pollard, RA Casper, ML Anda, RF Livengood, JR TI National trends in the initial hospitalization for heart failure SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; UNITED-STATES; MEDICARE PATIENTS; DISCHARGE SURVEY; ELDERLY PATIENTS; DIAGNOSIS; RATES; DYSFUNCTION; MORTALITY; ACCURACY AB OBJECTIVES: Heart failure is a major hearth care burden among older adults, but information on recent trends has not been available. We compare rates, sociodemographic characteristics, and discharge outcomes of the initial hospitalization for heart failure in the Medicare populations of 1986 and 1993. DESIGN: Information reported on the Medicare hospital claims record during initial hospitalization for heart failure was compared for patients aged 65 and older hospitalized in 1986 (N = 631,306) and those aged 65 and older hospitalized in 1993 (N = 803,506). RESULTS: Age-standardized hospitalization rates (per 1000 person-years) for any diagnosis of heart failure were higher in 1993 than in 1986 (white: 24.6 vs 22.4, black: 26.1 vs 22.4, respectively). Age-specific results suggested an earlier onset of heart failure in black adults. In 1993, compared with 1986, higher proportions of heart failure patients were discharged to another care facility (white: 23.9% vs 16.8%, black: 17.6% vs 10.5%, respectively) or to health service care at home (white: 11.3% vs 6.0%, black: 12.4% vs 6.5%, respectively). In contrast, in-hospital mortality was lower in 1993 than in 1986 (white: 10.4% vs 13.3%, black: 8.9% vs 11.1%, respectively). CONCLUSION: The increased numbers of hospitalizations for heart failure and the likelihood that these patients will require advanced nursing care after discharge have important implications for future national health care expenditures and resources. C1 CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,STAT BRANCH,ATLANTA,GA 30341. RP Croft, JB (reprint author), CTR DIS CONTROL & PREVENT,CARDIOVASC HLTH STUDIES BRANCH,MAILSTOP K-47,4770 BUFORD HWY NE,ATLANTA,GA 30341, USA. NR 34 TC 74 Z9 75 U1 0 U2 0 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD MAR PY 1997 VL 45 IS 3 BP 270 EP 275 PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA WL773 UT WOS:A1997WL77300002 PM 9063270 ER PT J AU Meyer, H Ropp, SL Esposito, JJ AF Meyer, H Ropp, SL Esposito, JJ TI Gene for A-type inclusion body protein is useful for a polymerase chain reaction assay to differentiate orthopoxviruses SO JOURNAL OF VIROLOGICAL METHODS LA English DT Article DE orthopoxvirus; PCR; differentiation; ATI-gene ID SMALLPOX AB Orthopoxvirus species were identified and differentiated by polymerase chain reaction amplification of genome DNA using a single primer-pair based on sequences coding for the major protein component of the cowpox virus acidophilic-type inclusion body (ATI). DNA available for 6 of 8 Old World (cowpox, variola, monkeypox, camelpox, ectromelia and vaccinia viruses) and 3 New World (skunkpox, volepox, and raccoonpox) resulted in amplicons that ranged in size from 510 to 1673 base pairs depending on the species, except for raccoonpox virus DNA which did not amplify. XbaI digest gel electrophoresis profiles of the amplicons improved resolution of the differences. (C) 1997 Elsevier Science B.V. C1 US PHS,CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. RP Meyer, H (reprint author), FED ARMED FORCES MED ACAD,INST MICROBIOL,NEUHERBERGSTR 11,D-80937 MUNICH,GERMANY. NR 11 TC 75 Z9 80 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0166-0934 J9 J VIROL METHODS JI J. Virol. Methods PD MAR PY 1997 VL 64 IS 2 BP 217 EP 221 DI 10.1016/S0166-0934(96)02155-6 PG 5 WC Biochemical Research Methods; Biotechnology & Applied Microbiology; Virology SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology; Virology GA WP033 UT WOS:A1997WP03300011 PM 9079767 ER PT J AU Vine, A Swaminathan, B AF Vine, A Swaminathan, B TI Nucleotide sequence analysis of two virulence-associated genes in Listeria monocytogenes serotype 1/2b and comparison with the same genes in other serotypes important in human disease SO LETTERS IN APPLIED MICROBIOLOGY LA English DT Article ID PHOSPHOLIPASE-C; VACUOLE; ESCAPE AB The nucleotide sequences of the hly and plcA genes (encoding listeriolysin, a thiol-activated cytolysin and a non-specific phospholipase C, respectively) were determined for two strains of Listeria monocytogenes serotype 1/2b. The deduced amino acid sequences for listeriolysin were identical for the two strains and identical to that of listeriolysin from serotype 4b. The two serotype 1/2b strains differed in one amino acid (histidine vs asparagine) in the deduced amino acid sequence for phosopholipase C. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,FOODBORNE & DIARRHEAL DIS BRANCH,ATLANTA,GA 30333. CLARK ATLANTA UNIV,ATLANTA,GA 30314. NR 12 TC 5 Z9 8 U1 0 U2 0 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD, OXON, ENGLAND OX2 0NE SN 0266-8254 J9 LETT APPL MICROBIOL JI Lett. Appl. Microbiol. PD MAR PY 1997 VL 24 IS 3 BP 166 EP 168 DI 10.1046/j.1472-765X.1997.00361.x PG 3 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA WM708 UT WOS:A1997WM70800003 PM 9080692 ER PT J AU Curado, I Duarte, AMRC Lal, AA Oliveira, SG Kloetzel, JK AF Curado, I Duarte, AMRC Lal, AA Oliveira, SG Kloetzel, JK TI Antibodies anti bloodstream and circumsporozoite antigens (Plasmodium vivax and Plasmodium malariae P-brasilianum) in areas of very low malaria endemicity in Brazil SO MEMORIAS DO INSTITUTO OSWALDO CRUZ LA English DT Article DE malaria serology; Plasmodium vivax; Plasmodium vivax VK247; human Plasmodium vivax-like; Plasmodium malaria P-brasilianum; circumsporozoite protein; Brazil ID SYNTHETIC PEPTIDES; PROTEIN GENE; SPOROZOITES; PARASITE; INDIVIDUALS; IMMUNITY; VARIANT AB During 1992-1994, 33 malaria cases were reported in two regions in Brazil where few sporadic atypical cases occur most of them in home owners, who are weekenders, while home caretakers live there permanently. Indirect Fluorescent Antibody Test (IFAT), with Plasmodium vivax, and Enzime Linked Immunosorbent Assay (ELISA) with repeat peptides of the circumsporozoite (CS) proteins of the 3 known P. vivax variants and P. malarie/P. brasilianum, were performed on 277 sera, obtained within a 5 to 10 km range of malaria cases. Very rarely did any of these donors recall typical malaria episodes. Blood smears of all but 5 were negative. One of the 5 malaria cases included in our serology was of a home owner, 1 of a permanent resident, 3 from Superintendencia de Controle de Endemias employees who went there to capture mosquitoes. In Region 1 the prevalence of IFAT positive sera was 73% and 28% among caretakers, 18% and 9.6% among home owners. In Region 2 (3 localities) no distinction was possible between caretakers and home owners, IFAT positivity being 38%, 28% and 7%. The relative percentage of positive anti-CS repeats ELISA, differed for each of the peptides among localities. Dwellings are in the vicinity of woods, where monkeys are frequently seen. The origin of these malaria cases, geographical differences and high seropositivity is discussed. C1 INST TROP MED,BR-05403000 SAO PAULO,BRAZIL. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,MALARIA DIV,ATLANTA,GA 30341. INST EVANDRO CHAGAS,BR-66090000 BELEM,PARA,BRAZIL. USP,INST CIENCIAS BIOMED,DEPT PARASITOL,BR-05508900 SAO PAULO,BRAZIL. RP Curado, I (reprint author), INST BUTANTAN,LAB IMUNOPATOL,AV VITAL BRASIL 1500,BR-05503900 SAO PAULO,BRAZIL. NR 37 TC 25 Z9 27 U1 0 U2 2 PU FUNDACO OSWALDO CRUZ PI RIO DE JANEIRO, RJ PA AV BRASIL 4365, 21045-900 RIO DE JANEIRO, RJ, BRAZIL SN 0074-0276 J9 MEM I OSWALDO CRUZ JI Mem. Inst. Oswaldo Cruz PD MAR-APR PY 1997 VL 92 IS 2 BP 235 EP 243 PG 9 WC Parasitology; Tropical Medicine SC Parasitology; Tropical Medicine GA WR478 UT WOS:A1997WR47800017 PM 9332584 ER PT J AU Charp, PA AF Charp, PA TI Al Eskan disease: Persian gulf syndrome SO MILITARY MEDICINE LA English DT Letter RP Charp, PA (reprint author), US PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA 30333, USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 SN 0026-4075 J9 MIL MED JI Milit. Med. PD MAR PY 1997 VL 162 IS 3 BP R2 EP R2 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WP113 UT WOS:A1997WP11300003 PM 9121655 ER PT J AU DaSilva, AJ Slemenda, SB Visvesvara, GS Schwartz, DA Wilcox, CM Wallace, S Pieniazek, NJ AF DaSilva, AJ Slemenda, SB Visvesvara, GS Schwartz, DA Wilcox, CM Wallace, S Pieniazek, NJ TI Detection of Septata intestinalis (Microsporidia) Cali et al. 1993 using polymerase chain reaction primers targeting the small subunit ribosomal RNA coding region SO MOLECULAR DIAGNOSIS LA English DT Article DE microsporidia; molecular diagnostics; AIDS; diarrhea ID IN-VITRO CULTURE; ENTEROCYTOZOON-BIENEUSI; ENCEPHALITOZOON-CUNICULI; NUCLEOTIDE-SEQUENCE; AIDS PATIENTS; IDENTIFICATION; INFECTIONS; STOOL; PCR; DIAGNOSIS AB Background: The microsporidian Septata intestinalis, recently suggested to be reclassified as Encephalitozoon intestinalis, is probably the second most common microsporidian isolated from AIDS patients after Enterocytozoon bieneusi. S. intestinalis causes a disseminated disease, including infections of the gastroin-testinal tract, whereas E. bieneusi is confined strictly to the gastrointestinal tract. It is important to differentiate between these two microsporidians, as only infections caused by S. intestinalis can, at this time, be effectively treated. Currently, diagnosis of infections caused by S. intestinalis can be achieved only by transmission electron microscopy. Methods and Results: In this study are described specific polymerase chain reaction primers for diagnosis of S. intestinalis infections based on the region coding for the small subunit ribosomal RNA cloned from a S. intestinalis isolate. These primers were tested for specificity on cloned ribosomal RNA sequences of different species of microsporidia, as well as on cultured samples of E. bieneusi, Encephalitozoon cuniculi, Encephalitozoon hellem, and Vittaforma corneae (Nosema corneum), without showing any cross-amplification. By use of these polymerase chain reaction primers, eight different microsporidian isolates grown in culture and one diagnostic sample, collected as an ethanol-fixed duodenal-jejunal segment, were identified as S. intestinalis. Conclusion: These primers are powerful diagnostic tools and can enhance or replace traditional methods used to diagnose this microsporidian. C1 UNIV FED RIO DE JANEIRO,INST MICROBIOL,RIO JANEIRO,BRAZIL. CTR DIS CONTROL & PREVENT,BIOL & DIAGNOST BRANCH,DIV PARASIT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30341. EMORY UNIV,SCH MED,ATLANTA,GA 30322. GRADY MEM HOSP,ATLANTA,GA 30322. NR 23 TC 58 Z9 61 U1 0 U2 0 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI NEW YORK PA 650 AVENUE OF THE AMERICAS, NEW YORK, NY 10011 SN 1084-8592 J9 MOL DIAGN JI Mol. Diagn. PD MAR PY 1997 VL 2 IS 1 BP 47 EP 52 DI 10.1016/S1084-8592(97)80010-0 PG 6 WC Biotechnology & Applied Microbiology; Medical Laboratory Technology; Medicine, Research & Experimental SC Biotechnology & Applied Microbiology; Medical Laboratory Technology; Research & Experimental Medicine GA XW605 UT WOS:A1997XW60500009 ER PT J AU Lehmann, T Besansky, NJ Hawley, WA Fahey, TG Kamau, L Collins, FH AF Lehmann, T Besansky, NJ Hawley, WA Fahey, TG Kamau, L Collins, FH TI Microgeographic structure of Anopheles gambiae in western Kenya based on mtDNA and microsatellite loci SO MOLECULAR ECOLOGY LA English DT Article DE Anopheles; microgeographic population structure; microsatellite; mtDNA; population genetics ID ALLELE FREQUENCIES; DNA-SEQUENCE; POPULATION; COMPLEX; SUBDIVISION; MOSQUITO; MALARIA; AFRICA AB The population genetic structure of the Anopheles gambiae in western Kenya was studied using length variation at five microsatellite loci and sequence variation in a 648-nt mtDNA fragment. Mosquitoes were collected from houses in villages spanning up to 50 km distance. The following questions were answered, (i) Are mosquitoes in a house more related genetically to each other than mosquitoes between houses? (ii) What degree of genetic differentiation occurs on these geographical scales? (iii) How consistent are the results obtained with both types of genetic markers? At the house level, no differentiation was detected by F-ST and R(ST), and the band sharing index test revealed no significant associations of alleles across loci. Likewise, indices of kinship based on mtDNA haplotypes in houses were even lower than in the pooled sample. Therefore, the hypothesis that mosquitoes in a house are more related genetically was rejected. At increasing geographical scales, microsatellite allele distributions were similar among all population samples and no subdivision of the gene pool was detected by F-ST or R(ST). Likewise, estimates of haplotype divergence of mtDNA between populations were not higher than the within population estimates, and mtDNA-based F-ST values were not significantly different from zero. That sequence variation in mtDNA provided matching results with microsatellite loci (while high genetic variation was observed in all loci), suggested that this pattern represents the whole genome. The minimum area associated with a deme of A. gambiae in western Kenya is therefore larger than 50 km in diameter. C1 EMORY UNIV,DEPT BIOL,ATLANTA,GA 30322. CLIN RES CTR,KENYA MED RES INST,NAIROBI,KENYA. RP Lehmann, T (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,MAILSTOP F22,4770 BUFORD HIGHWAY,CHAMBLEE,GA 30341, USA. NR 37 TC 71 Z9 75 U1 0 U2 3 PU BLACKWELL SCIENCE LTD PI OXFORD PA P O BOX 88, OSNEY MEAD, OXFORD, OXON, ENGLAND OX2 0NE SN 0962-1083 J9 MOL ECOL JI Mol. Ecol. PD MAR PY 1997 VL 6 IS 3 BP 243 EP 253 DI 10.1046/j.1365-294X.1997.00177.x PG 11 WC Biochemistry & Molecular Biology; Ecology; Evolutionary Biology SC Biochemistry & Molecular Biology; Environmental Sciences & Ecology; Evolutionary Biology GA WK617 UT WOS:A1997WK61700005 PM 9076979 ER PT J AU Yoon, PW Bresee, JS Olney, RS James, LM Khoury, MJ AF Yoon, PW Bresee, JS Olney, RS James, LM Khoury, MJ TI Epidemiology of biliary atresia: A population-based study SO PEDIATRICS LA English DT Article DE biliary atresia; bile ducts; space-time clustering; race ID REOVIRUS TYPE-3 INFECTION; NEONATAL HEPATITIS; 2 SETS; TWINS; VIRUS; ASSOCIATION; RECURRENCE; ETIOLOGY; NEWBORN; DISEASE AB Objective. Biliary atresia is the leading cause of extrahepatic obstructive jaundice in the newborn and is the single most frequent indication for liver transplantation in children. The cause of biliary atresia is unknown, although several mechanisms have been postulated to explain the inflammatory process that obliterates the bile ducts. Most interest has been directed toward viral infections, information about the epidemiologic characteristics of biliary atresia in well-defined populations is lacking but is essential for developing and addressing hypotheses of causation for the disease. Methods. Infants with biliary atresia were identified in metropolitan Atlanta from 1968 through 1993 by a population-based birth defects surveillance system that ascertains infants with serious birth defects in the first year of life using active case ascertainment. Birth prevalence rates were analyzed for spatial and temporal clustering and effects attributable to county of residence, sex, race, maternal age, parity, and birth weight. Logistic regression was used to study the independent effects of the risk factors and to look for interactions. Results. Fifty-seven infants with biliary atresia were identified, for a rate of 0.73 per 10 000 live births. There was significant seasonal clustering of the disease, with rates three times higher from December through March compared with rates from April through July. Rates were significantly higher among nonwhite infants compared with white infants (0.96 vs 0.44 per 10 000 live births) and infants born at term with low birth weights (<2500 g) compared with infants born at term with normal birth weights (greater than or equal to 2500 g) (2.62 vs 0.75 per 10 000 live births). Conclusions. Our study is the first in the United States to describe the epidemiologic characteristics of biliary atresia using a population-based approach. The demonstration of significant seasonal clustering provides support for theories that biliary atresia may be caused by environmental exposure (consistent with a viral cause) during the perinatal period. C1 CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30341. RP Yoon, PW (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV BIRTH DEFECTS & DEV DISABILITIES,MS F-45,ATLANTA,GA 30341, USA. NR 43 TC 96 Z9 103 U1 0 U2 4 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD MAR PY 1997 VL 99 IS 3 BP 376 EP 382 DI 10.1542/peds.99.3.376 PG 7 WC Pediatrics SC Pediatrics GA WR147 UT WOS:A1997WR14700012 PM 9041292 ER PT J AU Mermin, J Hoar, B Angulo, FJ AF Mermin, J Hoar, B Angulo, FJ TI Iguanas and Salmonella Marina infection in children: A reflection of the increasing incidence of reptile-associated salmonellosis in the United States SO PEDIATRICS LA English DT Article DE antibiotics; Salmonella Marina; infant; pediatric AB Objective. To investigate clinical aspects and risk factors for Salmonella serotype Marina infection in the United States. Methods. We identified all isolates of S Marina reported in 1994 to the National Salmonella Surveillance System. Patients were interviewed about demographic information, clinical course, diet, travel history, and contact with reptiles before illness. Results. Twenty-six (81%) of 32 patients were infants (<1 year of age) and 24 (75%) were male. This differs from other Salmonella isolates reported to the Centers for Disease Control and Prevention in 1994, of which 14% were from infants and 49% from male patients. Eleven patients (34%) were hospitalized for a median of 3.5 days (range: 2 to 21 days), and 1 died. Of 28 patients (88%) with reported iguana exposure, only 4 (14%) touched the reptile, and only 12 respondents (43%) realized that it might have been the source of infection. Seven (32%) of 22 families who owned an iguana at the time of illness continued to own an iguana when contacted a median of 28 weeks later. Persons who thought that the iguana was the source of infection were more likely to have given away or sold the pet than those who did not. Four isolates (13%) were from blood. Bacteremia was associated with taking antibiotics during the 30 days before S Marina infection (odds ratio: 24; 95% confidence interval: 1.2-1309). Conclusion. S Marina infection is a potentially serious illness associated with iguana exposure, and it reflects the larger problem of reptile-associated salmonellosis. Many parents do not know that owning an iguana puts their children at risk for Salmonella infection. Pediatricians, veterinarians, and pet store owners should inform their patients and customers of the potential risks of owning reptiles and provide appropriate preventive education. RP Mermin, J (reprint author), CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333, USA. RI Mermin, Jonathan/J-9847-2012 NR 18 TC 95 Z9 102 U1 1 U2 4 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD MAR PY 1997 VL 99 IS 3 BP 399 EP 402 DI 10.1542/peds.99.3.399 PG 4 WC Pediatrics SC Pediatrics GA WR147 UT WOS:A1997WR14700015 PM 9041295 ER PT J AU Freedman, DS Srinivasan, SR Valdez, RA Williamson, DF Berenson, GS AF Freedman, DS Srinivasan, SR Valdez, RA Williamson, DF Berenson, GS TI Secular increases in relative weight and adiposity among children over two decades: The Bogalusa Heart Study SO PEDIATRICS LA English DT Article DE child; obesity; body weight; secular trends; blacks; longitudinal studies ID BODY-MASS INDEX; NUTRITION EXAMINATION SURVEYS; CARDIOVASCULAR RISK-FACTORS; UNITED-STATES CHILDREN; PHYSICAL-ACTIVITY; CHILDHOOD WEIGHT; NATIONAL-HEALTH; ENERGY-INTAKE; LONG-TERM; FOLLOW-UP AB Objective. To examine trends in relative weight and obesity among 5- to 24-year-olds between 1973 and 1994. Design. A panel design consisting of seven cross-sectional surveys of schoolchildren and three surveys of post-high-school subjects. Anthropometric measurements included height, weight, and subscapular and triceps skinfolds. Study Population. All schoolchildren residing in Ward 4 of Washington Parish, Louisiana biracial community, were considered eligible; participation rates were >80%. Young adults were eligible if they had participated previously as schoolchildren. A total of 26 371 examinations were performed on 11 564 persons. Results. During the study period, substantial increases in mean levels of weight (0.2 kg/y) and skinfold thickness (0.15 mm/y) were observed; these changes were independent of height, age, and other covariates. The prevalence of overweight, defined by the 85th percentile of weight-for-height in 1973 to 1974 increased approximately twofold by 1994. Although secular increases were seen both among boys and girls and among blacks and whites, the largest increases were seen among 19- to 24-year-olds. Furthermore, the yearly increases in relative weight and obesity during the latter part of the study period (1983 through 1994) were similar to 50% greater than those between 1973 and 1982. Conclusions. The increasing prevalence of obesity in early life indicates a need for primary prevention. Additional study is needed to determine whether these trends are continuing to accelerate and to examine possible explanations, such as diet and physical activity, for these changes. C1 CTR DIS CONTROL & PREVENT,DIV NUTR,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,DIV DIABET TRANSLAT,ATLANTA,GA 30341. TULANE UNIV,SCH PUBL HLTH & TROP MED,TULANE CTR CARDIOVASC HLTH,NEW ORLEANS,LA 70112. FU NHLBI NIH HHS [HL 15103] NR 54 TC 260 Z9 270 U1 2 U2 5 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD MAR PY 1997 VL 99 IS 3 BP 420 EP 426 DI 10.1542/peds.99.3.420 PG 7 WC Pediatrics SC Pediatrics GA WR147 UT WOS:A1997WR14700019 PM 9041299 ER PT J AU Scariati, PD GrummerStrawn, LM Fein, SB Yip, R AF Scariati, PD GrummerStrawn, LM Fein, SB Yip, R TI Risk of diarrhea related to iron content of infant formula: Lack of evidence to support the use of low-iron formula as a supplement for breastfed infants SO PEDIATRICS LA English DT Article DE infant food; diarrhea; breastfeeding; iron ID DECLINING PREVALENCE; DEFICIENCY; ANEMIA; RESISTANCE AB Background. Concern has been raised by infant feeding experts that supplementing breastfed infants with iron-fortified formula rather than low-iron formula may have an undesirable impact on their gastrointestinal flora. Thus far, there have been no clinical studies to address this issue directly. We compared the reported frequency of diarrhea for breastfed infants given iron-fortified formula with those fed low-iron formula. Methods. Mothers participating in a mail panel provided feeding and diarrhea information on their infants at 2, 3, 4, 5, 6, 7, 9, and 12 months (n = 1743). Infants were grouped into five feeding categories: (1) breast milk only, (2) breast milk and low-iron formula, (3) breast milk and iron-fortified formula, (4) low-iron formula only, and (5) iron-fortified formula only. We calculated the number of diarrheal episodes per week for each feeding category and used rate ratios to estimate the relative impact of low-iron and iron-fortified formulas. Results. Among infants who received both breast milk and formula, the rate ratio for iron-fortified formula versus low-iron formula was 1.06 (confidence interval, 0.84 to 1.34), indicating that the type of formula a breastfed infant receives does not significantly affect the frequency of diarrhea. Conclusions. We found no evidence to support the hypothesis that breastfed infants given iron-fortified formula are at greater risk of having diarrhea. This, in addition to the fact that iron-fortified formula has played a major role in preventing childhood iron deficiency anemia, supports the current recommendation that any formula given to infants be fortified with iron. C1 CTR DIS CONTROL & PREVENT, EPIDEM INTELLIGENCE SERV, EPIDEMIOL PROGRAM OFF, ATLANTA, GA 30341 USA. US FDA, CTR FOOD SAFETY & APPL NUTR, OFF SCI ANAL & SUPPORT, WASHINGTON, DC 20204 USA. RP Scariati, PD (reprint author), CTR DIS CONTROL & PREVENT, DIV NUTR & PHYS ACTIV, NATL CTR CHRON DIS PREVENT & HLTH PROMOT, ATLANTA, GA 30341 USA. NR 17 TC 7 Z9 7 U1 0 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD MAR PY 1997 VL 99 IS 3 BP art. no. EP e2 DI 10.1542/peds.99.3.e2 PG 4 WC Pediatrics SC Pediatrics GA WR147 UT WOS:A1997WR14700027 PM 9099767 ER PT J AU Folland, DS AF Folland, DS TI Treatment of croup - Sending home an improved child and relieved parents SO POSTGRADUATE MEDICINE LA English DT Article ID LARYNGOTRACHEITIS; DEXAMETHASONE; TRIALS AB Croup is the most common cause of upper airway obstruction in children between the ages of 6 months and 6 years. Most children can be effectively treated in the office or emergency department with nebulized saline solution and oral or intramuscular dexamethasone (Decadron, Hexadrol) in a dose of 0.6 mg/kg. Occasionally, nebulized racemic epinephrine must be given; a dose of 0.5 mL of 2.25% solution diluted in 2.5 mL of 2.25% saline solution is safe for all ages. Children requiring two epinephrine treatments should be hospitalized. Home care consists of adequate hydration and humidification and fever control. Antihistamines, decongestants, and antibiotics have no proven effect on uncomplicated viral croup. C1 UNIV UTAH,SCH MED,SALT LAKE CITY,UT. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. NR 11 TC 2 Z9 2 U1 0 U2 0 PU MCGRAW HILL HEALTHCARE PUBLICATIONS PI MINNEAPOLIS PA 4530 WEST 77TH ST, MINNEAPOLIS, MN 55435-5000 SN 0032-5481 J9 POSTGRAD MED JI Postgrad. Med. PD MAR PY 1997 VL 101 IS 3 BP 271 EP & PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WN184 UT WOS:A1997WN18400019 PM 9074564 ER PT J AU Zaza, S BeckSague, CM Jarvis, WR AF Zaza, S BeckSague, CM Jarvis, WR TI Tracing patients exposed to health care workers with tuberculosis SO PUBLIC HEALTH REPORTS LA English DT Article ID RESISTANT MYCOBACTERIUM-TUBERCULOSIS; HIV-INFECTED PATIENTS; NOSOCOMIAL TRANSMISSION; OUTBREAK AB Objectives. Following an outbreak of tuberculosis (TB) among health care workers at a public hospital, the study was undertaken to (a) locate all exposed patients and administer tuberculin skin tests (TSTs) to them, (b) provide clinical treatment or prophylaxis to infected patients, and (c) ascertain the risk of M. tuberculosis transmission from health care workers to patients. Methods. The authors identified all patients who had been hospitalized on floors where health care workers with symptomatic TB worked. The staff of the hospital's outpatient HIV/AIDS clinic notified and evaluated clinic patients who had been hospitalized on those floors. County health department personnel attempted to contact the remaining patients by letter and phone. Results. The authors identified 586 patients hospitalized during the health;care worker outbreak, of whom 503 were potentially susceptible. Of these, 172 (34.2%) could be contacted, and 138 (80.2%) completed tuberculin skin testing or other follow-up evaluation. Of 134 who completed testing, 28 (20.9%) had reactive TSTs. In all, 362 patients (72%) were lost to follow-up, including many HIV-positive and homeless patients, who are at high risk of developing active TB once infected with M. tuberculosis. Conclusions. The reemergence of TB as a public health threat and the emergence of other infectious diseases make it imperative to elicit accurate addresses and contact information from hospitalized patients and to develop better methods of contacting patients after hospital discharge. C1 CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,DIV STD TB & HIV LAB RES,NATL CTR INFECT DIS,ATLANTA,GA 30333. NR 7 TC 7 Z9 7 U1 1 U2 1 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPT OF DOCUMENTS, WASHINGTON, DC 20402-9325 SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAR-APR PY 1997 VL 112 IS 2 BP 153 EP 157 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WN191 UT WOS:A1997WN19100030 PM 9071278 ER PT J AU Seage, GR Mayer, KH Lenderking, WR Wold, C Gross, M Goldstein, R Cai, B Heeren, T Hingson, R Holmberg, S AF Seage, GR Mayer, KH Lenderking, WR Wold, C Gross, M Goldstein, R Cai, B Heeren, T Hingson, R Holmberg, S TI HIV and hepatitis B infection and risk behavior in young gay and bisexual men SO PUBLIC HEALTH REPORTS LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; UNITED-STATES; EPIDEMIOLOGY AB Objectives. To estimate the prevalence of and identify risk factors for human immunodeficiency virus type I (HIV-I) and hepatitis B virus (HBV) infections and unprotected anal intercourse among young homosexual and bisexual men. Methods. The authors performed a cross-sectional analysis of data from a prospective cohort of 508 young gay and bisexual men ages 18-29. Results. HIV-I seroprevalence was 2.4%, with five (1.3%) of 390 college students and seven (6.0%) of 117 non-students infected. After adjusting for confounders, HIV-I infection was associated with having a history of a sexually transmitted disease other than HIV-I or hepatitis B. The prevalence of hepatitis B markers in unvaccinated men was 12.9%. The presence of hepatitis B markers in unvaccinated men was significantly associated with Asian ethnicity, off-campus residence, and history of a sexually transmitted disease other than HIV-I or hepatitis B and inversely associated with recent non-intravenous drug use. Eighteen percent of the participants reported having had sex with women during the previous 12 months, and 26.4% reported a history of unprotected anal intercourse during the previous six months. Men who reported unprotected anal intercourse were more likely to have at least one steady partner, to have met their partners in anonymous settings, and to be identified as probably alcohol dependent. Conclusions. Although the prevalence of HIV-I infection among young homosexual and bisexual men in Boston was relatively low, the high rates of unprotected anal intercourse suggest a potential for future HIV-I and hepatitis B transmission. Interventions should focus on young men with histories of sexually transmitted diseases, alcohol abuse, and depression. C1 BOSTON DEPT HLTH & HOSP,BOSTON,MA. HARVARD UNIV,SCH MED,CAMBRIDGE,MA 02138. HARVARD UNIV,SCH PUBL HLTH,CAMBRIDGE,MA 02138. ABT ASSOCIATES INC,CAMBRIDGE,MA 02138. BROWN UNIV,SCH MED,PROVIDENCE,RI 02912. MASSACHUSETTS GEN HOSP,DEPT PSYCHIAT,BOSTON,MA 02114. CAMBRIDGE HOSP,CAMBRIDGE,MA 02139. CTR DIS CONTROL & PREVENT,DIV HIV AIDS,ATLANTA,GA 30333. RP Seage, GR (reprint author), BOSTON UNIV,SCH PUBL HLTH,DEPT BIOSTAT & EPIDEMIOL,80 E CONCORD ST,BOSTON,MA 02118, USA. FU NIAAA NIH HHS [R01 AA9320-02]; PHS HHS [U64-CCU 108309-02] NR 26 TC 55 Z9 56 U1 2 U2 2 PU US GOVERNMENT PRINTING OFFICE PI WASHINGTON PA SUPT OF DOCUMENTS, WASHINGTON, DC 20402-9325 SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD MAR-APR PY 1997 VL 112 IS 2 BP 158 EP 167 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WN191 UT WOS:A1997WN19100031 PM 9071279 ER PT J AU Krause, JS Anson, CA AF Krause, JS Anson, CA TI Adjustment after spinal cord injury: Relationship to gender and race SO REHABILITATION PSYCHOLOGY LA English DT Article ID EMPLOYMENT; LIFE AB The study of psychological adjustment after spinal cord injury (SCI) has been limited by the use of easy-to-obtain participant samples that have included mostly young Caucasian males and by the lack of refined measures of adjustment. The two primary goals of the current study were: (1) to generate data on gender and race differences on subjective well-being (life satisfaction, adjustment, and problems) and (2) to develop an improved measure of subjective outcomes after SCI. A total of 362 participants from a southeastern rehabilitation center who were stratified according to gender, race, and age at injury onset completed the Multidimensional Adjustment Profile (MAP). Ten subjective adjustment scales were developed from the MAP, nine of which were based on factor analysis of sets of 20 life satisfaction items and 31 problem items. Compared with minority participants, Caucasian participants reported significantly higher levels of Career Satisfaction and fewer problems with Skills Deficit and Financial Limitations. Interactions between gender and race were observed for three scales (Emotional Distress, Physical Discomfort, and Adjustment), with more positive scores reported by minority males and Caucasian females. Results pointed to the importance of race differences in adaptation after SCI. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Krause, JS (reprint author), SHEPHERD CTR,2020 PEACHTREE RD NW,ATLANTA,GA 30309, USA. NR 25 TC 20 Z9 20 U1 0 U2 1 PU SPRINGER PUBL CO PI NEW YORK PA 536 BROADWAY, NEW YORK, NY 10010-3955 SN 0090-5550 J9 REHABIL PSYCHOL JI Rehabil. Psychol. PD SPR PY 1997 VL 42 IS 1 BP 31 EP 46 DI 10.1037//0090-5550.42.1.31 PG 16 WC Psychology, Clinical; Rehabilitation SC Psychology; Rehabilitation GA XE353 UT WOS:A1997XE35300003 ER PT J AU Amler, RW AF Amler, RW TI Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites: Introduction SO REPRODUCTIVE TOXICOLOGY LA English DT Article C1 AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA. NR 12 TC 5 Z9 5 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 221 EP 222 DI 10.1016/S0890-6238(96)00105-0 PG 2 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000008 PM 9100296 ER PT J AU Savitz, DA Bornschein, RL Amler, RW Bove, FI Edmonds, LD Hanson, JW Kaye, WE Khoury, M Kiely, M Lemasters, GK Sever, LE Shepard, TH Spengler, RF Steinberg, KK YearginAllsopp, M AF Savitz, DA Bornschein, RL Amler, RW Bove, FI Edmonds, LD Hanson, JW Kaye, WE Khoury, M Kiely, M Lemasters, GK Sever, LE Shepard, TH Spengler, RF Steinberg, KK YearginAllsopp, M TI Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites .1. Birth defects and developmental disorders SO REPRODUCTIVE TOXICOLOGY LA English DT Article ID ABORTIONS AB Members of the workgroup on birth defects and developmental disorders discussed methods to assess structural anomalies, genetic changes and mutations, fetal and infant mortality, functional deficits, and impaired fetal and neonatal growth. Tier 1 assessments for all five adverse reproductive outcomes consist of questionnaires and reviews of medical records rather than laboratory testing of biologic specimens, The workgroup members noted a role for neurodevelopmental testing and for limited genetic studies, such as karyotyping in Tier 2 assessments, Emerging methodologies to identify chromosomal aberrations, DNA adducts, and repair inhibition were reserved for Tier 3. (C) 1997 Elsevier Science Inc. C1 UNIV N CAROLINA,CHAPEL HILL,NC 27515. UNIV CINCINNATI,CINCINNATI,OH 45221. AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA. CTR DIS CONTROL & PREVENT,ATLANTA,GA. UNIV IOWA,IOWA CITY,IA 52242. US HLTH RESOURCES & SERV ADM,PUBL HLTH SERV,ROCKVILLE,MD 20857. BATTELLE SEATTLE RES CTR,SEATTLE,WA. UNIV WASHINGTON,SEATTLE,WA 98195. NR 20 TC 9 Z9 9 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 223 EP 230 DI 10.1016/S0890-6238(96)00106-2 PG 8 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000009 PM 9100297 ER PT J AU Scialli, AR Swan, SH Amler, RW Baird, DD Eskenazi, B Gist, G Hatch, MC Kesner, JS Lemasters, GK Marcus, M Paul, ME Schulte, P Taylor, Z Wilcox, AJ Zahniser, C AF Scialli, AR Swan, SH Amler, RW Baird, DD Eskenazi, B Gist, G Hatch, MC Kesner, JS Lemasters, GK Marcus, M Paul, ME Schulte, P Taylor, Z Wilcox, AJ Zahniser, C TI Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites .2. Female reproductive disorders SO REPRODUCTIVE TOXICOLOGY LA English DT Article ID FOLLICLE-STIMULATING-HORMONE; LUTEINIZING-HORMONE; PREGNANCY OUTCOMES; OVARIAN TOXICITY; OVULATION; WOMEN; CALIFORNIA; ACCURACY; LEVEL; WATER AB Members of the workgroup on female reproductive disorders discussed methods to evaluate five principal functions: menstrual dysfunction, infertility, pregnancy loss, lactation disorders, and pregnancy complications. To test each function, a nested strategy was considered, based on progressive levels of effort available to conduct field investigations. This strategy mas analogous to the three-tier classification of biomarkers used by other workshops. The lowest level of effort, corresponding to Tier 1, consists only of questionnaires, diaries, and reviews of maternal and infant medical records. The medium level of effort (Tier 2) collects data from questionnaires and diaries, and some biologic specimens, Suggested laboratory analyses included measurement of progesterone in saliva and several glycoprotein hormones in urine that evaluate menstrual dysfunction, infertility, and pregnancy loss. The highest level of effort (Tier 3) involves prospective collection of diary information and simultaneous collection of biological specimens. (C) 1997 Elsevier Science Inc. C1 GEORGETOWN UNIV,MED CTR,WASHINGTON,DC 20057. CALIF DEPT HLTH SERV,BERKELEY,CA 94704. AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA. NIEHS,RES TRIANGLE PK,NC 27709. UNIV CALIF BERKELEY,BERKELEY,CA 94720. COLUMBIA UNIV,SCH PUBL HLTH,NEW YORK,NY 10027. NIOSH,CINCINNATI,OH 45226. UNIV CINCINNATI,CINCINNATI,OH 45221. UNIV MASSACHUSETTS,MED CTR,WORCESTER,MA. CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 31 TC 12 Z9 13 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 231 EP 242 DI 10.1016/S0890-6238(96)00107-4 PG 12 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000010 PM 9100298 ER PT J AU Wyrobek, AJ Schrader, SM Perreault, SD Fenster, L Huszar, G Katz, DF Osorio, AM Sublet, V Evenson, D AF Wyrobek, AJ Schrader, SM Perreault, SD Fenster, L Huszar, G Katz, DF Osorio, AM Sublet, V Evenson, D TI Assessment of reproductive disorders and birth defects in communities near hazardous chemical sites .3. Guidelines for field studies of male reproductive disorders SO REPRODUCTIVE TOXICOLOGY LA English DT Article ID SEMIAUTOMATIC IMAGE-ANALYSIS; CREATINE-KINASE ACTIVITY; HUMAN-SPERM MORPHOLOGY; HUMAN-SPERMATOZOA; CHROMATIN STRUCTURE; OCCUPATIONAL HAZARDS; ETHYLENE DIBROMIDE; OLIGOSPERMIC MEN; FLOW-CYTOMETRY; SEMEN ANALYSIS AB Exposures to environmental toxicants can have detrimental effects on several aspects of human male reproduction: fertility, sexual function, hormone status, and pregnancy/birth outcomes. However, no simple prescreening methods are available for reliably identifying potential hazards; questionnaires alone are relatively imprecise and inefficient in the absence of field data. Multidisciplinary field studies are required that include detailed exposure information, health and reproductive histories, physical examinations, semen analyses, and possibly, hormone analyses. Semen analysis is a critical component of field studies for evaluating two aspects of male reproduction: 1) changes in sperm or seminal content, which may be indicative of adverse effects on the male reproductive system with possible implications for fertility potential; and 2) defects in sperm DNA or chromosomes, which may be associated with subsequent changes in viability during embryonic development and health risks to the offspring. Semen analyses may be tiered: 1) initially, each semen study may include conventional semen assays (concentration, motility, and morphology) as well as specific biomarkers indicated by the health effect of concern in the study cohort; and 2) archived samples (i.e., frozen, videotaped, or smeared) mag be utilized in later second-tier analyses to further characterize specific findings. Before initiating any field study, it is cost effective to critically evaluate the suitability of the cohort by confirming exposure and determining that there are adequate numbers of male participants in each exposure category. Such evaluations must be based on the statistical sensitivities of the specific tissue biomarkers and health endpoints for detecting changes. This article summarizes the components of the ideal field study and identifies research needs for improving field studies of mate effects and for understanding the mechanisms of male reproductive toxicity. Several promising semen methods currently under development are also discussed. (C) 1997 Elsevier Science Inc. C1 NIOSH,ROBERT A TAFT LABS,CINCINNATI,OH 45226. US EPA,NATL HLTH & ENVIRONM EFFECTS RES LAB,REPROD TOXICOL DIV,RES TRIANGLE PK,NC 27711. DEPT HLTH SERV,REPROD EPIDEMIOL SECT,BERKELEY,CA. YALE UNIV,SCH MED,DEPT OBSTET & GYNECOL,NEW HAVEN,CT 06510. DUKE UNIV,DEPT BIOMED ENGN,DURHAM,NC 27706. DEPT HLTH SERV,BERKELEY,CA. SUBLET & ASSOCIATES,COLUMBUS,OH. S DAKOTA STATE UNIV,OLSON BIOCHEM FLOW CYTOMETRY LAB,BROOKINGS,SD 57007. RP Wyrobek, AJ (reprint author), LAWRENCE LIVERMORE NATL LAB,BIOL & BIOTECHNOL RES PROGRAM,L-452,POB 808,7000 EAST AVE,LIVERMORE,CA 94550, USA. RI Schrader, Steven/E-8120-2011 FU NIEHS NIH HHS [Y01-ES-10203-00] NR 72 TC 39 Z9 44 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 243 EP 259 DI 10.1016/S0890-6238(96)00108-6 PG 17 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000011 PM 9100299 ER PT J AU Oakley, G AF Oakley, G TI New Approaches for Assessing the Etiology and Risks of Developmental Abnormalities from Chemical Exposure - National Academy of Sciences Auditorium - December 11-12, 1995 - Session 1: Impacts and Approaches for Assessing Developmental Abnormalities in Human Populations SO REPRODUCTIVE TOXICOLOGY LA English DT Article RP Oakley, G (reprint author), CTR DIS CONTROL & PREVENT,DIV BIRTH DEFECTS & DEV DISABIL,4770 BUFORD HIGHWAY F34,ATLANTA,GA 30341, USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 265 EP 266 DI 10.1016/S0890-6238(96)00163-3 PG 2 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000013 ER PT J AU Boyle, CA AF Boyle, CA TI Surveillance of developmental disabilities with an emphasis on special studies SO REPRODUCTIVE TOXICOLOGY LA English DT Article DE chemical insults; Developmental disabilities surveillance ID CEREBRAL-PALSY; BIRTH-WEIGHT; EXPOSURE; RISK AB The developing central nervous system seems to be particularly vulnerable to chemical insults, A model for developmental disabilities surveillance is presented that provides a reasonable framework for monitoring the prevalence of various developmental abnormalities in human populations. Effective monitoring will not only increase the likelihood of detecting the adverse effects of new physical or chemical agents in the environment but will provide a readily available case series for specially directed case-control studies. A specific example is provided of a large case-control study of cerebral palsy and intrapartum magnesium exposure among very low birth weight children, which is being conducted within the framework of a developmental disabilities surveillance program. (C) 1997 Elsevier Science Inc. RP Boyle, CA (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,DIV BIRTH DEFECTS & DEV DISABIL,ATLANTA,GA 30333, USA. NR 17 TC 4 Z9 4 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, ENGLAND OX5 1GB SN 0890-6238 J9 REPROD TOXICOL JI Reprod. Toxicol. PD MAR-JUN PY 1997 VL 11 IS 2-3 BP 271 EP 274 DI 10.1016/S0890-6238(96)00144-X PG 4 WC Reproductive Biology; Toxicology SC Reproductive Biology; Toxicology GA WQ840 UT WOS:A1997WQ84000015 PM 9100301 ER PT J AU Marrazzo, JM Celum, CL Hillis, SD Fine, D Delisle, S Handsfield, H AF Marrazzo, JM Celum, CL Hillis, SD Fine, D Delisle, S Handsfield, H TI Performance and cost-effectiveness of selective screening criteria for Chlamydia trachomatis infection in women - Implications for a national chlamydia control strategy SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID PELVIC INFLAMMATORY DISEASE; FAMILY-PLANNING CLINICS; SEXUALLY-TRANSMITTED DISEASES; CHAIN-REACTION ASSAY; BACTERIAL VAGINOSIS; UNITED-STATES; RISK-FACTORS; INFERTILITY; PREVALENCE; DIAGNOSIS AB Background and Objectives: Detection of subclinical Chlamydia trachomatis infection in women is a high but costly public health priority. Goals: To develop and test simple selective screening criteria for chlamydia in women, to assess the contribution of cervicitis to screening criteria, and to evaluate cost-effectiveness of selective versus universal screening. Study Design: Cross-sectional study and cost-effectiveness analysis of 11,141 family planning (FP) and 19,884 sexually transmitted diseases (STD) female clients in Washington, Oregon, Alaska, and Idaho who were universally tested for chlamydia using cell culture, direct fluorescent antibody, enzyme immunoassay, or DNA probe. Results: Prevalence of cervical chlamydial infection was 6.6%. Age younger than 20 years, signs of cervicitis, and report of new sex partner, two or more partners, or symptomatic partner were independent predictors df infection, Selective screening criteria consisting of age 20 years or younger or any partner-related risk detected 74% of infections in FP clients and 94% in STD clients, and required testing 53% of FP and 77% of STD clients, Including cervicitis in the screening criteria did not substantially improve their performance, Universal screening was more cost-effective than selective screening at chlamydia prevalences greater than 3.1% in FP clients and greater than 7% in STD clients. Conclusions: Age and behavioral history are as sensitive in predicting chlamydial infection as criteria that include cervicitis, Cost-effectiveness of selective screening is strongly influenced by the criteria's sensitivity in predicting infection, which was significantly higher in STD clients, At the chlamydia prevalences in the populations studied, it would be cost saving to screen universally in FP clinics and selectively in STD clinics, the reverse of current practice in many locales. C1 UNIV WASHINGTON, DEPT MED, SEATTLE, WA USA. CTR DIS CONTROL & PREVENT, DIV STD HIV PREVENT, ATLANTA, GA USA. SEATTLE KING CTY DEPT PUBL HLTH, SEATTLE, WA USA. OI Marrazzo, Jeanne/0000-0002-9277-7364 FU NIAID NIH HHS [T32 AI-07140] NR 56 TC 143 Z9 144 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0148-5717 EI 1537-4521 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD MAR PY 1997 VL 24 IS 3 BP 131 EP 141 DI 10.1097/00007435-199703000-00003 PG 11 WC Infectious Diseases SC Infectious Diseases GA WM755 UT WOS:A1997WM75500003 PM 9132979 ER PT J AU Knapp, JS Wongba, C Limpakarnjanarat, K Young, NL Parekh, MC Neal, SW Buatiang, A Chitwarakorn, A Mastro, TD AF Knapp, JS Wongba, C Limpakarnjanarat, K Young, NL Parekh, MC Neal, SW Buatiang, A Chitwarakorn, A Mastro, TD TI Antimicrobial susceptibilities of strains of Neisseria gonorrhoeae in Bangkok, Thailand: 1994-1995 SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID RESISTANCE; CIPROFLOXACIN AB Background and Objectives: Failure of uncomplicated gonococcal infections acquired in the Far East to respond to doses of ciprofloxacin and ofloxacin recommended by the Centers for Disease Control and Prevention have been identified in Australia, the United Kingdom, and the United States. In the Republic of the Philippines, 54.3% of strains exhibited decreased susceptibility to fluoroquinolones; 12% of strains were resistant to ciprofloxacin. This study was undertaken to compare the antimicrobial susceptibilities of gonococcal isolates in Bangkok, Thailand, with those in the Republic of the Philippines. Goal: To determine the frequency and diversity of antimicrobial resistance, particularly to fluoroquinolones, in gonococcal strains in Bangkok, Thailand. Study Design: Strains of Neisseria gonorrhoeae isolated from 101 patients with uncomplicated gonorrhea in Bangkok, Thailand, in July, 1994 (46 strains) and November, 1994 to July, 1995 (55 strains), were characterized by auxotype/serovar class, antimicrobial susceptibilities, and plasmid profile. Susceptibilities were determined to penicillin G, tetracycline, ceftriaxone, cefixime, cefoxitin, ciprofloxacin, ofloxacin, norfloxacin, erythromycin, kanamycin, and thiamphenicol. Results: Of 101 strains, 89.1% (90/101) were resistant to penicillin or tetracycline. Plasmid-mediated resistance to penicillin or tetracycline was identified in 33.7% (34/101) of the isolates: penicillinase-producing Neisseria gonorrhoeae (17.8%; 18/101), tetracycline-resistant Neisseria gonorrhoeae (7.9%; 18/101), and penicillinase-producing/tetracycline-resistant Neisseria gonorrhoeae (7.9%; 8/101). Most penicillinase-producing strains (96.2%; 25/26) possessed the 4.4-megadalton (Md) beta-lactamase plasmid; one strain possessed the 3.2-Md beta-lactamase plasmid. Chromosomally mediated resistance to penicillin and tetracycline was exhibited by 51.5% (52/101) of strains, and 4.0% (4/101) were tetracycline resistant. All strains were susceptible to spectinomycin. Of 21.8% (22/101) strains exhibiting decreased susceptibility to ciprofloxacin (minimal inhibitory concentration [MIC] greater than or equal to 0.125 mu g/ml), one strain (ciprofloxacin MIC, 0.5 mu g/ml; ciprofloxacin inhibition zone diameter of 23 mm) had MICs of 2.0 and 8.0 mu g/ml for ofloxacin and norfloxacin, respectively, indicating resistance to these agents. Decreased susceptibility to ciprofloxacin was identified in strains with chromosomally mediated resistance to penicillin or tetracycline and in penicillinase-producing strains. Conclusions: In Bangkok, Thailand, gonococcal isolates exhibit resistance to penicillin, tetracycline, kanamycin, and thiamphenicol. Decreased susceptibility to fluoroquinolones is emerging in a variety of strains of N. gonorrhoeae, Thus, all gonococcal infections should be treated with antimicrobial therapies known to be active against all gonococcal strains to reduce the spread of strains exhibiting decreased susceptibilities to fluoroquinolones. C1 CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA. MINIST PUBL HLTH,DEPT COMMUNICABLE DIS CONTROL,DIV VENEREAL DIS CONTROL,BANGKOK,THAILAND. HIV AIDS COLLABORAT,NONTHABURI,THAILAND. RP Knapp, JS (reprint author), CTR DIS CONTROL & PREVENT,GONORRHEA CHLAMYDIA & CHANCROID BRANCH,DIV AIDS STD & TB LAB RES,ATLANTA,GA 30333, USA. NR 22 TC 26 Z9 27 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD MAR PY 1997 VL 24 IS 3 BP 142 EP 148 DI 10.1097/00007435-199703000-00004 PG 7 WC Infectious Diseases SC Infectious Diseases GA WM755 UT WOS:A1997WM75500004 PM 9132980 ER PT J AU Mertz, KJ Levine, WC Mosure, DJ Berman, SM Dorian, KJ AF Mertz, KJ Levine, WC Mosure, DJ Berman, SM Dorian, KJ TI Trends in the prevalence of chlamydial infections - The impact of community-wide testing SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID FAMILY-PLANNING CLINICS; TRACHOMATIS INFECTION; POPULATION; WOMEN AB Background: Evaluation of existing testing programs should guide the national effort to expand programs for the prevention of chlamydial infections, The Columbus (Ohio) Health Department instituted community-wide testing for Chlamydia trachomatis in 1988. Goals: To assess trends in the prevalence of chlamydial infection, the coverage of screening, and concurrent trends in the prevalence of gonorrhea. Study Design: This was a cross-sectional study of women 15. to 44 years of age tested for C. trachomatis at over 50 provider sites in Columbus, Ohio, from 1989 to 1992. Results: The prevalence of chlamydial infection among all women tested decreased by 33% from 1989 to 1992, Prevalence decreased least (19%) among black women 15 to 19 years of age, the group with the highest initial prevalence (20.2%), even though 42% of this population in the city was tested, Prevalence did not decrease at all among prenatal patients 15 to 19 years of age, For women tested for both gonorrhea and chlamydia, gonorrhea decreased by 39% during the 4-year period. Conclusions: Screening appeared to have limited effect on the prevalence of chlamydial infection for groups with highest initial prevalence, despite the relatively high percentage of the population tested. Expanding screening programs to include men and instituting behavioral interventions may be necessary to reduce more rapidly the prevalence of chlamydia among these women. C1 COLUMBUS HLTH DEPT,COLUMBUS,OH. RP Mertz, KJ (reprint author), CTR DIS CONTROL & PREVENT,DIV STD PREVENT,NATL CTR HIV STD & TB PREVENT,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 17 TC 61 Z9 63 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD MAR PY 1997 VL 24 IS 3 BP 169 EP 175 DI 10.1097/00007435-199703000-00009 PG 7 WC Infectious Diseases SC Infectious Diseases GA WM755 UT WOS:A1997WM75500009 PM 9132985 ER PT J AU Johnson, BL AF Johnson, BL TI Hazardous waste: Human health effects (Reprinted from Hazardous Waste, Impacts on Human and Ecological Health, pg 283-304, 1997) SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Reprint DE ATSDR; CERCLA; exposure pathways; hazardous waste; human health; NPL sites; RCRA; toxicological profile; workers ID NATIONAL-EXPOSURE-REGISTRY; CANCER MORTALITY; PRIORITIES LIST; SITES; RISK; MALFORMATIONS; SUBSTANCES; PROXIMITY; COUNTIES; WORKERS RP Johnson, BL (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,1600 CLIFTON RD NE,MAIL STOP E-28,ATLANTA,GA 30333, USA. NR 49 TC 6 Z9 6 U1 1 U2 3 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD MAR-JUN PY 1997 VL 13 IS 2-3 BP 121 EP 143 PG 23 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA XE901 UT WOS:A1997XE90100003 PM 9200784 ER PT J AU Lichtveld, MY Clinton, JJ AF Lichtveld, MY Clinton, JJ TI Science put to service: Enhancing environmental health services in communities affected by hazardous substances (Reprinted from Hazardous Waste, Impacts on Human and Ecological Health, pg 328-345, 1997) SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Reprint DE community-based environmental medicine C1 DEPT HLTH & HUMAN SERV,ATLANTA,GA. RP Lichtveld, MY (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,MS-E33,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 29 TC 0 Z9 0 U1 1 U2 1 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD MAR-JUN PY 1997 VL 13 IS 2-3 BP 267 EP 284 PG 18 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA XE901 UT WOS:A1997XE90100013 PM 9200794 ER PT J AU Miller, MS McGeehin, MA AF Miller, MS McGeehin, MA TI Reported health outcomes among residents living adjacent to a hazardous waste site, Harris County, Texas, 1992 (Reprinted from Hazardous Waste, Impacts on Human and Ecological Health, pg 390-398, 1997) SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Reprint DE cross-sectional study; hazardous waste sites; polyaromatic hydrocarbons; volatile organic compounds C1 PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,ATLANTA,GA. NR 7 TC 8 Z9 8 U1 0 U2 0 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD MAR-JUN PY 1997 VL 13 IS 2-3 BP 311 EP 319 PG 9 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA XE901 UT WOS:A1997XE90100016 PM 9200797 ER PT J AU Gregory, EW West, LK Weber, WM AF Gregory, EW West, LK Weber, WM TI The role of demographics in public health assessments at Superfund sites: A case study of Rocky Mountain Arsenal (Reprinted from Hazardous Waste, Impacts on Human and Ecological Health, pg 465-471, 1997) SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Reprint DE demographics; environmental health; geography; pathways; population; Superfund RP Gregory, EW (reprint author), PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,MAILSTOP E-56,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 5 TC 1 Z9 1 U1 0 U2 3 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD MAR-JUN PY 1997 VL 13 IS 2-3 BP 363 EP 371 PG 9 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA XE901 UT WOS:A1997XE90100020 PM 9200801 ER PT J AU Klein, HM Rosheim, C AF Klein, HM Rosheim, C TI Local health department activity at hazardous waste sites: A spectrum of responses (Reprinted from Hazardous Waste, Impacts on Human and Ecological Health, pg 531-544, 1997) SO TOXICOLOGY AND INDUSTRIAL HEALTH LA English DT Reprint DE community concerns; local health departments C1 PUBL HLTH SERV,AGCY TOX SUBST & DIS REGISTRY,US DEPT HHS,ATLANTA,GA. RP Klein, HM (reprint author), NATL ASSOC CTY & CITY HLTH OFF,440 1ST ST NW,SUITE 450,WASHINGTON,DC 20001, USA. NR 3 TC 1 Z9 1 U1 0 U2 0 PU PRINCETON SCIENTIFIC PUBL INC PI PRINCETON PA PO BOX 2155, PRINCETON, NJ 08543 SN 0748-2337 J9 TOXICOL IND HEALTH JI Toxicol. Ind. Health PD MAR-JUN PY 1997 VL 13 IS 2-3 BP 379 EP 384 PG 6 WC Public, Environmental & Occupational Health; Toxicology SC Public, Environmental & Occupational Health; Toxicology GA XE901 UT WOS:A1997XE90100022 PM 9200803 ER PT J AU Garcia, HH Gilman, RH Tsang, VCW Gonzalez, AE Verastegui, M Torres, MP Miranda, E Herrera, G Gavidia, C Barron, E Falcon, N Lopez, MT Martinez, M Evans, C Pilcher, JB AF Garcia, HH Gilman, RH Tsang, VCW Gonzalez, AE Verastegui, M Torres, MP Miranda, E Herrera, G Gavidia, C Barron, E Falcon, N Lopez, MT Martinez, M Evans, C Pilcher, JB TI Clinical significance of neurocysticercosis in endemic villages SO TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE LA English DT Article DE cysticercosis; Taenia solium; epilepsy; Peru ID LINKED IMMUNOELECTROTRANSFER BLOT; CYSTICERCOSIS TAENIA-SOLIUM; MEXICO; EPILEPSY; ASSAY; PERU AB Cerebral cysticercosis is the main cause of late-onset epilepsy in most developing countries. Data on the neuroepidemiology of cysticercosis in endemic populations is scarce. In an endemic village on the northern coast of Peru, 49 individuals with neurological symptomatology (41 epileptic and 8 non-epileptic) were screened for antibodies to Taenia solium, using a serum electroimmunotransfer blot assay. Fifteen subjects were seropositive, 14 (34%) of those with epilepsy but only one (13%) of those who were nonepileptic. A history of passing proglottides was associated with positive serology. Thirteen of the 15 seropositive individuals underwent cerebral computed tomography; only 7 (54%) were abnormal. A randomly selected sample of 20 pigs from the village was also tested, and 6 (30%) were seropositive. This study demonstrated the importance of cysticercosis in the aetiology of epilepsy in endemic villages and the close relationship between porcine and human infection. C1 INST NACL CIENCIAS NEUROL,LIMA,PERU. AB PRISMA,LIMA,PERU. JOHNS HOPKINS UNIV,BALTIMORE,MD. CTR DIS CONTROL & PREVENT,ATLANTA,GA. UNIV NACL MAYOR SAN MARCOS,LIMA 14,PERU. RP Garcia, HH (reprint author), UNIV PERUANA CAYETANO HEREDIA,DEPT MICROBIOL,AV HONORIO DELGADO 430,LIMA 31,PERU. OI Gavidia, Cesar Miguel/0000-0003-3936-5077 FU NIAID NIH HHS [1-U01AI35894-01] NR 16 TC 31 Z9 31 U1 0 U2 0 PU ROYAL SOC TROPICAL MEDICINE PI LONDON PA MANSON HOUSE 26 PORTLAND PLACE, LONDON, ENGLAND W1N 4EY SN 0035-9203 J9 T ROY SOC TROP MED H JI Trans. Roy. Soc. Trop. Med. Hyg. PD MAR-APR PY 1997 VL 91 IS 2 BP 176 EP 178 DI 10.1016/S0035-9203(97)90213-3 PG 3 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WY965 UT WOS:A1997WY96500021 PM 9196761 ER PT J AU Epstein, JS Schochetman, GC AF Epstein, JS Schochetman, GC TI Relative sensitivity of United States and European assays for screening blood donors for antibodies to human immunodeficiency viruses - Reply SO TRANSFUSION LA English DT Letter C1 CTR DIS CONTROL & PREVENT,DIV AIDS,STD & TB LAB RES,ATLANTA,GA. RP Epstein, JS (reprint author), US FDA,OFF BLOOD RES & REVIEW,ROCKVILLE,MD 20857, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC BLOOD BANKS PI BETHESDA PA 8101 GLENBROOK RD, BETHESDA, MD 20814-2749 SN 0041-1132 J9 TRANSFUSION JI Transfusion PD MAR PY 1997 VL 37 IS 3 BP 353 EP 354 PG 2 WC Hematology SC Hematology GA WP266 UT WOS:A1997WP26600019 ER PT J AU Yang, CF Collins, WE Xiao, LH Saekhou, AM Reed, RC Nelson, CO Hunter, RL Jue, DL Fang, SN Wohlhueter, RM Udhayakumar, V Lal, AA AF Yang, CF Collins, WE Xiao, LH Saekhou, AM Reed, RC Nelson, CO Hunter, RL Jue, DL Fang, SN Wohlhueter, RM Udhayakumar, V Lal, AA TI Induction of protective antibodies in Saimiri monkeys by immunization with a multiple antigen construct (MAC) containing the Plasmodium vivax circumsporozoite protein repeat region and a universal T helper epitope of tetanus toxin SO VACCINE LA English DT Article DE multiple antigen construct (MAC); protection; malaria ID DEFINED SYNTHETIC VACCINE; MALARIA VACCINE; IMMUNODOMINANT EPITOPE; SCIUREUS-BOLIVIENSIS; COPOLYMER ADJUVANTS; PEPTIDE VACCINE; CELL EPITOPES; IMMUNOGENICITY; SPOROZOITES; FALCIPARUM AB Previous attempts in inducing protective immunity against Plasmodium vivax in human volunteers and nonhuman primates with recombinant circumsporozoite (CS) proteins have been unsuccessful, largely due to the failure of generating antibodies against the protective B epitope AGDR in the CS protein repeat region. We report here an immunization study in Saimiri monkeys with a multiple antigen construct (MAC) containing the P. vivax CS protein repeat region and a T helper epitope of tetanus toxin formulated in different adjuvants. Monkeys immunized three times with MAC in copolymer P1005, copolymer P1005 plus RaLPS, or MF-75 had titers of antibodies against CS repeat, sporozoites and the protective B epitope AGDR significantly higher than those immunized with MAC in alum or PBS (P<0.05). Antibody levels in animals that received P1005 were maintained at high level for 7 months after the last immunization. Upon challenge with 10000 sporozoites 2 weeks after the last immunization, 75% (three of four) of monkeys from the alum group, 50% (three of six) of moneys from the P1005 plus RaLPS group, 40% (two of five) of monkeys from the P1005 group, 33% (two of six) of monkeys from the MF-75 group, and 17% (one of six) of monkeys from the MAC alone group were fully protected. When immunized animals were challenged again with 30000 sporozoites 22 weeks after the last immunization, 40% (two of five) monkeys from the P1005 group were fully protected. The remaining (three) in this group developed low parasitemia (<2000 parasites mm(-3) of blood) after significantly longer prepatent period (P<0.05). In addition, 17% (one of six) of monkeys each from the P1005 plus RaLPS and MF-75 groups were also fully protected. Protected animals had higher levels of prechallenge anti-AGDR antibody titers than unprotected (1933 vs 281 for the first challenge, P>0.05; 21527 vs 196 for the rechallenge, P<0.05). Anti-AGDR antibody titers were positively correlated with the prepatent period of infected animals (r=0.42 for the first challenge, P>0.05, r=0.50 for the rechallenge, P<0.05) and negatively correlated with the peak parasitemia (r=-0.39 for the first challenge, P<0.05; r=-0.50 for the rechallenge, P<0.05). The results suggested that when combined with the use of potent adjuvants and T helper epitopes, MAC subunit vaccines may potentially, offer protection against malaria infection. Published by Elsevier Science Ltd. C1 CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,BIOTECHNOL CORE FACIL,NATL CTR INFECT DIS,PUBL HLTH SERV,ATLANTA,GA 30341. EMORY UNIV,DEPT PATHOL & LAB MED,ATLANTA,GA 30322. RI Xiao, Lihua/B-1704-2013; Yang, Chunfu/G-6890-2013 OI Xiao, Lihua/0000-0001-8532-2727; NR 33 TC 25 Z9 26 U1 0 U2 2 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, OXON, ENGLAND OX5 1GB SN 0264-410X J9 VACCINE JI Vaccine PD MAR PY 1997 VL 15 IS 4 BP 377 EP 386 DI 10.1016/S0264-410X(97)00200-4 PG 10 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA WT721 UT WOS:A1997WT72100008 PM 9141208 ER PT J AU Karter, AJ Casper, ML Cohen, RD Gazzaniga, JM Blanton, CJ Kaplan, GA AF Karter, AJ Casper, ML Cohen, RD Gazzaniga, JM Blanton, CJ Kaplan, GA TI Secular trends in ischemic heart disease mortality in California versus the United States, 1980 to 1991 SO WESTERN JOURNAL OF MEDICINE LA English DT Article ID CARDIOVASCULAR-DISEASES; DECLINE; ONSET AB We compare the recent trends in ischemic heart disease mortality in California and the United States. Because California was among the first states to have declines in ischemic heart disease mortality, an examination of these recent trends may provide important clues for upcoming national trends. Age-adjusted and -specific ischemic heart disease mortality rates were calculated by sex for persons aged 35 and older during the years 1980 to 1991, Log-linear regression modeling was used to estimate the average annual percentage change in mortality. Between 1980 and 1991, the annual age-adjusted ischemic heart disease mortality declined less in California than in the United States for both women (1.9% versus 3.1%) and men (3.1% versus 3.5%). In California, it increased slightly between 1986 and 1990 for the oldest women and men. The slower rates of decline in mortality of this disease in California compared with the United States and the rising rates among the most elderly Californians suggest that careful attention should be paid to these trends in death rates of and risk factors for this disease in California. C1 CTR DIS CONTROL & PREVENT,CARDIOVASC HLTH STUD BRANCH,DIV CHRON DIS CONTROL & COMMUN INTERVENT,ATLANTA,GA. CTR DIS CONTROL & PREVENT,STAT BRANCH,DIV CHRON DIS CONTROL & COMMUN INTERVENT,ATLANTA,GA. CALIF DEPT HLTH SERV,PUBL HLTH FDN,HUMAN POPULAT LAB,BERKELEY,CA 94704. CALIF DEPT HLTH SERV,SACRAMENTO,CA. RP Karter, AJ (reprint author), KAISER PERMANENTE MED CARE PROGRAM,DIV RES,3505 BROADWAY,OAKLAND,CA 94611, USA. NR 24 TC 1 Z9 1 U1 0 U2 0 PU CARDEN JENNINGS PUBL CO LTD PI CHARLOTTESVILLE PA BLAKE CTR, STE 200, 1224 W MAIN ST, CHARLOTTESVILLE, VA 22903 SN 0093-0415 J9 WESTERN J MED JI West. J. Med. PD MAR PY 1997 VL 166 IS 3 BP 185 EP 188 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WW667 UT WOS:A1997WW66700002 PM 9143193 ER PT J AU Sowell, A Carroll, M Huff, D AF Sowell, A Carroll, M Huff, D TI Prevalence of low serum vitamin A concentrations among children in the United States 1988-1994: Results from the third National Health and Nutrition Examination Survey (NHANES III) SO FASEB JOURNAL LA English DT Meeting Abstract C1 CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,NATL CTR HLTH STAT,HYATTSVILLE,MD 20782. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD FEB 28 PY 1997 VL 11 IS 3 BP 1089 EP 1089 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA WL530 UT WOS:A1997WL53001091 ER PT J AU Diamond, AM Murray, JL Folks, TM Sandstrom, PA AF Diamond, AM Murray, JL Folks, TM Sandstrom, PA TI Selenium-dependent glutathione peroxidase (SeGPx) activity can alter the course of a human immunodeficiency virus (HIV) infection. SO FASEB JOURNAL LA English DT Meeting Abstract C1 UNIV CHICAGO,DEPT RADIAT CELL ONC,CHICAGO,IL 60637. CTR DIS CONTROL,NATL CTR INFECT DIS,ATLANTA,GA 30333. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD FEB 28 PY 1997 VL 11 IS 3 BP 1373 EP 1373 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA WL530 UT WOS:A1997WL53001373 ER PT J AU Houston, D Johnson, MA Edmonds, J Nozza, R Cutler, M Lewis, R Modlesky, C Gunter, E AF Houston, D Johnson, MA Edmonds, J Nozza, R Cutler, M Lewis, R Modlesky, C Gunter, E TI Age-related hearing loss and vitamin B-12, calcium, and bone health in postmenopausal women. SO FASEB JOURNAL LA English DT Meeting Abstract C1 CTR DIS CONTROL,ATLANTA,GA 30341. NR 0 TC 0 Z9 0 U1 0 U2 0 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD FEB 28 PY 1997 VL 11 IS 3 BP 1375 EP 1375 PG 1 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA WL530 UT WOS:A1997WL53001377 ER PT J AU Ranson, H Cornel, AJ Fournier, D Vaughan, A Collins, FH Hemingway, J AF Ranson, H Cornel, AJ Fournier, D Vaughan, A Collins, FH Hemingway, J TI Cloning and localization of a glutathione S-transferase class I gene from Anopheles gambiae SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID DDT-DEHYDROCHLORINASE; MOLECULAR-CLONING; SEQUENCE; MOSQUITO; THETA; PURIFICATION; RESISTANCE; FAMILY; FORMS; RAT AB 1,1,1-Trichloro-2,2-bis(p-chlorophenyl)ethane (DDT) resistance in both adults and larvae of Anopheles gambiae is mediated by stage-specific glutathione S-transferases (GSTs). On the basis of their biochemical characteristics the larval resistance-associated GSTs are likely to be insect class I GSTs, Aggst1-2, a class I GST gene, which is expressed in larvae, has been cloned from the malaria vector A, gambiae. The gene was inserted into a bacterial expression system, and the detection of 1-chloro-2,4-dinitrobenzene (CDNB) conjupating activity in Eschericia coli expressing the recombinant enzyme confirmed that aggst1-2 encodes a catalytically active GST, The gene encodes a 209 amino acid protein with 46% sequence similarity to a Drosophila melanogaster class I GST (GST-DI), 44% similarity with a Musca domestica class I GST (MdGST-1), but only low levels of homology with class II insect GSTs, including the adult specific AgGST2-1 from A, gambiae. Southern analysis of genomic DNA indicated that A. gambiae has multiple class I GSTs, In situ hybridization of class I, genomic and cDNA clones to polytene chromosomes identified a single region of complementarity on chromosome 2R division 18B, suggesting that these class I GSTs in A, gambiae are arranged sequentially in the genome, Three positive overlapping recombinant clones were identified from an A, gambiae genomic library, Mapping and partial sequencing of these clones suggests that there are several GSTs and truncated GST pseudogenes within the 30kb of DNA that these clones span. C1 UNIV WALES COLL CARDIFF,DEPT PURE & APPL BIOL,CARDIFF CF1 3TL,S GLAM,WALES. CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,ENTOMOL BRANCH,CHAMBLEE,GA 30341. UNIV TOULOUSE 3,LAB ENTOMOL APPL,F-31062 TOULOUSE,FRANCE. FU Wellcome Trust NR 30 TC 38 Z9 42 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD FEB 28 PY 1997 VL 272 IS 9 BP 5464 EP 5468 PG 5 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA WK747 UT WOS:A1997WK74700016 PM 9038148 ER PT J AU Ndoyo, J Siopathis, RM Klugman, KP Wasas, A AF Ndoyo, J Siopathis, RM Klugman, KP Wasas, A TI Antibiotic resistance among nasopharyngeal isolates of Streptococcus pneumoniae and Haemophilus influenzae - Bangui, 1995 (Reprinted from MMWR, vol 46, pg 62-64, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 S AFRICAN MRC,JOHANNESBURG,SOUTH AFRICA. S AFRICAN INST MED RES,WITWATERSRAND PNEUMOCOCCAL DIS RES UNIT,JOHANNESBURG,SOUTH AFRICA. CDC,INT CHILD SURVIVAL & EMERGING INFECT PROGRAM SUPP,DIV PARASIT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP Ndoyo, J (reprint author), MINIST POPULAT & PUBL HLTH,BANGUI,CENT AFR REPUBL. NR 1 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 26 PY 1997 VL 277 IS 8 BP 621 EP 621 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WJ498 UT WOS:A1997WJ49800014 ER PT J AU Bresee, JS Mast, EE Yu, MYW Schneider, LS Alter, MJ AF Bresee, JS Mast, EE Yu, MYW Schneider, LS Alter, MJ TI Hepatitis C virus and intravenous immune globulin - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter RP Bresee, JS (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 5 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 26 PY 1997 VL 277 IS 8 BP 627 EP 628 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WJ498 UT WOS:A1997WJ49800023 ER PT J AU Frieden, TR Sherman, LF Maw, KL AF Frieden, TR Sherman, LF Maw, KL TI Highly drug-resistant tuberculosis - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 NEW YORK CITY DEPT HLTH,NEW YORK,NY 10013. RP Frieden, TR (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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 26 PY 1997 VL 277 IS 8 BP 629 EP 629 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WJ498 UT WOS:A1997WJ49800027 ER PT J AU LeBaron, CW Chaney, M Baughman, AL Dini, EF Maes, E Dietz, V Bernier, R AF LeBaron, CW Chaney, M Baughman, AL Dini, EF Maes, E Dietz, V Bernier, R TI Impact of measurement and feedback on vaccination coverage in public clinics, 1988-1994 SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID IMMUNIZATION; PREVENTION; PRESCHOOL; CHILDREN AB Objective.-To investigate whether a reported rise in vaccination coverage in Georgia public clinics during the period 1988 through 1994 was artifactual or real and, if real, to determine the extent to which the rise could be associated with a program of measurement and feedback. Design.-Examination of data from Georgia public clinics, doses-administered records, and National Health Interview Surveys. Setting/Participants.-Children attending Georgia public clinics. Intervention.-Measurement of vaccination coverage and feedback to providers. Main Outcome Measure.-Vaccination coverage rates. Results.-For the period 1988 through 1994, 136 004 Georgia public clinic vaccination records for children 21 to 23 months of age were reviewed. Median series-completion rates at public clinics rose from 53% to 89%, while indexes of under-vaccination fell: missed opportunities for simultaneous vaccination (6% to 0%), lost contact for more than 12 months (14% to 1%), and first vaccination more than 1 month late (19% to 8%). According to the independent doses-administered database, the proportion of children starting the primary series very late (greater than or equal to 12 months old) fell from 14% to 6%, and the series-completion index rose from 64% to 83%, suggesting that improvements could not be wholly ascribed to better clinic record keeping. In 1988, vaccination coverage of children 24 months of age in the National Health Interview Survey (NHIS) was 53%, identical to median public clinic coverage in Georgia; in 1993, NHIS coverage was 60%, while median public clinic coverage in Georgia was 90%, suggesting that the rise in coverage in Georgia public clinics exceeded national trends. Patterns within the coverage changes suggest an association with the process of measurement and feedback. Conclusions.-A marked increase in vaccination coverage occurred in Georgia public clinics associated with a program of annual measurement and feedback. C1 GEORGIA DIV PUBL HLTH,ATLANTA,GA. RP LeBaron, CW (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,MS E-52,ATLANTA,GA 30333, USA. NR 19 TC 79 Z9 79 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 26 PY 1997 VL 277 IS 8 BP 631 EP 635 DI 10.1001/jama.277.8.631 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WJ498 UT WOS:A1997WJ49800030 PM 9039880 ER PT J AU Mussolino, ME Looker, AC Madans, JH Edelstein, D Walker, RE Lydick, E Epstein, RS Yates, AJ AF Mussolino, ME Looker, AC Madans, JH Edelstein, D Walker, RE Lydick, E Epstein, RS Yates, AJ TI Phalangeal bone density and hip fracture risk SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID RADIOGRAPHIC ABSORPTIOMETRY; SKELETAL SITES; WOMEN; MASS; OSTEOPOROSIS; PREDICTION; ACCURACY; WHITE AB Objective: To assess the long-term predictive usefulness of radiographic absorptiometry measurements of phalangeal bone density for hip fracture risk. Methods: Participants were members of the First National Health and Nutrition Examination Survey Epidemiologic Follow Up Study cohort. Subjects were followed up for a maximum of 16 years. The First National Health and Nutrition Examination Survey data were obtained from a nationally representative sample of noninstitutionalized civilians. A cohort of 3481 white and black subjects (1559 white women) aged 45 through 74 years at baseline (1971-1975) were observed through 1987. Ninety-eight percent of the original cohort completed the study. Hospital records and death certificates were used to identify a total of 72 hip fracture cases. Phalangeal bone density at baseline was measured using photodensitometry (PD), and later reanalyzed by radiographic absorptiometry (RA), a newer, more sophisticated technique. Results: Results were evaluated to determine the relative risk for hip fracture per 1-SD decrease in bone density, after controlling for age at baseline, race, gender, weight, and previous fractures. Both RA and PD measurements showed a significant inverse relationship to hip fracture risk, with RA density measurements showing a slightly higher adjusted relative risk per 1-SD density decrease than PD measurements. For RA bone density, the relative risk for all subjects was 1.81 (95% confidence interval, 1.34-2.44) compared with 1.57 (95% confidence interval, 1.19-2.07) for PD bone density after adjusting for age at baseline, race, gender, weight, and previous fractures. Results for white women were essentially the same as those for all subjects for RA bone density and PD bone density. Conclusions: Phalangeal bone density determined from standard hand x-ray films is a significant predictor of future hip fracture risk. Availability of a valid method to assess fracture risk using conventional radiographs will expand the ability to identify individuals with osteoporosis. C1 COMPUMED INC, MANHATTAN BEACH, CA 90266 USA. MERCK & CO INC, W POINT, PA USA. MERCK MEDCO MANAGED CARE, MONTVALE, NJ USA. MERCK & CO INC, RAHWAY, NJ 07065 USA. RP Mussolino, ME (reprint author), CTR DIS CONTROL & PREVENT, NATL CTR HLTH STAT, DIV EPIDEMIOL, 6525 BELCREST RD, ROOM 730, HYATTSVILLE, MD 20782 USA. NR 35 TC 16 Z9 22 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA SN 0003-9926 EI 1538-3679 J9 ARCH INTERN MED JI Arch. Intern. Med. PD FEB 24 PY 1997 VL 157 IS 4 BP 433 EP 438 DI 10.1001/archinte.157.4.433 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WJ254 UT WOS:A1997WJ25400008 ER PT J AU Vernon, SD Unger, ER Miller, DL Lee, DR Reeves, WC AF Vernon, SD Unger, ER Miller, DL Lee, DR Reeves, WC TI Association of human papillomavirus type 16 integration in the E2 gene with poor disease-free survival from cervical cancer SO INTERNATIONAL JOURNAL OF CANCER LA English DT Article ID SERUM ANTIBODY-RESPONSES; INSITU HYBRIDIZATION; PHYSICAL STATE; CARCINOMA; DNA; GENOME; AMPLIFICATION; SEQUENCES; LESIONS AB To determine the clinical relevance of human papillomavirus (HPV) integration and E2 function suggested by in vitro studies, we investigated 50 patients with HPV 16 positive primary cervical carcinoma (stage Ib-IV) diagnosed and treated at one institution. The physical state of HPV was determined by colorimetric in situ hybridization and was not found to vary by stage. Overall, 62% of tumors had integrated HPV, 16% had episomal and 22% had both integrated and episomal. The E11E2 region was evaluated by 8 separate polymerase chain reactions, which resulted in overlapping products. There was no significant variation in ability to amplify the E1/E2 region with stage. E1/E2 amplification correlated with physical state. Nearly all tumors with episomal or mixed HPV 16 DNA amplified all 8 E1/E2 fragments. Half of the tumors with integrated HPV 16 DNA failed to amplify one or more E1/E2 fragments. Disruptions were most frequent in the E2 region. For all 46 patients receiving curative therapy, the Kaplan-Meier estimate of disease-free survival was determined for those whose primary tumors had amplifiable E2 compared with those lacking one or more E2 DNA fragments. Disruption of E2 was associated with significantly shortened disease-free survival. (C) 1997 Wiley-Liss, Inc,. C1 EMORY UNIV,SCH MED,DEPT PATHOL,ATLANTA,GA 30322. EMORY UNIV,SCH MED,DEPT LAB MED,ATLANTA,GA 30322. RP Vernon, SD (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,VIRAL EXANTHEMS & HERPESVIRUS BRANCH,ATLANTA,GA 30333, USA. OI Unger, Elizabeth/0000-0002-2925-5635 NR 27 TC 82 Z9 86 U1 0 U2 3 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0020-7136 J9 INT J CANCER JI Int. J. Cancer PD FEB 20 PY 1997 VL 74 IS 1 BP 50 EP 56 DI 10.1002/(SICI)1097-0215(19970220)74:1<50::AID-IJC9>3.0.CO;2-# PG 7 WC Oncology SC Oncology GA XA678 UT WOS:A1997XA67800009 PM 9036869 ER PT J AU Sexton, DJ Rollin, PE Breitschwerdt, EB Corey, GR Myers, SA Dumais, MR Bowen, MD Goldsmith, CS Zaki, SR Nichol, ST Peters, CJ Ksiazek, TG AF Sexton, DJ Rollin, PE Breitschwerdt, EB Corey, GR Myers, SA Dumais, MR Bowen, MD Goldsmith, CS Zaki, SR Nichol, ST Peters, CJ Ksiazek, TG TI Life-threatening Cache Valley virus infection SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CENTRAL-NERVOUS-SYSTEM; BUNYAMWERA SEROGROUP VIRUSES; MALFORMATIONS C1 CTR DIS CONTROL & PREVENT,SPECIAL PATHOGENS BRANCH,ATLANTA,GA 30333. DUKE UNIV,DEPT MED,DIV INFECT DIS,DURHAM,NC. N CAROLINA STATE UNIV,COLL VET MED,INTRACELLULAR PATHOGENS LAB,RALEIGH,NC. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. NR 10 TC 51 Z9 52 U1 0 U2 5 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 20 PY 1997 VL 336 IS 8 BP 547 EP 549 DI 10.1056/NEJM199702203360804 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA WJ240 UT WOS:A1997WJ24000004 PM 9023091 ER PT J AU Kasting, G Rollin, PE AF Kasting, G Rollin, PE TI Wound care following needlestick injuries SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID B-VIRUS C1 CTR DIS CONTROL & PREVENT,SPECIAL PATHOGENS BRANCH,ATLANTA,GA 30333. RP Kasting, G (reprint author), CTR DIS CONTROL & PREVENT,OCCUPAT HLTH CLIN,ATLANTA,GA 30333, USA. NR 4 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 19 PY 1997 VL 277 IS 7 BP 517 EP 517 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WH297 UT WOS:A1997WH29700002 PM 9032142 ER PT J AU Tourtelotte, D Ross, J Ryan, H Naor, E Bartlett, N AF Tourtelotte, D Ross, J Ryan, H Naor, E Bartlett, N TI Injuries and deaths associated with use of snowmobiles - Maine, 1991-1996 (Reprinted from MMWR, vol 46, pg 1-4, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 MAINE DEPT HUMAN SERV,BUR HLTH,OFF HLTH DATA & PROGRAM MANAGEMENT,AUGUSTA,ME 04333. CDC,NATL CTR INJURY PREVENT & CONTROL,DIV UNINTENT INJURY PREVENT,ATLANTA,GA 30333. CDC,NATL CTR HLTH STAT,DIV HLTH PROMOT STAT,ATLANTA,GA 30333. RP Tourtelotte, D (reprint author), MAINE DEPT INLAND FISHERIES & WILDLIFE,STATE HOUSE STN 41,AUGUSTA,ME 04333, USA. NR 2 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 19 PY 1997 VL 277 IS 7 BP 526 EP 527 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WH297 UT WOS:A1997WH29700012 ER PT J AU Adams, MM Wilson, HG Casto, DL Berg, CJ McDermott, JM Gaudino, JA McCarthy, BJ AF Adams, MM Wilson, HG Casto, DL Berg, CJ McDermott, JM Gaudino, JA McCarthy, BJ TI Constructing reproductive histories by linking vital records SO AMERICAN JOURNAL OF EPIDEMIOLOGY LA English DT Article DE birth certificates; epidemiologic methods; fetal death; medical record linkage; reproductive history ID PERINATAL-MORTALITY; BIRTH AB Certificates of 1,449,287 live births and fetal deaths filed in Georgia from 1980 through 1992 were linked to create chronologies that, excluding induced abortions and ectopic pregnancies, constituted the reproductive experience of individual women. The authors initially used a deterministic method (whereby linking rules were not based on probability theory) to link as many records as possible, knowing that some of the linkages would be incorrect. They subsequently used a probabilistic method (whereby evaluation of linkages was developed from probability theory) to evaluate each linkage, and they broke those that were judged to be incorrect. Of the 1.4 million records, 38% did not link to another record. From the remaining records, 369,686 chains of two or more events were constructed. The longest chain included 12 events. Of the chains, 69% included two events; 22% included three events. Longer chains tended to have lower scores for probable validity. The probability-based evaluation of chains affected 3.0% of the records that had been in chains at the end of the deterministic linkage. A greater percentage of records in longer chains were affected by the evaluation. Unfortunately, the small subset of records that were the most difficult to link tended to overrepresent groups with the greatest risk of adverse pregnancy outcomes. Researchers contemplating a similar linkage can anticipate that, for the majority of records, linkage can be accomplished with a relatively straightforward, deterministic approach. C1 DEPT HUMAN RESOURCES,DIV PUBL HLTH,OFF PERINATAL EPIDEMIOL,EPIDEMIOL & PREVENT BRANCH,ATLANTA,GA. CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,DIV FIELD EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. RP Adams, MM (reprint author), CTR DIS CONTROL & PREVENT,WHO COLLABORATING CTR PERINATAL CARE & HLTH SERV,ATLANTA,GA 30341, USA. NR 12 TC 31 Z9 32 U1 0 U2 0 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0002-9262 J9 AM J EPIDEMIOL JI Am. J. Epidemiol. PD FEB 15 PY 1997 VL 145 IS 4 BP 339 EP 348 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WJ260 UT WOS:A1997WJ26000007 PM 9054238 ER PT J AU Seaman, J Mercer, AJ Herwaldt, BL AF Seaman, J Mercer, AJ Herwaldt, BL TI Visceral leishmaniasis in southern Sudan - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30341. RP Seaman, J (reprint author), MED SANS FRONTIERES HOLLAND,AMSTERDAM,NETHERLANDS. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD FEB 15 PY 1997 VL 126 IS 4 BP 332 EP 332 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WH068 UT WOS:A1997WH06800020 ER PT J AU Riggs, MW Stone, AL Yount, PA Langer, RC Arrowood, MJ Bentley, DL AF Riggs, MW Stone, AL Yount, PA Langer, RC Arrowood, MJ Bentley, DL TI Protective monoclonal antibody defines a circumsporozoite-like glycoprotein exoantigen of Cryptosporidium parvum sporozoites and merozoites SO JOURNAL OF IMMUNOLOGY LA English DT Article ID HYPERIMMUNE BOVINE COLOSTRUM; NEUTRALIZATION-SENSITIVE EPITOPES; SEVERE COMBINED IMMUNODEFICIENCY; MICRONEMES POSSESSING EPITOPES; NEONATAL MICE; PERSISTENT CRYPTOSPORIDIOSIS; FALCIPARUM SPOROZOITES; COW COLOSTRUM; SCID MICE; INFECTION AB The apicomplexan protozoan parasite Cryptosporidium parvum causes a diarrheal disease in humans and other mammals for which specific therapy and immunoprophylaxis are unavailable. Passive immunization with Abs against whole C. parvum organisms has Variable efficacy in immunocompromised or neonatal hosts. Because apical and surface-exposed zoite Ags of the Apicomprexa are critical to infectivity and targets of protective immunity, we examined the ability of mAbs generated against such Ags in C. parvum sporozoites to passively protect against infection and identify biologically relevant parasite molecules. A panel of mAbs was produced against affinity-purified native Ags using sporozoite apical- and surface-reactive mAb C4A1 as binding ligand. One resulting mAb, designated 3E2, elicited prominent morphologic changes in sporozoites and merozoites characterized by rapid and progressive formation, posterior movement, and release of membranous Ag-mAb precipitates. These changes had a striking resemblance-to the malarial circumsporozoite precipitate (CSP) reaction. Sporozoite infectivity was completely neutralized after in vitro exposure to 3E2 and the CSP-like reaction. Furthermore, orally administered 3E2 completely prevented or markedly reduced infection in neonatal BALB/c mice. 3E2 bound to apical complex and surface molecules of zoites and was demonstrated in membranous precipitates by immunoelectron microscopy. In Western blots, 3E2 recognized multiple 46 to similar to 770 kDa sporozoite Ags and an similar to 1300-kDa Ag designated CSL, also expressed by merozoites. CSL was characterized as a soluble glycoprotein exoantigen released by infectious sporozoites. Further, CSL was determined to be the molecular species mechanistically involved in the CSP-like reaction by its identification in SDS-PACE gels and Western blots of purified membranous precipitates. These findings indicate that CSL has a functional role in sporozoite infectivity and is a candidate molecular target for passive or active immunization against cryptosporidiosis. C1 UNIV ARIZONA,ARIZONA RES LABS,DIV BIOTECHNOL,TUCSON,AZ 85721. CTR DIS CONTROL & PREVENT,IMMUNOL BRANCH,DIV PARASIT DIS,NATL CTR INFECT DIS,ATLANTA,GA. RP Riggs, MW (reprint author), UNIV ARIZONA,DEPT VET SCI & MICROBIOL,ROOM 202 VET SCI MICROBIOL BLDG,TUCSON,AZ 85721, USA. FU NIAID NIH HHS [AI 30223] NR 60 TC 52 Z9 55 U1 0 U2 2 PU AMER ASSOC IMMUNOLOGISTS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 SN 0022-1767 J9 J IMMUNOL JI J. Immunol. PD FEB 15 PY 1997 VL 158 IS 4 BP 1787 EP 1795 PG 9 WC Immunology SC Immunology GA WG304 UT WOS:A1997WG30400035 PM 9029117 ER PT J AU Williamson, DF AF Williamson, DF TI Appetite-suppressant drugs and primary pulmonary hypertension SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter RP Williamson, DF (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30341, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 13 PY 1997 VL 336 IS 7 BP 512 EP 512 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WG776 UT WOS:A1997WG77600018 PM 9019653 ER PT J AU McGeer, A Low, DE Davies, HD Schwartz, B AF McGeer, A Low, DE Davies, HD Schwartz, B TI Invasive group A streptococcal infections - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter ID DISEASE C1 MT SINAI HOSP,TORONTO,ON M5G 1X5,CANADA. ALBERTA CHILDRENS PROV GEN HOSP,CALGARY,AB T2N 1N4,CANADA. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. RP McGeer, A (reprint author), PRINCESS MARGARET HOSP,TORONTO,ON M4X 1K9,CANADA. RI Low, Donald/B-1726-2012; mcgeer, allison /H-7747-2014 OI mcgeer, allison /0000-0001-5647-6137 NR 4 TC 2 Z9 2 U1 0 U2 0 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD FEB 13 PY 1997 VL 336 IS 7 BP 514 EP 514 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WG776 UT WOS:A1997WG77600023 ER PT J AU Mendelson, M Solomon, R Shekletski, E Henry, K Campbell, S Collins, A Thurn, J Lebahn, F Rhame, F Gerberding, J Fahrner, R TurnerHubbard, K Jensen, P AF Mendelson, M Solomon, R Shekletski, E Henry, K Campbell, S Collins, A Thurn, J Lebahn, F Rhame, F Gerberding, J Fahrner, R TurnerHubbard, K Jensen, P TI Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures - Minneapolis St Paul, New York City, and San Francisco, 1993-1995 (Reprinted from MMWR, vol 46, pg 21-25, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID NEEDLESTICK INJURIES C1 ST PAUL RAMSEY MED CTR,ST PAUL,MN 55101. MINNEAPOLIS VET AFFAIRS MED CTR,MINNEAPOLIS,MN. UNIV MINNESOTA HOSP,MINNEAPOLIS,MN. SAN FRANCISCO GEN HOSP,SAN FRANCISCO,CA 94110. VET AFFAIRS MED CTR,SAN FRANCISCO,CA 94121. CTR DIS CONTROL,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333. RP Mendelson, M (reprint author), MT SINAI MED CTR,NEW YORK,NY 10029, USA. NR 11 TC 4 Z9 4 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 12 PY 1997 VL 277 IS 6 BP 449 EP 450 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WG054 UT WOS:A1997WG05400010 ER PT J AU Mendelson, M Sperling, R Brodman, M Dottino, P Morrow, J Solomon, J Raucher, B Stein, J Roche, N Jacobs, A Nicholas, P Karmin, I Brown, B AF Mendelson, M Sperling, R Brodman, M Dottino, P Morrow, J Solomon, J Raucher, B Stein, J Roche, N Jacobs, A Nicholas, P Karmin, I Brown, B TI Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures - New York City, March 1943 June 1994 (Reprinted from MMWR, vol 46, pg 25-29, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID CLOSURE C1 BETH ISRAEL MED CTR,NEW YORK,NY 10003. ELMHURST HOSP,NEW YORK,NY. CTR DIS CONTROL,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333. RP Mendelson, M (reprint author), MT SINAI MED CTR,NEW YORK,NY 10029, USA. NR 9 TC 6 Z9 6 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 12 PY 1997 VL 277 IS 6 BP 451 EP 452 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WG054 UT WOS:A1997WG05400011 ER PT J AU Kludt, P Lett, SM DeMaria, A Crutcher, JM Curtis, NM Garvey, CW Frank, LL Danner, A Benjamin, GC Dwyer, D AF Kludt, P Lett, SM DeMaria, A Crutcher, JM Curtis, NM Garvey, CW Frank, LL Danner, A Benjamin, GC Dwyer, D TI Outbreaks of pneumococcal pneumonia among unvaccinated residents in chronic-care facilities - Massachusetts, October 1995, Oklahoma, February 1996, and Maryland, May-June 1996 (Reprinted from MMWR, vol 46, pg 60-62, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint ID VACCINE C1 OKLAHOMA DEPT HLTH,OKLAHOMA CITY,OK 73117. MONTGOMERY CTY DEPT HLTH & HUMAN SERV,ROCKVILLE,MD 20850. MARYLAND DEPT HLTH & MENTAL HYG,BALTIMORE,MD 21201. CTR DIS CONTROL,NATL IMMUNIZAT PROGRAM,ADULT VACCINE PREVENTABLE DIS BRANCH,ATLANTA,GA 30333. CTR DIS CONTROL,NATL CTR INFECT DIS,CHILDHOOD & RESP DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. RP Kludt, P (reprint author), MASSACHUSETTS DEPT PUBL HLTH,BOSTON,MA 02111, USA. NR 12 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 12 PY 1997 VL 277 IS 6 BP 452 EP & PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WG054 UT WOS:A1997WG05400012 ER PT J AU Tokars, JI Miller, ER AF Tokars, JI Miller, ER TI Vascular access in patients receiving hemodialysis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter RP Tokars, JI (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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 12 PY 1997 VL 277 IS 6 BP 455 EP 455 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WG054 UT WOS:A1997WG05400016 PM 9020261 ER PT J AU Narayan, KMV AF Narayan, KMV TI Cost-effectiveness of intensive insulin therapy in the diabetes control and complications trial SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter RP Narayan, KMV (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 2 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 5 PY 1997 VL 277 IS 5 BP 374 EP 374 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WE771 UT WOS:A1997WE77100017 PM 9010163 ER PT J AU Zangwill, KM Schuchat, A Riedo, FX Pinner, RW Koo, DT Reeves, MW Wenger, JD AF Zangwill, KM Schuchat, A Riedo, FX Pinner, RW Koo, DT Reeves, MW Wenger, JD TI School-based clusters of meningococcal disease in the United States - Descriptive epidemiology and a case-control analysis SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID NEISSERIA-MENINGITIDIS; RISK-FACTORS; OUTBREAK; TRANSMISSION; POPULATION; CLASSROOM; INFECTION; CONTACTS AB Objective.-To evaluate the epidemiologic features and risk factors for multiple cases of meningococcal disease in schools. Design.-Population-based prospective evaluation and case-control study of clusters of meningococcal disease that occurred in schools from January 1989 to June 1994. Setting.-Surveillance conducted through state health departments in the United States. Main Outcome Measures.-Descriptive epidemiology of school-based clusters of meningococcal disease and determinants of their occurrence. Results.-We identified 22 clusters of meningococcal disease in 15 states. The estimated incidence of secondary meningococcal disease among schoolchildren aged 5 to 18 years was 2.5 per 100 000 population, a relative risk of 2.3 (95% confidence interval [Cl], 1.6-3.3). The median number of students per cluster was 2 (range, 2-4), Of 30 subsequent cases, 10 (33%) occurred 2 or fewer days after the index case, and 22 (79%) occurred 14 or fewer days after the index case. Among the 8 schools with 2 or more cases, 50% of the additional cases occurred 2 or more days after the Second case. Secondary schools (grades 7 through 12) accounted for 15 (75%) of 20 cluster schools compared with 9 (45%) of 20 matched control schools (P<.05). In 16 (73%) of 22 clusters, interaction between case patients was noted. The index patient in cluster schools was more likely than the controls to have participated in a-school-based group activity 14 or fewer days before illness (matched odds ratio, 7.0; 95% Cl, 0.9-57). Conclusions.-Three quarters of the school clusters occurred in secondary schools, with over 70% of subsequent cases occurring within 2 weeks of the index case. Rapid initiation of a chemoprophylaxis program after 2 cases of meningococcal disease in a school would have potentially prevented 50% of subsequent cases in the clusters described. C1 CTR DIS CONTROL & PREVENT,CHILDHOOD & RESP DIS BRANCH,NATL CTR INFECT DIS,ATLANTA,GA 30333. NR 27 TC 52 Z9 54 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD FEB 5 PY 1997 VL 277 IS 5 BP 389 EP 395 DI 10.1001/jama.277.5.389 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA WE771 UT WOS:A1997WE77100029 PM 9010171 ER PT J AU Skjeldestad, FE Atrash, HK AF Skjeldestad, FE Atrash, HK TI Evaluation of induced abortion as a risk factor for ectopic pregnancy - A case-control study SO ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA LA English DT Article DE case-control study; ectopic pregnancy; induced abortion; pregnancy outcomes; risk factors AB Objective. To assess the risk of ectopic pregnancy after one or more induced abortions. Design. Population-based case-control study. Methods. We studied all women who had a histologically verified ectopic pregnancy in one Norwegian county between January 1, 1987, and December 31, 1990. We identified population-based control sets of women among participants in the second Norwegian fertility study (1988-1989). Gravida women 20-39 years of age, who were not using contraceptives and had become spontaneously pregnant, were eligible for analysis. The final analyses included 174 women with ectopic pregnancy, 115 pregnant control women and 227 nonpregnant control women. Statistical methods. Chi-square test and unconditional logistic regression. Results. Fifty-three (30.5%) of women with ectopic pregnancy, 18 (15.7%) of pregnant control women and 51 (22.5%) of nonpregnant control women had had one or more previous induced abortions. The adjusted odds ratio of ectopic pregnancy among women with one previous induced abortion was 1.3 (95% confidence interval; 0.9 to 1.8) and 1.2 (95% CI; 0.8 to 1.7) compared with pregnant and nonpregnant control women, respectively. Among women who had two or more induced abortions, the adjusted odds ratio of ectopic pregnancy was 0.2 (95% CI; 0.04 to 0.9) compared with pregnant control women and 1.8 (95% CI; 0.4 to 7.8) compared with nonpregnant control women. When we used the outcome of the most recent pregnancy, birth as reference, we found no association between an outcome of induced abortion and subsequent ectopic pregnancy regardless of whether the control women were pregnant. Conclusion. We found no association between induced abortion and subsequent ectopic pregnancy Women who had induced abortions were characterized as having several other risk factors for ectopic pregnancy. C1 NORWEGIAN UNIV SCI & TECHNOL,FAC MED,DEPT GYNECOL & OBSTET,N-7034 TRONDHEIM,NORWAY. CTR DIS CONTROL & PREVENT,DIV REPROD HLTH,ATLANTA,GA. NR 23 TC 8 Z9 8 U1 0 U2 0 PU MUNKSGAARD INT PUBL LTD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0001-6349 J9 ACTA OBSTET GYN SCAN JI Acta Obstet. Gynecol. Scand. PD FEB PY 1997 VL 76 IS 2 BP 151 EP 158 DI 10.3109/00016349709050072 PG 8 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WK413 UT WOS:A1997WK41300012 PM 9049289 ER PT J AU Skjeldestad, FE Kendrick, JS Atrash, HK Daltveit, AK AF Skjeldestad, FE Kendrick, JS Atrash, HK Daltveit, AK TI Increasing incidence of ectopic pregnancy in one Norwegian county - A population based study, 1970-1993 SO ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA LA English DT Article DE assisted reproduction; ectopic pregnancy; incidence; repeat ectopic pregnancy; surveillance; time trends ID INDUCED-ABORTION; TRENDS; WOMEN; NORWAY; TIME AB Objective. To estimate time trends related to ectopic pregnancy while considering the contribution of repeal ectopic pregnancy and changing treatment for infertile couples over the past 24 years. Methods. Population based incidence data on ectopic pregnancy were collected from the only two hospitals in one Norwegian county from 1970 through 1993. Cases were identified through hospital discharge registries and all medical records were reviewed. Only females, aged 15-44 years, living permanently in the county and having a histologically verified ectopic pregnancy were eligible for the study. Data were analyzed in 5-year periods and 5-year age-groups. Results. The incidence of ectopic pregnancy (per 1,000 woman-years) increased fourfold from the first to the last period. When we restricted the analyses to women with no previous ectopic pregnancy and no previous infertility surgery or treatment, we observed a linear threefold increase in the number of ectopic pregnancies. Conclusions. Repeal ectopic pregnancy and increased infertility treatment in the late 1970s and early 1980s might explain at most 25% of the increase in the incidence of ectopic pregnancy. After 1985, assisted reproduction might contribute to 4-5% of ectopic pregnancies diagnosed. The introduction of laparoscopy might explain some of this increase in the 1970s; however, we doubt that the introduction of more sensitive pregnancy tests oi vaginal ultrasound in the 1980s contributed to the observed increase in ectopic pregnancy. C1 NORWEGIAN UNIV SCI & TECHNOL,DEPT GYNECOL & OBSTET,N-7034 TRONDHEIM,NORWAY. NATL CTR CHRON DIS PREVENT & HLTH PROMOT,CTR DIS CONTROL & PREVENT,DIV REPROD HLTH,ATLANTA,GA. UNIV BERGEN,MED BIRTH REGISTRY NORWAY,BERGEN,NORWAY. NR 30 TC 16 Z9 16 U1 0 U2 0 PU MUNKSGAARD INT PUBL LTD PI COPENHAGEN PA 35 NORRE SOGADE, PO BOX 2148, DK-1016 COPENHAGEN, DENMARK SN 0001-6349 J9 ACTA OBSTET GYN SCAN JI Acta Obstet. Gynecol. Scand. PD FEB PY 1997 VL 76 IS 2 BP 159 EP 165 DI 10.3109/00016349709050073 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WK413 UT WOS:A1997WK41300013 PM 9049290 ER PT J AU MacGowan, RJ Brackbill, RM Rugg, DL Swanson, NM Weinstein, B Couchon, A Scibak, J Molde, S McLaughlin, P Barker, T Voigt, R AF MacGowan, RJ Brackbill, RM Rugg, DL Swanson, NM Weinstein, B Couchon, A Scibak, J Molde, S McLaughlin, P Barker, T Voigt, R TI Sex, drugs and HIV counseling and testing: A prospective study of behavior-change among methadone-maintenance clients in New England SO AIDS LA English DT Article DE HIV counseling and testing; injecting drug users; behaviour change; methadone treatment ID USERS; PROGRAMS; ABUSE AB Objectives: To determine whether changes in injecting drug use and sexual behavior over a 12-month follow-up are associated with HIV counseling and testing (C and T) of injecting drug users in methadone maintenance treatment programs (MMTP) in Massachusetts and Connecticut. Methods: Clients were invited to participate in a longitudinal study involving five interviews. Data were also obtained by ethnographers and from clinical records. Behavioral outcomes of interest were numb;er pf drug injections, sharing of unclean 'works' (injecting equipment), number of unprotected sex partners, and number of unprotected sexual episodes. Data analyses included multiple regression, odds ratios, and quantitative analysis of text-based data. Results: Subjects reported reductions in both injecting drug use and sexual behavior. Primary associations with reduced injecting drug use were remaining in the MMTP and attending HIV-positive support groups. A reduction in high-risk sexual behavior was associated with an HIV-positive test result and duration of HIV counseling in the MMTP. Increase in drug injecting use was associated with an HIV-positive test result. Inconsistent condom use was associated with enrollment in the MMTP where condoms were available only upon request and abstinence and monogamy between uninfected partners were promoted. Conclusions: Injecting drug users who self-select to participate in MMTP and HIV C and T, two public health HIV-prevention interventions, reduce their HIV-risk behaviors. Clients should be encouraged to remain in MMTP and HIV-infected clients should attend support groups for HIV-positive persons. MMTP staff should promote a variety of safer sex behaviors and provide condoms without request. C1 UNIV CONNECTICUT,CTR HLTH,FARMINGTON,CT. CONNECTICUT DEPT PUBL HLTH,HARTFORD,CT. PROVIDENCE HOSP,HOLYOKE,MA. APT FDN,NEW HAVEN,CT. HARTFORD DISPENSARY,HARTFORD,CT. JOHN SNOW INC,MASSACHUSETTS DEPT PUBL HLTH,BOSTON,MA. RP MacGowan, RJ (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,NATL CTR HIV STD TB PREVENT,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 21 TC 34 Z9 34 U1 0 U2 0 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD FEB PY 1997 VL 11 IS 2 BP 229 EP 235 DI 10.1097/00002030-199702000-00014 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WF391 UT WOS:A1997WF39100014 PM 9030371 ER PT J AU Hamers, FF Bueller, HA Peterman, TA AF Hamers, FF Bueller, HA Peterman, TA TI Communication of HIV serostatus between potential sex partners in personal ads SO AIDS EDUCATION AND PREVENTION LA English DT Article ID SELF-DISCLOSURE; INFECTION; HEALTH; GAY; MEN; INTERCOURSE; RISK AB We studied reference to HIV in personal ads from 1986 to 1993 to assess knowledge of HIV serostatus as a criterion for selecting sex partners. Personals increased exponentially during 1986 to 1993. Men seeking men (MSM) were more likely (8%) to mention HIV than persons seeking other situations (0% to 1.6%). The proportion of personals mentioning HIV increased from 0.5% to 2.9% globally and from 1.9% to 12.2% for MSM (chi-square tests for trend; p < .001). Younger MSM mentioned HIV less often than MSM older than 35 years (odds ratio = .46; 95% confidence interval: .31 to .70). The increasing proportion of personals mentioning HIV suggests that serostatus is increasingly used as a criterion for partner selection, although most (84%) such ads concerned MSM. We discuss the implications of these findings for preventing sexual transmission of HIV. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,DIV STD HIV PREVENT,NATL CTR PREVENT SERV,ATLANTA,GA. NR 18 TC 8 Z9 8 U1 0 U2 1 PU GUILFORD PUBLICATIONS INC PI NEW YORK PA 72 SPRING STREET, NEW YORK, NY 10012 SN 0899-9546 J9 AIDS EDUC PREV JI Aids Educ. Prev. PD FEB PY 1997 VL 9 IS 1 BP 42 EP 48 PG 7 WC Education & Educational Research; Public, Environmental & Occupational Health SC Education & Educational Research; Public, Environmental & Occupational Health GA WN128 UT WOS:A1997WN12800004 PM 9083590 ER PT J AU McDonnell, S GrummerStrawn, L Trowbridge, F AF McDonnell, S GrummerStrawn, L Trowbridge, F TI Screening and early detection of hemochromatosis SO AMERICAN FAMILY PHYSICIAN LA English DT Letter RP McDonnell, S (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 7 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD FEB 1 PY 1997 VL 55 IS 2 BP 440 EP 440 PG 1 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA WG817 UT WOS:A1997WG81700005 PM 9054215 ER PT J AU Stern, FB Sweeney, MH Ward, E AF Stern, FB Sweeney, MH Ward, E TI Proportionate mortality among unionized construction ironworkers SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE ironworker; construction; proportionate mortality; injuries; lung cancer ID SAFETY-AND-HEALTH; LUNG-CANCER; DIESEL EXHAUST; UNITED-STATES; INDUSTRY; INSTITUTE; ASBESTOS; WORKERS AB This report presents the results of proportionate mortality ratios (PMR) and proportionate cancer mortality ratios (PCMR) among 13,301 members of the International Union of Bridge, Structural, and Ornamental Ironworkers who had been members for a minimum of 1 year were actively paying dues into the death beneficiary fund, and had died between 1984-1991. Using the United States proportionate mortality rates as the comparison population, statistically significant elevated risks, using 95% confidence intervals (Cl), were observed for several types of injuries: falls (N = 259, PMR = 3.57, Cl = 3.15-4.03), transportation injuries (N = 363, PMR = 1.22, Cl = 1.10-1.35), and other types of injuries (N = 225, PMR = 1.63, Cl = 1.43-1.86). The deaths due to falls were significantly elevated for each 10-year age group under age 60 (PMR>7.00) and for those workers with <20 years in the onion (PMR>6.00). Elevated mortality risks were also observed for all malignant neoplasms combined (N = 3,682, PMR = 1.09, Cl = 1.06-1.13) as well as for site-specific malignant neoplasms of the lung (N = 1,523, PMR = 1.28, Cl = 1.21-1.35), pleural mesothelioma (N 7, PMR = 1.67, Cl = 0.67-3.44) and ''other and unspecified sites'' (N = 307, PMR = 1.29, Cl = 1.15-1.44). The category ''prdeumoconiosis and other respiratory diseases'' was also significantly elevated (N = 690, PMR = 1.11, Cl = 1.03-1.20); in this category, deaths due to asbestosis had the greatest elevated risk (N = 10, PMR = 3.56, Cl = 1.70-6.54). No elevation in risk was found for kidney cancer or for chronic nephritis which were of interest because of Ironworkers' potential exposure to lead. The present study underscores the importance of fall protection and other injury prevention efforts in the construction industry, as well as the need to control airborne exposures to asbestos, welding fumes and other respirable disease hazards. (C) 1997 Wiley-Liss, Inc. RP Stern, FB (reprint author), NIOSH,4676 COLUMBIA PKWY,MS-13,CINCINNATI,OH 45226, USA. NR 37 TC 17 Z9 18 U1 2 U2 2 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD FEB PY 1997 VL 31 IS 2 BP 176 EP 187 DI 10.1002/(SICI)1097-0274(199702)31:2<176::AID-AJIM7>3.0.CO;2-Y PG 12 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WF879 UT WOS:A1997WF87900007 PM 9028434 ER PT J AU delaHoz, RE Young, RO Pedersen, DH AF delaHoz, RE Young, RO Pedersen, DH TI Exposure to potential occupational asthmogens: Prevalence data from the National Occupational Exposure Survey SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE asthma; occupational diseases; prevalence; lung diseases; surveillance ID DISEASE; ASTHMA AB Few data are available about the prevalence of occupational exposures to agents which can cause occupational asthma or aggravate preexisting asthma (asthmogens). Using potential occupational exposure data from the National Occupational Exposure Survey (NOES) of 1980-1983, we investigated the number of asthmogen exposures, asthmogen-exposure(s) per production worker and unprotected occupational asthmogen exposures in different industries and occupations. Data for the entire United States were used to generate estimates of occupational exposure at two selected state and local levels. It was estimated that 7,864,000 workers in the surveyed industries were potentially exposed to one or more occupational asthmogen(s) in the United States. The average number of observed potential exposures per asthmogen-exposed worker was 4.4, and varied from 11.9, in the Water Transportation industry, to 1.2 in Local and Suburban transportation. The largest number of observed potential exposures was recorded in the Apparel and Other Finished Products (garment) industry. This work and further analyses using this approach are expected to contribute to a better understanding of the epidemiology of occupational asthma, and to serve as a guide to target future occupational asthma surveillance efforts. (C) 1997 Wiley-Liss, Inc. C1 NYU,SCH MED,NEW YORK,NY. NIOSH,CTR DIS CONTROL,DIV HAZARD EVALUAT & FIELD STUDIES,SURVEILLANCE BRANCH,HAZARD SECT,CINCINNATI,OH. RP delaHoz, RE (reprint author), BELLEVUE HOSP CTR,CHEST SERV & OCCUPAT MED CLIN,1ST AVE & 27TH ST,ROOM CD349,NEW YORK,NY 10016, USA. OI de la Hoz, Rafael E./0000-0002-8949-9279 FU NHLBI NIH HHS [HL 03386-02] NR 21 TC 13 Z9 13 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD FEB PY 1997 VL 31 IS 2 BP 195 EP 201 DI 10.1002/(SICI)1097-0274(199702)31:2<195::AID-AJIM9>3.0.CO;2-Z PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WF879 UT WOS:A1997WF87900009 PM 9028436 ER PT J AU Roscoe, RJ AF Roscoe, RJ TI An update of mortality from all causes among white uranium miners from the Colorado Plateau study group SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE uranium miners; cohort mortality, radon progeny; lung cancer; pneumoconioses ID LUNG-CANCER; RADON DAUGHTERS; PROGENY AB To place previously recognized mortality risks into the context of the total mortality from all causes, an updated retrospective cohort mortality study was conducted on 3,238 white males from the US Public Health Service cohort of Colorado Plateau uranium miners. Vital status was followed from 1960 through 1990. Life-table analyses used combined New Mexico, Arizona, Utah, and Colorado mortality rates for external comparison and mortality risks within the lowest radon-exposure or duration-employed category for internal comparison. Significantly elevated SMRs were found for pneumoconioses (SMR = 24.1, 95% CI 16.0-33.7), lung cancer (SMR = 5.8, 95% CI 5.2-6.4), tuberculosis (SMR = 3.7, 95% CI 1.9-6.2) chronic obstructive respiratory diseases (SMR = 2.8, 95% CI 2.2-3.5), emphysema (SMR = 2.5, 95% CI 1.9-3.2), benign and unspecified turners (SMR = 2.4, 95% CI 1.0-4.6), and diseases of the blood and blood-forming organs (SMR = 2.4, 95% CI 1.0-5.0). No significantly lowered SMRs were found for any disease. For lung cancer and pneumoconioses, standardized rate ratios increased with increasing exposure to radon progeny or duration of employment. Most findings from this update are consistent with previous studies. Not observed were previously elevated SMRs for chronic nephritis and for acute alcoholism. New findings observed were elevated SMRs for benign and unspecified tumors and for diseases of the blood and blood-forming organs. The most important long-term mortality risks for the white uranium-miners continue to be lung cancer and pneumoconioses, for which SMRs remain significantly elevated after a mean period of 22.4 years since last uranium mining. (C) 1997 Wiley-Liss, Inc. RP Roscoe, RJ (reprint author), NIOSH, CTR DIS CONTROL & PREVENT, R-21, 4676 COLUMBIA PKWY, CINCINNATI, OH 45226 USA. NR 24 TC 30 Z9 30 U1 3 U2 6 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0271-3586 EI 1097-0274 J9 AM J IND MED JI Am. J. Ind. Med. PD FEB PY 1997 VL 31 IS 2 BP 211 EP 222 DI 10.1002/(SICI)1097-0274(199702)31:2<211::AID-AJIM11>3.0.CO;2-4 PG 12 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WF879 UT WOS:A1997WF87900011 PM 9028438 ER PT J AU Steenland, K Johnson, J Nowlin, S AF Steenland, K Johnson, J Nowlin, S TI A follow-up study of job strain and heart disease among males in the NHANES1 population SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Article DE job strain; job stress; heart disease; NHANES1 ID CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; WORKING POPULATION; DECISION LATITUDE; RANDOM SAMPLE AB Several studies have associated heart disease with job strain, defined as low job control and high job demands. We have studied incident heart disease (519 cases) and job strain among 3,575 males in NHANESI survey who were currently employed at baseline in the early 1970s, and followed through 1987. Scores for job control and job demands were assigned to each subject based on current occupation at baseline. Controlling for conventional risk factors, we found no excess risk for those with the highest strain (lowest control and highest demands, rate ratio 1.08). Those with highest job control did have significantly decreased risk (rate ratio 0.71, 95% CI 0.54-0.93). In blue-collar workers (58% of subjects) there was a significant inverse trend in risk with increasing job demands. Control for level of physical activity did not change this finding. A combination of high control and demand was protective among blue-collar workers (odds ratio 0.69, 0.48-0.99) Our findings suggest that class-specific analyses are needed in studying job stress, and that ''active'' blue-collar workers with high control and high demand are protected against heart disease. The ''job demand'' variable may measure whether work is challenging rather than fast-paced Our findings are limited by the use of assigned job scores based on job title. (C) 1997 Wiley-Liss. Inc. C1 JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,BALTIMORE,MD. RP Steenland, K (reprint author), NIOSH,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 18 TC 74 Z9 76 U1 1 U2 6 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD FEB PY 1997 VL 31 IS 2 BP 256 EP 260 DI 10.1002/(SICI)1097-0274(199702)31:2<256::AID-AJIM16>3.0.CO;2-0 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WF879 UT WOS:A1997WF87900016 PM 9028443 ER PT J AU PablosMendez, A Knirsch, CA Barr, RG Lerner, BH Frieden, TR AF PablosMendez, A Knirsch, CA Barr, RG Lerner, BH Frieden, TR TI Nonadherence in tuberculosis treatment: Predictors and consequences in New York City SO AMERICAN JOURNAL OF MEDICINE LA English DT Article ID DIRECTLY OBSERVED THERAPY; DRUG-RESISTANT TUBERCULOSIS; UNITED-STATES; RESURGENT TUBERCULOSIS; PATIENT; EPIDEMIOLOGY; ADHERENCE; REGIMENS; RATES AB BACKGROUND: Poor adherence to antituberculosis treatment is the most important obstacle to tuberculosis control. PURPOSE: TO identify and analyze predictors and consequences of nonadherence to antituberculosis treatment. PATIENTS AND METHODS: Retrospective study of a citywide cohort of 184 patients with tuberculosis in New York City, newly diagnosed by culture in April 1991--before the strengthening of its control program--and followed up through 1994. Follow-up information was collected through the New York City tuberculosis registry. Nonadherence was defined as treatment default for at least 2 months. RESULTS: Eighty-eight of the 184 (48%) patients were nonadherent. Greater nonadherence was noted among blacks (unadjusted relative risk [RR] 3.0, 95% confidence interval [CI] 1.1 to 8.6, compared with whites), injection drug users RR 1.5, 95% CI 1.1 to 2.0), homeless (RR 1.4, 95% CI 1.0 to 1.8), alcoholics (RR 1.4, 95% CI 1.0 to 1.9), and HIV-infected patients (RR 1.4, 95% CI 1.1 to 1.9); also, census-derived estimates of household income were lower among nonadherent patients (P = 0.018). In multivariate analysis, only injection drug use and homelessness predicted nonadherence, yet 46 (39%) of 117 patients who were neither homeless nor drug users were nonadherent. Nonadherent patients took longer to convert to negative culture (254 versus 64 days, P <0.001), were more likely to acquire drug resistance (RR 5.6, 95% CI 0.7 to 44.2), required longer treatment regimens (560 versus 324 days, P <0.0001), and were less likely to complete treatment (RR 0.5, 95% CI 0.4 to 0.7). There was no association between treatment adherence and all-cause mortality. CONCLUSIONS: In the absence of public health intervention, half the patients defaulted treatment for 2 months or longer. Although common among the homeless and injection drug users, the problem occurred frequently and unpredictably in other patients. Nonadherence may contribute to the spread of tuberculosis and the emergence of drug resistance, and may increase the cost of treatment. These data lend support to directly observed therapy in tuberculosis. (C) 1997 by Excerpta Medica, Inc. C1 COLUMBIA UNIV,COLL PHYS & SURG,DIV GEN MED,NEW YORK,NY. COLUMBIA UNIV,SCH PUBL HLTH,DIV EPIDEMIOL,NEW YORK,NY. NEW YORK CITY DEPT HLTH,BUR TB CONTROL,NEW YORK,NY 10013. COLUMBIA UNIV,COLL PHYS & SURG,DIV INFECT DIS,NEW YORK,NY. COLUMBIA UNIV,CTR STUDY SOC & MED,NEW YORK,NY. CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 51 TC 142 Z9 150 U1 0 U2 4 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 SN 0002-9343 J9 AM J MED JI Am. J. Med. PD FEB PY 1997 VL 102 IS 2 BP 164 EP 170 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA WK378 UT WOS:A1997WK37800007 PM 9217566 ER PT J AU Cieslak, PR Noble, SJ Maxson, DJ Empey, LC Ravenholt, O Legarza, G Tuttle, J Doyle, MP Barrett, TJ Wells, JG McNamara, AM Griffin, PM AF Cieslak, PR Noble, SJ Maxson, DJ Empey, LC Ravenholt, O Legarza, G Tuttle, J Doyle, MP Barrett, TJ Wells, JG McNamara, AM Griffin, PM TI Hamburger-associated Escherichia coli O157:H7 infection in Las Vegas: A hidden epidemic SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID HEMOLYTIC-UREMIC-SYNDROME; BLOODY DIARRHEA; O157-H7; OUTBREAK AB Objectives. This study sought to determine whether a multistate fast food hamburger-associated outbreak of Escherichia coli O157:H7 infection involved Las Vegas residents as well and, if so, why public health officials had not detected it. Methods. A matched case-control study was conducted among persons with bloody diarrhea and their healthy meal companions. Hamburger production, distribution, and cooking methods were reviewed. Unused hamburger patties were cultured, and E. coli O157:H7 isolates were characterized. Local laboratory stool culture practices were reviewed. Results. Fifty-eight cases of bloody diarrhea were identified. illness was associated with eating regular hamburgers (matched odds ratio [OR] = 9.0, 95% confidence interval [CI] = 1.02, 433.4), but 25% of ill persons reported eating only jumbo hamburgers. Regular and jumbo hamburger patties yielded E. coli O157:H7 indistinguishable from the lone clinical isolate. No local laboratory cultured routinely for E. coli O157:H7 until after the outbreak. Conclusions. A large outbreak of E. coli O157:H7 infections escaped timely notice in Las Vegas because local laboratories did not culture for this pathogen, Health officials should encourage laboratories to screen at least all bloody stools on sorbitol-MacConkey medium. C1 CLARK CTY HLTH DIST,LAS VEGAS,NV. BUR LAB SERV,NEVADA DIV,RENO,NV. UNIV GEORGIA,GEORGIA STN,CTR FOOD SAFETY & QUAL ENHANCEMENT,GRIFFIN,GA 30223. USDA,FOOD SAFETY INSPECT SERV,WASHINGTON,DC 20250. RP Cieslak, PR (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,FOODBORNE & DIARRHEAL DIS BRANCH,MS A-38,ATLANTA,GA 30333, USA. NR 18 TC 27 Z9 29 U1 0 U2 1 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD FEB PY 1997 VL 87 IS 2 BP 176 EP 180 DI 10.2105/AJPH.87.2.176 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WN493 UT WOS:A1997WN49300009 PM 9103093 ER PT J AU Koo, DT Baron, RC Rutherford, GW AF Koo, DT Baron, RC Rutherford, GW TI Transmission of Mycobacterium tuberculosis in a California state prison, 1991 SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID YORK-CITY; SKIN-TEST; INFECTION; SYSTEM; ASSOCIATION; JAIL; RISK AB Objectives. An investigation was conducted to determine whether ongoing transmission of Mycobacterium tuberculosis was occurring in a California state prison. Method. Prison pharmacy records were used to identify cases of active tuberculosis (TB). Results. Ten of the 18 cases of active TB treated at the facility during 1991 were diagnosed at the prison that same year (an incidence of 184 per 100 000). Three inmates were infectious for a total of 7 months while imprisoned. The prevalence of TB skin test-positivity among inmates was 30%, and the incidence of new infection attributable to incarceration was 5.9 per 100 inmates per year. Conclusions. Transmission of M. tuberculosis may he occur-ring in the California prison system. C1 CTR DIS CONTROL & PREVENT,DIV FIELD EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. UNIV CALIF BERKELEY,SCH PUBL HLTH,BERKELEY,CA. NR 28 TC 18 Z9 19 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD FEB PY 1997 VL 87 IS 2 BP 279 EP 282 DI 10.2105/AJPH.87.2.279 PG 4 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WN493 UT WOS:A1997WN49300027 PM 9103111 ER PT J AU Decoufle, P Boyle, C AF Decoufle, P Boyle, C TI Dose-response analyses of women's alcohol use during pregnancy and children's cognitive functioning SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Letter RP Decoufle, P (reprint author), CTR DIS CONTROL & PREVENT,DEV DISABIL BRANCH,DIV BIRTH DEFECTS & DEV DISABIL,ATLANTA,GA 30341, USA. NR 2 TC 1 Z9 1 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD FEB PY 1997 VL 87 IS 2 BP 299 EP 300 DI 10.2105/AJPH.87.2.299 PG 2 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WN493 UT WOS:A1997WN49300038 PM 9103122 ER PT J AU Zuber, PLF Binkin, NJ Vogt, RL AF Zuber, PLF Binkin, NJ Vogt, RL TI Tuberculosis screening for immigrants and refugees: Diagnostic outcomes in the state of Hawaii SO AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE LA English DT Letter RP Zuber, PLF (reprint author), CTR DIS CONTROL,NATL CTR PREVENT SERV,DIV TB ELIMINAT,ATLANTA,GA 30333, USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER LUNG ASSOC PI NEW YORK PA 1740 BROADWAY, NEW YORK, NY 10019 SN 1073-449X J9 AM J RESP CRIT CARE JI Am. J. Respir. Crit. Care Med. PD FEB PY 1997 VL 155 IS 2 BP 771 EP 771 PG 1 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA WH871 UT WOS:A1997WH87100063 ER PT J AU Sarti, E Flisser, A Schantz, PM Gleizer, M Loya, M Plancarte, A Avila, G Allan, J Craig, P Bronfman, M Wijeyaratne, P AF Sarti, E Flisser, A Schantz, PM Gleizer, M Loya, M Plancarte, A Avila, G Allan, J Craig, P Bronfman, M Wijeyaratne, P TI Development and evaluation of a health education intervention against Taenia solium in a rural community in Mexico SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID PORCINE CYSTICERCOSIS; MICHOACAN STATE; VILLAGE; PREVALENCE; HUMANS; PIGS AB A comprehensive study was undertaken in a rural community in the state of Morelos, Mexico to evaluate health education as an intervention measure against Taenia solium. An educational program was developed to promote recognition and knowledge of the transmission of the parasite and to improve hygienic behavior and sanitary conditions that foster transmission. The effects of educational intervention were evaluated by measuring changes in knowledge and practices and prevalence of human taeniasis and swine cysticercosis before and after the campaign. The health education strategy was implemented with the active participation of the population based on the information obtained from a sociologic study. A questionnaire was designed and used before, immediately after the intervention, and six months later. Statistically significant improvements occurred in knowledge of the parasite, its life cycle, and how it is acquired by humans; however, changes in behavior related to transmission were less dramatic and persistent. The prevalences of cysticercosis in pigs at the start of the education intervention were 2.6% and 5.2% by lingual examination and antibody detection (immunoblot assay), respectively, and approximately one year after the intervention they were 0% and 1.2% (P < 0.05). These changes were accompanied by significant reductions in the reported access of pigs to sources of infection and freedom to roam. We conclude that health education, developed along with community involvement, reduced opportunities for transmission of T. solium in the human-pig cycle. C1 UNIV NACL AUTONOMA MEXICO,FAC MED,MEXICO CITY 04510,DF,MEXICO. INST NACL DIAGNOST & REFERENCIA EPIDEMIOL,SECRETARIA SALUD,MEXICO CITY,DF,MEXICO. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30341. UNIV SALFORD,DEPT BIOL SCI,SALFORD MS4 5WT,LANCS,ENGLAND. INT DEV RES CTR,OTTAWA,ON,CANADA. RP Sarti, E (reprint author), SECRETARIA SALUD MEXICO,DIRECC GEN EPIDEMIOL,MEXICO CITY,DF,MEXICO. FU Wellcome Trust NR 26 TC 102 Z9 105 U1 0 U2 7 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD FEB PY 1997 VL 56 IS 2 BP 127 EP 132 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WP436 UT WOS:A1997WP43600004 PM 9080868 ER PT J AU Edwards, JF Karabatsos, N Collisson, EW Bermejillo, AD AF Edwards, JF Karabatsos, N Collisson, EW Bermejillo, AD TI Ovine fetal malformations induced by in utero inoculation with Main Drain, San Angelo, and LaCrosse viruses SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID CACHE VALLEY VIRUS; BUNYAMWERA SEROGROUP VIRUSES; LA-CROSSE VIRUS; CONGENITAL-MALFORMATIONS; SHEEP; INFECTION AB The teratogenic potential of three bunyaviruses, two California serogroup bunyaviruses, LaCrosse virus and San Angelo virus, and a Bunyamwera serogroup member, Main Drain virus, in sheep was studied following in utero inoculation of ewes in early gestation. Although Main Drain virus appeared to be most teratogenic, all three viruses induced a range of lesions including arthrogryposis, hydrocephalus, fetal death, axial skeletal deviations, anasarca, and oligohydramnios. The teratogenic effects of these viruses are identical to those described in ovine infections by Cache Valley and Akabane viruses. Demonstration of a common bunyaviral tropism for fetal tissue infection that results in congenital brain and musculoskeletal malformations provides evidence that human in utero infection by bunyaviruses could result in similar malformations in human infants. C1 CTR DIS CONTROL & PREVENT,FT COLLINS,CO 80522. CTR AGR RES & EXTENS,AGR EXPT STN,SAN ANGELO,TX 76901. RP Edwards, JF (reprint author), TEXAS A&M UNIV,COLL VET MED,DEPT VET PATHOBIOL,COLLEGE STN,TX 77840, USA. NR 14 TC 22 Z9 24 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD FEB PY 1997 VL 56 IS 2 BP 171 EP 176 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WP436 UT WOS:A1997WP43600012 PM 9080876 ER PT J AU Collins, WE Sullivan, JS Morris, CL Galland, GG Jue, DL Fang, SN Wohlhueter, R Reed, RC Yang, CF Hunter, RL Lal, AA AF Collins, WE Sullivan, JS Morris, CL Galland, GG Jue, DL Fang, SN Wohlhueter, R Reed, RC Yang, CF Hunter, RL Lal, AA TI Protective immunity induced in squirrel monkeys with a multiple antigen construct against the circumsporozoite protein of Plasmodium vivax SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID SAIMIRI-SCIUREUS-BOLIVIENSIS; DEFINED SYNTHETIC VACCINE; SALVADOR I-STRAIN; IMMUNIZATION; MALARIA; ANTIBODIES; INDUCTION; ADJUVANTS; EPITOPES; PEPTIDES AB Saimiri boliviensis monkeys were immunized with a multiple antigen construct [(PvCS)(2)](2)(P2)(2) directed against the circumsporozoite protein of Plasmodium vivax or a combination of the multiple antigen construct with nonionic copolymer P1005, with P1005 and lipopolysaccharide, with muramyl tripeptide Mf-75, or with alum. Following intravenous challenge with 10,000 sporozoites of the Salvador I strain of P. vivax, 11 of the 26 monkeys were protected against patent parasitemia. Ten additional animals were partially protected. Following rechallenge of the 26 monkeys with 30,000 sporozoites of the homologous strain of parasite, four monkeys were totally protected and nine animals were partially protected. C1 EMORY UNIV,DEPT PATHOL & LAB MED,ATLANTA,GA 30322. CTR DIS CONTROL & PREVENT,SCI RESOURCES PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP Collins, WE (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,MAILSTOP F12,ATLANTA,GA 30333, USA. RI Yang, Chunfu/G-6890-2013 NR 19 TC 22 Z9 22 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD FEB PY 1997 VL 56 IS 2 BP 200 EP 210 PG 11 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WP436 UT WOS:A1997WP43600017 PM 9080881 ER PT J AU Schlagenhauf, P Lobel, H Steffen, R Johnson, R Popp, K Tschopp, A Letz, R Crevoisier, C AF Schlagenhauf, P Lobel, H Steffen, R Johnson, R Popp, K Tschopp, A Letz, R Crevoisier, C TI Tolerance of mefloquine by SwissAir trainee pilots SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID BEHAVIORAL-EVALUATION; PROPHYLAXIS; SYMPTOMS; MALARIA; REGIMENS; EXPOSURE; SYSTEM; TERM AB Due to presumed adverse performance impact, a World Health Organization clause currently restricts the use of mefloquine malaria chemoprophylaxis in individuals requiring fine coordination and spatial discrimination. We conducted a double-blind, placebo-controlled, cross-over study to quantitatively assess the effects of mefloquine at steady state on performance in 23 trainee airline pilots. Flying performance was assessed using a flight simulator, psychomotor function was evaluated, sleep and wake cycles were monitored, and symptoms and moods were assessed using standardized questionnaires. A simplified postural sway meter recorded sway in three test positions. In the mefloquine loading dose phase, there was one withdrawal due to dizziness, diarrhea, and flu-like symptoms, and three volunteers reported nonserious, sleep-related adverse events. There was no significant difference in flying performance, psychomotor functions, or mean sway for any test position. Nonsignificant reductions in mean total nocturnal sleep (mefloquine = 450 min versus placebo = 484 min) and poorer sleep quality were detected in the mefloquine phases. The mood findings indicated a predominance of positive states, with vigor the predominant mood in all phases. No significant performance deficit was documented under laboratory conditions during use of mefloquine at steady state. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30333. USA,ENVIRONM MED RES INST,NATICK,MA 01760. UNIV ZURICH,INST SOCIAL & PREVENT MED,DIV BIOSTAT,CH-8006 ZURICH,SWITZERLAND. WALTER REED ARMY INST RES,DEPT BEHAV BIOL,WASHINGTON,DC 20307. EMORY UNIV,ROLLINS SCH PUBL HLTH,ATLANTA,GA 30322. F HOFFMANN LA ROCHE & CO LTD,DEPT CLIN PHARMACOL,CH-4002 BASEL,SWITZERLAND. RP Schlagenhauf, P (reprint author), UNIV ZURICH,INST SOCIAL & PREVENT MED,DIV COMMUNICABLE DIS,SUMATRASTR 30,CH-8006 ZURICH,SWITZERLAND. NR 29 TC 31 Z9 31 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD FEB PY 1997 VL 56 IS 2 BP 235 EP 240 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WP436 UT WOS:A1997WP43600022 PM 9080886 ER PT J AU Snider, DE Satcher, D AF Snider, DE Satcher, D TI Behavioral and social sciences at the Centers for Disease Control and Prevention - Critical disciplines for public health SO AMERICAN PSYCHOLOGIST LA English DT Article AB The mission of the Centers for Disease Control and Prevention (CDC) is to promote health and quality of life by preventing and controlling disease, injury, and disability. Fifty years ago, CDC's efforts were focused on epidemiologic and laboratory studies of malaria typhus, and plague. Today, CDC's activities cover a broad range of diseases and conditions, and a broader range of disciplines are required to address these diverse public health problems. The behavioral and social sciences have a critical role to play in helping the public understand risk group characteristics and the frequency, context, and determinants of risky behaviors and in developing, implementing, and assessing prevention programs. CDC is taking steps to foster an environment in which behavioral and social sciences can flourish and to integrate these sciences into all of CDC's prevention activities. Other articles in this section describe the breadth and nature of the contributions of behavioral and social sciences at CDC. RP Snider, DE (reprint author), CTR DIS CONTROL & PREVENT,1600 CLIFTON RD NE,MAILSTOP D-50,ATLANTA,GA 30333, USA. NR 5 TC 6 Z9 6 U1 0 U2 1 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD FEB PY 1997 VL 52 IS 2 BP 140 EP 142 PG 3 WC Psychology, Multidisciplinary SC Psychology GA WH064 UT WOS:A1997WH06400004 PM 9104086 ER PT J AU Roberts, GW Banspach, SW Peacock, N AF Roberts, GW Banspach, SW Peacock, N TI Behavioral scientists at the Centers for Disease Control and Prevention - Evolving and integrated roles SO AMERICAN PSYCHOLOGIST LA English DT Article ID COMMUNITIES AB The behavioral sciences offer theories and methods that are critical to fulfilling the mission of the Centers for Disease Control and Prevention (CDC). Behavioral scientists have been integrated into the epidemiological and biomedical traditions of the agency, thereby broadening the effectiveness of prevention strategies that rely on behavior change. The diversity and changing nature of the roles of CDC behavioral scientists are presented,: along with a discussion of how they connect to ongoing public health efforts. Psychological theories and methods, especially, have relevance for tackling many of the challenges facing public health. Some of these challenges, and the opportunities they present for psychologists and other behavioral scientists, are discussed. C1 CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA. RP Roberts, GW (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INJURY PREVENT & CONTROL,4770 BUFORD HIGHWAY NE,MAILSTOP K-02,ATLANTA,GA 30341, USA. NR 18 TC 5 Z9 5 U1 0 U2 0 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD FEB PY 1997 VL 52 IS 2 BP 143 EP 146 PG 4 WC Psychology, Multidisciplinary SC Psychology GA WH064 UT WOS:A1997WH06400005 PM 9104087 ER PT J AU Rugg, DL Levinson, R DiClemente, R Fishbein, M AF Rugg, DL Levinson, R DiClemente, R Fishbein, M TI Centers for Disease Control and Prevention partnerships with external behavioral and social scientists - Roles, extramural funding, and employment SO AMERICAN PSYCHOLOGIST LA English DT Article AB The Centers for Disease Control and Prevention (CDC) must have strong external partnerships with behavioral and social scientists to refine and carry out its research and programmatic mission. This article examines funding, employment, and other mechanisms used to develop and foster such partnerships. The authors describe in detail funding mechanisms (especially the often-used cooperative agreement and contracting mechanisms) and identify specific sources of information about funding opportunities. Furthermore, they describe several different long- and short-term employment mechanisms that can be used to link CDC staff and external behavioral scientists. Finally, external behavioral and social scientists can serve in important roles as members of CDC advisory committees, peer reviewers of funding applications, and consultants; examples of these opportunities are also provided. C1 UNIV ALABAMA,MED CTR,SCH PUBL HLTH,TUSCALOOSA,AL 35487. EMORY UNIV,SCH PUBL HLTH,ATLANTA,GA 30322. CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV STD PREVENT,ATLANTA,GA. UNIV ILLINOIS,DEPT PSYCHOL,URBANA,IL 61801. RP Rugg, DL (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA 30329, USA. NR 1 TC 7 Z9 7 U1 0 U2 0 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD FEB PY 1997 VL 52 IS 2 BP 147 EP 153 PG 7 WC Psychology, Multidisciplinary SC Psychology GA WH064 UT WOS:A1997WH06400006 PM 9104088 ER PT J AU Galavotti, C Saltzman, LE Sauter, SL Sumartojo, E AF Galavotti, C Saltzman, LE Sauter, SL Sumartojo, E TI Behavioral science activities at the Centers for Disease Control and Prevention - A selected overview of exemplary programs SO AMERICAN PSYCHOLOGIST LA English DT Review ID HEALTH COMPLAINTS; MALE PARTNERS; HIGH-RISK; TUBERCULOSIS; JOB; EPIDEMIOLOGY; DISORDERS; STRESS; WOMEN; NIOSH AB Behavioral research and surveillance activities are conducted across the Centers for Disease Control and Prevention (CDC). This article highlights activities in 4 program areas: violence against women, tuberculosis elimination, HN prevention, and occupational health. The unique constraints and opportunities of each organization and program focus have shaped the way research has developed in each of these areas. Behavioral scientists also face many common challenges at CDC Despite the difficulties of integrating behavioral research into an institution that historically has focused on biomedical and epidemiological research, behavioral scientists have made important contributions to public health. Many opportunities remain for psychologists to translate theory and operationalize constructs for use in solving important public health problems. C1 CTR DIS CONTROL & PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,NIOSH,ATLANTA,GA. CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA. RP Galavotti, C (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. NR 102 TC 17 Z9 17 U1 1 U2 4 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD FEB PY 1997 VL 52 IS 2 BP 154 EP 166 PG 13 WC Psychology, Multidisciplinary SC Psychology GA WH064 UT WOS:A1997WH06400007 PM 9104089 ER PT J AU Holtgrave, DR Doll, LS Harrison, J AF Holtgrave, DR Doll, LS Harrison, J TI Influence of behavioral and social science on public health policymaking SO AMERICAN PSYCHOLOGIST LA English DT Article ID PSYCHOLOGY; PREVENTION AB Public health policies are important guiding principles that serve to shape the well-being of individuals, groups, and society. Behavioral and social scientists can play key influential roles in public health policymaking. The actors and processes involved in setting public health policy are described and several substantive examples of public health decision making are discussed, emphasizing HIV prevention policy experiences at the Centers for Disease Control and Prevention. The significant influence of behavioral and social science in each of these examples is identified and critiqued. Challenges to further integration of behavioral science and public health policy are identified and potential solutions are proposed. C1 CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. RP Holtgrave, DR (reprint author), MED COLL WISCONSIN,CTR AIDS INTERVENT RES,DEPT PSYCHIAT & BEHAV MED,MILWAUKEE,WI 53226, USA. NR 41 TC 10 Z9 10 U1 0 U2 0 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0003-066X J9 AM PSYCHOL JI Am. Psychol. PD FEB PY 1997 VL 52 IS 2 BP 167 EP 173 DI 10.1037/0003-066X.52.2.167 PG 7 WC Psychology, Multidisciplinary SC Psychology GA WH064 UT WOS:A1997WH06400008 PM 9104090 ER PT J AU Hawkins, JL Koonin, LM Palmer, SK Gibbs, CP AF Hawkins, JL Koonin, LM Palmer, SK Gibbs, CP TI Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990 SO ANESTHESIOLOGY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-of-Anesthesiologists CY OCT 09-14, 1993 CL WASHINGTON, DC SP Amer Soc Anesthesiologists DE anesthesia, obstetric, maternal mortality, pregnancy-related mortality, risk factors ID MATERNAL MORTALITY; CESAREAN-SECTION; CARDIAC-ARREST; RISK-FACTORS; BUPIVACAINE; CLAIMS AB Background Anesthesia-related complications are the sixth leading cause of pregnancy-related death in the United States. This study reports characteristics of anesthesia-related deaths during obstetric delivery in the United States from 1979-1990. Methods: Each state reports deaths that occur within 1 yr of delivery to the Centers for Disease Control and Prevention as part of the ongoing Pregnancy Mortality Surveillance. Maternal death certificates (with identifiers removed) matched with live birth or fetal death certificates when available from 1979-1990 were reviewed to identify deaths due to anesthesia, the cause of death, the procedure for delivery, and the type of anesthesia provided. Maternal mortality rates per million live births were calculated, Case fatality rates and risk ratios were computed to compare general to regional anesthesia for cesarean section deliveries. Results: The anesthesia-related maternal mortality rate decreased from 4.3 per million live births in the first triennium (1979-1981) to 1.7 per million in the last (1988-1990), The number of deaths involving general anesthesia have remained stable, but the number of regional anesthesia-related deaths have decreased since 1984. The case-fatality risk ratio for general anesthesia was 2.3 (95% confidence interval [CI], 1.9-2.9) times that for regional anesthesia before 1985, increasing to 16.7 (95% CI, 12.9-21.8) times that after 1985. Conclusions: Most maternal deaths due to complications of anesthesia occurred during general anesthesia for cesarean section. Regional anesthesia is not without risk, primarily because of the toxicity of local anesthetics and excessively high regional blocks. The incidence of these deaths is decreasing, however, and deaths due to general anesthesia remain stable in number and hence account for an increased proportion of total deaths, Heightened awareness of the toxicity of local anesthetics and related improvements in technique may have contributed to a reduction in complications of regional anesthesia. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Hawkins, JL (reprint author), UNIV COLORADO,HLTH SCI CTR,DEPT ANESTHESIOL,4200 E 9TH AVE,CAMPUS BOX B113,DENVER,CO 80262, USA. NR 27 TC 339 Z9 356 U1 0 U2 4 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0003-3022 J9 ANESTHESIOLOGY JI Anesthesiology PD FEB PY 1997 VL 86 IS 2 BP 277 EP 284 DI 10.1097/00000542-199702000-00002 PG 8 WC Anesthesiology SC Anesthesiology GA WG829 UT WOS:A1997WG82900002 PM 9054245 ER PT J AU Casper, ML Barnett, EB Armstrong, DL Giles, WH Banton, CJ AF Casper, ML Barnett, EB Armstrong, DL Giles, WH Banton, CJ TI Social class and race disparities in premature stroke mortality among men in North Carolina SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE cerebrovascular disease; socioeconomic status; race; mortality; men ID OCCUPATIONAL NOISE EXPOSURE; AMBULATORY BLOOD-PRESSURE; CORONARY HEART-DISEASE; JOB DECISION LATITUDE; SOCIOECONOMIC-STATUS; CARDIOVASCULAR-DISEASE; MYOCARDIAL-INFARCTION; JOHN-HENRYISM; STRAIN; STRESS AB The purpose of this work was to examine the association between social class and premature stroke mortality among blacks and whites. For black men and white men in North Carolina, aged 35-54 years, mortality data from. vital statistics files and population data from Census Public Use Microdata Sample files were matched according to social class for the years 1984-1993. Four categories of social class were defined based upon a two-dimensional classification scheme of occupations. For each category of social class, race-specific age-adjusted stroke mortality rates were calculated, and race-specific prevalences of income, wealth, education, unemployment, and disability were estimated. Women were excluded because comparable information on social class was not available from the mortality and population data sources. For both black men and white men, the highest rates of premature stroke mortality were observed among the lowest social classes. The rate ratios (RR) between the lowest and highest social class were 2.8 for black men and 2.3 for white men. Within each social class, black men had substantially higher rates of premature stroke mortality than white men (black-to-white RR ranged from 4.0 to 4.9). Among both black men and white mon, the highest social class consistently had the most favorable levels of income, wealth, education, and employment. The inverse association between social class and stroke mortality for both black men and white men supports the need for stroke prevention efforts that address the structural inequalities in economic and social conditions. (C) 1997 by Elsevier Science Inc. C1 W VIRGINIA UNIV,PREVENT RES CTR,MORGANTOWN,WV 26506. RP Casper, ML (reprint author), CTR DIS CONTROL & PREVENT,EPIDEMIOL INTELLIGENCE SERV,1600 CLIFTON RD,MS-K-47,ATLANTA,GA 30333, USA. RI Pathak, Elizabeth/H-2683-2013 OI Pathak, Elizabeth/0000-0002-9702-0782 NR 71 TC 26 Z9 27 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD FEB PY 1997 VL 7 IS 2 BP 146 EP 153 DI 10.1016/S1047-2797(96)00113-5 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WQ521 UT WOS:A1997WQ52100009 PM 9099402 ER PT J AU Leitch, GJ Scanlon, M Shaw, A Visvesvara, GS Wallace, S AF Leitch, GJ Scanlon, M Shaw, A Visvesvara, GS Wallace, S TI Use of a fluorescent probe to assess the activities of candidate agents against intracellular forms of Encephalitozoon microsporidia SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID IN-VITRO CULTURE; ENTEROCYTOZOON-BIENEUSI; SEPTATA-INTESTINALIS; MULTIDRUG-RESISTANCE; AIDS PATIENTS; N-SP; ALBENDAZOLE; SPORE; CUNICULI; HELLEM AB Microsporidia are obligate intracellular protozoan parasites. Three species of the genus Encephalitozoon are among the microsporidia that infect immunodeficient humans. These species, Encephalitozoon cuniculi, Encephalitozoon hellem, and Encephalitozoon intestinalis, all develop in a parasitophorous vacuole within a host cell. The present study describes a method that uses the fluorescent probe calcein and confocal microscopy to detect drug-induced effects in Encephalitozoon-infected green monkey kidney cells. The effects were as follows: (i) changes in parasite organization within the parasitophorous vacuole; (ii) swelling and gross morphological changes of parasite developing stages in situ; (iii) killing of developing parasite stages in situ, detected by their uptake of the fluorescent probe; and (iv) reduction in the viability of the host cell population, assessed by the loss of the probe. Verapamil and itraconazole were used to increase the vital dye loading by both uninfected and infected cells. Agents with known antimicrosporidial activity, albendazole and fumagillin, caused all three types of parasite changes at concentrations that had no detectable effect on host cell viability. The effective doses of albendazole and fumagillin that caused swelling and disorganization of parasite developing stages were 5 x 10(-7) and 10(-6) M respectively. Killing of developing stages was detected at 10-fold-higher concentrations for these agents and at 10(-5) M for metronidazole. This method can be used to screen candidate antimicrosporidial agents in infected cultured cells. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30341. RP Leitch, GJ (reprint author), MOREHOUSE SCH MED,DEPT PHYSIOL,720 WESTVIEW DR SW,ATLANTA,GA 30310, USA. FU NCRR NIH HHS [RR03034] NR 33 TC 13 Z9 13 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD FEB PY 1997 VL 41 IS 2 BP 337 EP 344 PG 8 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA WG303 UT WOS:A1997WG30300019 PM 9021189 ER PT J AU Drebot, MA Mulders, MN Campbell, JJ Kew, OM Fonseca, K Strong, D Lee, SHS AF Drebot, MA Mulders, MN Campbell, JJ Kew, OM Fonseca, K Strong, D Lee, SHS TI Molecular detection of an importation of type 3 wild poliovirus into Canada from the Netherlands in 1993 SO APPLIED AND ENVIRONMENTAL MICROBIOLOGY LA English DT Article ID PARALYTIC POLIOMYELITIS; UNITED-STATES; EPIDEMIOLOGY; IDENTIFICATION; ENTEROVIRUSES; STRATEGIES; OUTBREAK; DISEASE AB During the fall and winter of 1992-1993 an outbreak of wild poliovirus type 3-associated poliomyelitis involving 71 patients occurred in The Netherlands. Almost all of the individuals involved in the outbreak belonged to an orthodox religious denomination that prohibits vaccination. A surveillance was initiated to determine if there had been an importation of this same strain of wild poliovirus into a southern Alberta community ,vith a similar religious affiliation. Viral culture of stool samples from consenting individuals in the community resulted in viral isolates which typed as poliovirus type 3. Sequencing of amplicons generated from both the 5' nontranslated region and the VP1/2A portion of the genomes from representative poliovirus isolates indicated a greater than 99% genetic similarity to the strain from The Netherlands. The results of this study show that the utilization of PCR-based diagnostics offers an important molecular tool for the concise and rapid surveillance of possible cases of wild poliovirus importation into communities with individuals at risk for infection. C1 VICTORIA GEN HOSP,QUEEN ELIZABETH II HLTH SCI CTR,NATL CTR ENTEROVIRUSES,DEPT PATHOL & LAB MED,HALIFAX,NS B3H 1V8,CANADA. UNIV ALBERTA,PROVINCIAL LAB PUBL HLTH NO ALBERTA,EDMONTON,AB,CANADA. MED SERV BRANCH,REG COMMUN MED BRANCH,TSUU TINA,AB,CANADA. NATL INST PUBL HLTH & ENVIRONM PROTECT,RIVM,WHO,LAB VIROL,NL-3720 BA BILTHOVEN,NETHERLANDS. CTR DIS CONTROL & PREVENT,CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. NR 25 TC 12 Z9 12 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0099-2240 J9 APPL ENVIRON MICROB JI Appl. Environ. Microbiol. PD FEB PY 1997 VL 63 IS 2 BP 519 EP 523 PG 5 WC Biotechnology & Applied Microbiology; Microbiology SC Biotechnology & Applied Microbiology; Microbiology GA WF496 UT WOS:A1997WF49600024 PM 9023931 ER PT J AU Swanson, NG Galinsky, TL Cole, LL Pan, CS Sauter, SL AF Swanson, NG Galinsky, TL Cole, LL Pan, CS Sauter, SL TI The impact of keyboard design on comfort and productivity in a text-entry task SO APPLIED ERGONOMICS LA English DT Article DE alternative keyboard design; keyboard evaluation; work-related musculoskeletal disorders AB Concerns have arisen that the keyboard is a causal factor in the development of work-related musculoskeletal disorders (WRMDs) among video display terminal (VDT) operators. A number of alternative keyboard designs have been developed with altered geometry in an effort to improve comfort in keyboard operation. However, few data are available to substantiate whether these new keyboard designs are actually effective in reducing discomfort and musculoskeletal problems in users. The purpose of this study was to provide data on the efficacy of certain alternative keyboard design features (e.g. splitting the keyboard in half, and laterally inclining the keyboard halves) in reducing fatigue and musculoskeletal discomfort among keyboard operators. The study also explored the effects of these design features on performance. Fifty subjects performed a text-entry task for one day on a standard keyboard, then were assigned to one of five keyboard conditions for an evaluation period of two days (i.e. 10 subjects/condition). Outcome measures included performance (i.e. keystrokes/h, errors/h) and self-report measures of discomfort and fatigue. The results indicated an initial decline in productivity when subjects began typing on two of the alternative keyboards, but these productivity losses were recovered within the two-day evaluation period. The results also indicated no significant differences between keyboard conditions in discomfort and fatigue. These results suggest a minimal impact of the keyboard design features examined in this study on productivity, comfort and fatigue, at least after two days of exposure. RP Swanson, NG (reprint author), NIOSH, 4676 COLUMBIA PKWY, CINCINNATI, OH 45226 USA. NR 15 TC 41 Z9 42 U1 1 U2 8 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 FEB PY 1997 VL 28 IS 1 BP 9 EP 16 DI 10.1016/S0003-6870(96)00052-X PG 8 WC Engineering, Industrial; Ergonomics; Psychology, Applied SC Engineering; Psychology GA WC830 UT WOS:A1997WC83000002 PM 9414336 ER PT J AU Qureshi, AI Giles, WH Croft, JB Stern, BJ AF Qureshi, AI Giles, WH Croft, JB Stern, BJ TI Number of pregnancies and risk for stroke and stroke subtypes SO ARCHIVES OF NEUROLOGY LA English DT Article; Proceedings Paper CT 48th Annual Meeting of the American-Academy-of-Neurology CY MAR 23-30, 1996 CL SAN FRANCISCO, CA SP Amer Acad Neurol ID BLACK-WHITE DIFFERENCES; DIABETES-MELLITUS; FOLLOW-UP; DISEASE; HEALTH; WOMEN AB Objective: To examine the effect of the number of pregnancies on the subsequent risk for stroke and stroke subtypes. Design: Prospective cohort study. Participants: National cohort of 3852 women aged 45 to 74 years who participated in the first National Health and Nutrition Examination Survey Epidemiology Follow-up Study. Main Outcome Measures: Stroke, cerebral infarction, and intracerebral hemorrhage during a 20-year follow-up period. Results: After adjusting for differences in age, women with 6 or more pregnancies were at an increased risk for any type of stroke (relative risk [RR] = 1.7; 95% confidence interval [CI], 1.2-2.3) and cerebral infarction (RR = 1.6; 95% CI, 1.2-2.3). Adjustment for stroke risk factors explained some but not all of the risk associated with pregnancy (RR = 1.3; 95% CI, 0.9-1.9 for all stroke, and RR = 1.3; 95% CI, 0.9-1.9 for cerebral infarction). The rate of intracerebral hemorrhage was 3-fold higher among women who had been pregnant when compared with nulligravida women; however, this finding did not reach statistical significance possibly because of the small number of intracerebral hemorrhages (n = 33). Conclusion: The number of pregnancies may influence the risk for stroke, particularly cerebral infarction, in women. C1 CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA 30341. EMORY UNIV,SCH MED,DEPT NEUROL,ATLANTA,GA 30322. NR 16 TC 38 Z9 38 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD FEB PY 1997 VL 54 IS 2 BP 203 EP 206 PG 4 WC Clinical Neurology SC Neurosciences & Neurology GA WH268 UT WOS:A1997WH26800013 PM 9041862 ER PT J AU Schoendorf, KC Kiely, JL AF Schoendorf, KC Kiely, JL TI Birth weight and age-specific analysis of the 1990 US infant mortality drop - Was it surfactant? SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID RESPIRATORY-DISTRESS SYNDROME; BOVINE SURFACTANT; RANDOMIZED TRIAL; DOUBLE-BLIND; THERAPY; MULTICENTER AB Objective: To examine birth-weight-specific and age-specific mortality among US infants to determine if the large infant mortality decrease in 1990 was due to surfactant use. Design: Population-based analysis of data from the 1983-1991 National Linked Birth and Infant Death files. Mortality trends from 1983 to 1989 were used to calculate expected infant mortality rates for 1990 to 1991. Setting: United States. Participants and Study Population: All singleton infants with known birth weight born in the United States from 1983 to 1991. Interventions: None. Main Outcome Measures: Mortality at less than 1 day of life, 1 to 6 days, 7 to 27 days, or 28 to 364 days. Observed mortality rates were divided by the expected rates in 250-g birth-weight categories to create mortality ratios. Results: The observed infant mortality rate in 1990 was 8.05, significantly lower than the expected rate of 8.36. Infants weighing 750 to 1749 g had mortality ratios of approximately 0.8 for 1- to 6-day mortality, with ratios significantly less than 1.0 for mortality in all age groups except less than I day. Observed mortality among infants weighing less than 750 g or from 1750 to 2499 g was not significantly lower than expected at any age. Postneonatal mortality among infants weighing 2500 g or more was significantly lower than expected. Infants weighing less than 1500 g accounted for almost 700 fewer infant deaths than predicted in 1990. Infants weighing 2500 g or more accounted for approximately 550 fewer deaths than expected. Conclusions: The hypothesis that surfactant was partially responsible for the overall infant mortality drop in 1990 is supported by the lower than expected mortality among infants weighing 750 to 1749 g. However, the unexpected improvement in postneonatal mortality among infants weighing 2500 g or more was responsible for a substantial portion of the overall decline and suggests that other factors also acted to decrease US infant mortality in 1990. RP Schoendorf, KC (reprint author), CTR DIS CONTROL & PREVENT,INFANT & CHILD HLTH STUDIES BRANCH,NATL CTR HLTH STAT,ROOM 790,HYATTSVILLE,MD 20782, USA. NR 23 TC 25 Z9 25 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD FEB PY 1997 VL 151 IS 2 BP 129 EP 134 PG 6 WC Pediatrics SC Pediatrics GA WH431 UT WOS:A1997WH43100004 PM 9041866 ER PT J AU Tipple, M Knudsen, RC Morse, S Foster, J Richmond, JY AF Tipple, M Knudsen, RC Morse, S Foster, J Richmond, JY TI New federal regulations for transfer of infections agents and toxins SO ASM NEWS LA English DT Editorial Material C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0044-7897 J9 ASM NEWS JI ASM News PD FEB PY 1997 VL 63 IS 2 BP 66 EP 67 PG 2 WC Microbiology SC Microbiology GA WH376 UT WOS:A1997WH37600005 ER PT J AU Canfield, PJ Vogelnest, L Cunningham, ML Visvesvara, GS AF Canfield, PJ Vogelnest, L Cunningham, ML Visvesvara, GS TI Amoebic meningoencephalitis caused by Balamuthia mandrillaris in an orangutan SO AUSTRALIAN VETERINARY JOURNAL LA English DT Article DE orangutan; Pongo pygmaeus; amoebic meningoencephalitis; Balamuthia mandrillaris; pathology; immunofluorescence ID AMEBIC MENINGOENCEPHALITIS; LEPTOMYXID-AMEBA; ANIMALS; HUMANS; AGENT AB Objective To describe a case of meningoencephalitis caused by Balamuthia mandrillaris in an orang utan. Design A pathological case report. Animal A 20 years old male orang utan (Pongo pygmaeus). Procedure The disease process was investigated by clinical pathology, necropsy, histopathology and immunofluorescence labelling. Results The orang utan developed sudden onset of depression, lethargy, inappetence and apparent head pain. The condition was considered to be related to a 2 year history of upper and lower respiratory disease, and the animal was placed on antibiotics after extensive testing, By the seventh day the animal had become ataxic and disoriented and a brain abscess was suspected. He died on the ninth day of illness. At necropsy, and subsequent sectioning, the brain showed multiple circular, soft, white to grey brown areas of varying size, the largest being in the left temporal (3.5 cm diameter) and right occipital (2.5 cm diameter) regions of the cerebrum. Histological examination of these regions revealed many amoebic trophozoites and occasional cysts associated with areas of haemorrhage and inflammatory necrosis. The trophozoites were packed in perivascular spaces and their nuclei often contained two or more prominent nucleoli. Immunofluorescent labelling of histological sections suggested that the agent was B mandrillaris. Clinical implications This report provides further evidence that B mandrillaris, a free living amoeba, can act as a pathogen in animals as well as people, and cause fatal meningoencephalitis. Along with Naegleria and Acanthamoeba spp, B mandrillaris should be considered amongst the causes of acute onset meningoencephalitis in animals. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. RP Canfield, PJ (reprint author), UNIV SYDNEY,DEPT VET PATHOL,SYDNEY,NSW 2006,AUSTRALIA. NR 12 TC 21 Z9 21 U1 0 U2 0 PU AUSTRALIAN VETERINARY ASSN PI VICTORIA PA 272 BRUNSWICK RD BRUNSWICK, VICTORIA 3056, AUSTRALIA SN 0005-0423 J9 AUST VET J JI Aust. Vet. J. PD FEB PY 1997 VL 75 IS 2 BP 97 EP 100 DI 10.1111/j.1751-0813.1997.tb14165.x PG 4 WC Veterinary Sciences SC Veterinary Sciences GA WL517 UT WOS:A1997WL51700007 PM 9066963 ER PT J AU Cullinan, P Acquilla, S Dhara, VR AF Cullinan, P Acquilla, S Dhara, VR TI Respiratory morbidity 10 years after the Union Carbide gas leak at Bhopal: A cross sectional survey SO BRITISH MEDICAL JOURNAL LA English DT Article ID METHYL ISOCYANATE; EXPOSURE AB Objective: To examine the role of exposure to the 1984 Bhopal gas leak in the development of persistent obstructive airways disease. Design: Cross sectional survey. Setting: Bhopal, India. Subjects: Random sample of 454 adults stratified by distance of residence from the Union Carbide plant. Main outcome measures: Self reported respiratory symptoms; indices of lung function measured by simple spirometry and adjusted for age, sex, and height according to Indian derived regression equations. Results: Respiratory symptoms were significantly more common and lung function (percentage predicted forced expiratory volume in one second (FEV(1)), forced vital capacity (FVC), forced expiratory now between 25% and 75% of vital capacity (FEF(25-75)), and FEV(1)/FVC ratio) was reduced among those reporting exposure to the gas leak. The frequency of symptoms fell as exposure decreased (as estimated by distance lived from the plant), and lung function measurements displayed similar trends. These findings were not wholly accounted for by confounding by smoking or literacy, a measure of socioeconomic status. Lung function measurements were consistently lower in those reporting symptoms. Conclusion: Our results suggest that persistent small airways obstruction among survivors of the 1984 disaster may be attributed to gas exposure. C1 UNIV NEWCASTLE UPON TYNE,DEPT EPIDEMIOL & PUBL HLTH,NEWCASTLE TYNE NE2 4HH,TYNE & WEAR,ENGLAND. AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA 30333. RP Cullinan, P (reprint author), UNIV LONDON IMPERIAL COLL SCI TECHNOL & MED,NATL HEART & LUNG INST,DEPT OCCUPAT & ENVIRONM MED,LONDON SW3 6LR,ENGLAND. NR 17 TC 39 Z9 40 U1 0 U2 7 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON, ENGLAND WC1H 9JR SN 0959-8138 J9 BRIT MED J JI Br. Med. J. PD FEB 1 PY 1997 VL 314 IS 7077 BP 338 EP 342 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WF861 UT WOS:A1997WF86100029 PM 9040323 ER PT J AU Zhang, BL Yip, R Wen, FQ Wang, BQ AF Zhang, BL Yip, R Wen, FQ Wang, BQ TI Comparison of birth weight by gestational age between China and the United States SO CHINESE MEDICAL JOURNAL LA English DT Article ID FETAL GROWTH AB Objective To probe into the similarities and differences of birth weight by gestational age between China and the United States by a comparative study. Methods For China, we used the records of 2 4150single livebirth neonates. These records were collected between February 1986 and May 1987 from 43 hospitals and health care units in 15 large and middle cities in the South and North of China. For the United States, we used the natal records of National Center for Health Statistics from 1980 to 1987, selecting infants whose parents were coded as white and with higher socioeconomic back grounds in the birth records. A total of 6 295 102 singleton livebirth neonates were selected. We used a method based on probability plots to define birth weight distributions. Results The 50th and 95th percentiles of birth weights by gestational age of American newborns with white parents were more than those of Chinese newborns. The 50th percentile values of birth weights of American male and female newborns were 357 g and 277 g (about 10% and 8% respectively of the birth weight of a term newborn) more than those of Chinese male and female newborns respectively at 40 weeks of GA. Conclusions American white newborns were heavier than Chinese newborns. The differences were mainly due to race-specific influences, and were related to the differences in socioeconomic and educational background. We suggest that the references of birth weight by gestational age should be formulated separately in China and in the U.S.. C1 CTR DIS CONTROL,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA 30333. HUNAN MED UNIV,TEACHING HOSP 1,DEPT OBSTET & GYNECOL,CHANGSHA 410008,PEOPLES R CHINA. RP Zhang, BL (reprint author), HUNAN MED UNIV,TEACHING HOSP 1,DEPT PEDIAT,CHANGSHA 410008,PEOPLES R CHINA. NR 20 TC 9 Z9 10 U1 0 U2 0 PU CHINESE MEDICAL ASSOCIATION PI BEIJING PA 42 DONGSI XIDAJIE, BEIJING 100710, PEOPLES R CHINA SN 0366-6999 J9 CHINESE MED J-PEKING JI Chin. Med. J. PD FEB PY 1997 VL 110 IS 2 BP 148 EP 151 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WT710 UT WOS:A1997WT71000016 PM 9594289 ER PT J AU Archibald, L Phillips, L Monnet, D McGowan, JE Tenover, F Gaynes, R AF Archibald, L Phillips, L Monnet, D McGowan, JE Tenover, F Gaynes, R TI Antimicrobial resistance in isolates from inpatients and outpatients in the united states: Increasing importance of the intensive care unit SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID NOSOCOMIAL INFECTION; SURVEILLANCE AB To compare the occurrence of antimicrobial resistance in hospitals with that in the community, we analyzed data for isolates collected from inpatients and outpatients in eight U.S. hospitals, The percentage of resistant isolates from inpatients was higher than that from outpatients for the following combinations of antimicrobials and organisms: methicillin/coagulase-negative Staphylococcus (49.0% vs. 36.0%, respectively; P < .01); methicillin/Staphylococcus aureus (33.0% vs. 14.5%, respectively; P < .01); ceftazidime/Enterobacter cloacae (26.0% vs. 12.0%, respectively; P < .01); imipenem/Pseudomonas aeruginosa (12.0% vs. 6.5%, respectively; P < .01); ceftazidime/P. aeruginosa (7.8% vs. 4.0%, respectively; P < .01); and vancomycin/Enterococcus species (6.3% vs. 1.4%, respectively; P < .01), There was a significant stepwise decrease in the percentage of resistant organisms isolated from patients in the intensive care unit (ICU), non-ICU inpatients, and outpatients, These results suggest that resources allocated to control antimicrobial resistance should continue to be focused in the hospital, particularly in the ICU. C1 NATL CTR INFECT DIS,HOSP INFECT PROGRAM,CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. EMORY UNIV,ROLLINS SCH PUBL HLTH,DEPT EPIDEMIOL,ATLANTA,GA 30322. RI mcgowan jr, john/G-5404-2011 NR 17 TC 304 Z9 309 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD FEB PY 1997 VL 24 IS 2 BP 211 EP 215 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WH302 UT WOS:A1997WH30200021 PM 9114149 ER PT J AU Berg, SW Mitchell, BS Hanson, RK Olafson, RP Williams, RP Tueller, JE Burton, RJ Novak, DM Tsai, TF Wignall, FS AF Berg, SW Mitchell, BS Hanson, RK Olafson, RP Williams, RP Tueller, JE Burton, RJ Novak, DM Tsai, TF Wignall, FS TI Systemic reactions in US Marine Corps personnel who received Japanese encephalitis vaccine SO CLINICAL INFECTIOUS DISEASES LA English DT Article AB The overall hypersensitivity reaction rate among 14,249 U.S. Marine Corps personnel who received 36,850 doses of an investigational Japanese encephalitis vaccine was 10.3 per 10,000 doses; reaction rates were 16.1 and 10.3 per 10,000 doses for the first two doses, and 2.0 per 10,000 doses for the third, The reaction rate was 26.7 per 10,000 vaccinees, Of 38 reactors, 26 had urticaria and/or angioedema, and 11 had pruritus. Vaccine reaction intervals clustered within 48 hours for dose 1, but the median reaction interval for dose 2 was 96 hours, A history of urticaria or allergic rhinitis was associated with an increased probability of a vaccine reaction. C1 USN,CTR ENVIRONM HLTH,NORFOLK,VA. USN,ENVIRONM & PREVENT MED UNIT 6,HONOLULU,HI. FIRST MARINE EXPEDITIONARY FORCE,CAMP PENDLETON,CA. USN,AEROSP MED RES LAB,PENSACOLA,FL. ARMED FORCES MED INTELLIGENCE CTR,FREDERICK,MD. USN,ENVIRONM & PREVENT MED UNIT 5,SAN DIEGO,CA. NEVADA CTY PUBL HLTH DEPT,NEVADA CITY,CA. US ATLANTIC COMMAND,NORFOLK,VA. AEA INT,FREEPORT,INDONESIA. CTR DIS CONTROL & PREVENT,FT COLLINS,CO 80522. NR 4 TC 39 Z9 41 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD FEB PY 1997 VL 24 IS 2 BP 265 EP 266 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WH302 UT WOS:A1997WH30200032 PM 9114160 ER PT J AU Graves, PM Norris, JM Pallansch, MA Gerling, IC Rewers, M AF Graves, PM Norris, JM Pallansch, MA Gerling, IC Rewers, M TI The role of enteroviral infections in the development of IDDM - Limitations of current approaches SO DIABETES LA English DT Article ID COXSACKIE-B-VIRUS; DEPENDENT DIABETES-MELLITUS; POLYMERASE CHAIN-REACTION; 64,000-MR ISLET AUTOANTIGEN; ANTIBODY CAPTURE ELISA; GLUTAMATE-DECARBOXYLASE; ENCEPHALOMYOCARDITIS VIRUS; CHRONIC FATIGUE; RISK FACTOR; MICE AB Enteroviruses have been examined for their possible role in the etiology of IDDM for nearly 40 years, yet the evidence remains inconclusive. The mechanism of acute cytolytic infection of beta-cells, proposed by earlier studies, appears to be incompatible with the long preclinical period of autoimmunity preceding IDDM. Advances in molecular biology have improved our understanding of enteroviral biology and of potential alternative pathogenic mechanisms through which enteroviruses may cause diabetes. The focus of future human studies will likely shift from people with IDDM to those with prediabetic autoimmunity to determine whether acute enteroviral infections can promote progression from autoimmunity to overt diabetes. We propose that such studies use assays to detect enteroviral RNA, in addition to IgM serology. RNA assays can overcome sensitivity and type-specificity limitations of IgM assays as well as identify diabetogenic strains of enteroviruses, if such exist. Evaluation of the role of enteroviruses in triggering beta-cell autoimmunity in humans will require large prospective studies of young children. The Diabetes Autoimmunity Study in the Young-one of very few such studies currently underway-is focusing on potential interactions between HLA class II genes and enteroviral infections. Future studies will likely examine interactions between viral infections and non-HLA IDDM candidate genes, including those that may determine beta-cell tropism of candidate viruses. C1 UNIV COLORADO,HLTH SCI CTR C245,SCH MED,DEPT PREVENT MED & BIOMETR,DENVER,CO 80262. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. UNIV TENNESSEE,DEPT MICROBIOL,MEMPHIS,TN. RI Graves, Patricia/J-8691-2014 OI Graves, Patricia/0000-0002-5215-3901 FU NIDDK NIH HHS [R01 DK-32493] NR 59 TC 80 Z9 81 U1 0 U2 2 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0012-1797 J9 DIABETES JI Diabetes PD FEB PY 1997 VL 46 IS 2 BP 161 EP 168 DI 10.2337/diabetes.46.2.161 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA WD288 UT WOS:A1997WD28800001 PM 9000690 ER PT J AU Litzelman, DK Marriott, DJ Vinicor, F AF Litzelman, DK Marriott, DJ Vinicor, F TI The role of footwear in the prevention of foot lesions in patients with NIDDM - Conventional wisdom or evidence-based practice? SO DIABETES CARE LA Russian DT Article ID RISK AB OBJECTIVE - To conduct a prospective evaluation of footwear characteristics as predictors of diabetic foot wounds. RESEARCH DESIGN AND METHODS - A total of 352 patients with NIDDM enrolled in a randomized controlled trial aimed at preventing diabetic foot lesions in an academic general medicine practice were studied. Foot wounds (n = 63) were modeled univariately and multivariably using generalized estimating equations. The dependent variable was a wound classified as a 1.2 or greater according to the Seattle Wound Classification System, indicating at least a superficial or healing minor lesion with no functional interruption of the protective cutaneous barrier. Independent variables included detailed measures of style and material of patients' indoor and outdoor shoes, appropriate length and width, sock fibers, whether the patient had bought new shoes in the past 6 months, and if the patient had been recommended for special shoes. Modeling controlled for intervention status and physiological measures (base-line wound, monofilament abnormalities, and serum HDL level). RESULTS - Initial screening (P < 0.20) suggested that a recommendation for special shoes, shoe length, and shoe width were indicative of wounds at follow-up (odds ratios [ORs] 2.19, 1.84, 1.86, respectively), while having bought shoes in the past 6 months was associated with no wound at follow-up (OR 0.60). The final multivariable model included only the recommendation for special shoes (OR 2.19, 95% CI 1.07-4.49). CONCLUSIONS - Many variables commonly cited as protective measures in footwear for diabetic patients were not prospectively predictive when controlling for physiological risk factors. Rigorous analyses are needed to examine the many assumptions regarding footwear recommendations for diabetic patients. C1 RICHARD L ROUDEBUSH VET AFFAIRS MED CTR,HLTH SERV RES & DEV SERV,INDIANAPOLIS,IN 46202. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Litzelman, DK (reprint author), INDIANA UNIV,SCH MED,REGENSTRIEF INST HLTH CARE,6TH FLOOR,1001 W 10TH ST,INDIANAPOLIS,IN 46202, USA. FU PHS HHS [200-08-0661] NR 24 TC 46 Z9 47 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD FEB PY 1997 VL 20 IS 2 BP 156 EP 162 DI 10.2337/diacare.20.2.156 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA WC851 UT WOS:A1997WC85100007 PM 9118764 ER PT J AU Heijbel, H Chen, RT Dahlquist, G AF Heijbel, H Chen, RT Dahlquist, G TI Cumulative incidence of childhood-onset IDDM is unaffected by pertussis immunization SO DIABETES CARE LA English DT Article ID SWEDISH AB OBJECTIVE - To identify a possible effect of pertussis vaccination in infancy on the risk for developing human IDDM. RESEARCH DESIGN AND METHODS - A comparison was made of the cumulative incidence of IDDM in children age 0-12 years between two birth cohorts born before pertussis vaccination and two birth cohorts born after pertussis vaccination had been excluded from the Swedish national immunization program. The Swedish Childhood Diabetes registry was used to identify cases of IDDM. Yearly nurse reports on administered vaccines were used to determine coverage for diphtheria/tetanus/pertussis (DTP) and diphtheria/tetanus (DT) vaccines. Pertussis vaccine coverage was estimated based on number of doses of vaccine made available on license. RESULTS - No difference in cumulative incidence rate of IDDM up to the age of 12 years was found when the birth cohorts for 1978 and 1979 with high DTP vaccination coverage were compared with the cohorts of 1980 and 1981 with low pertussis vaccination coverage. CONCLUSIONS - The comparison of the cumulative incidence of IDDM, up to the age of 12 years, in birth cohorts with high and low exposure to pertussis vaccine does not support the hypothesis that pertussis could induce autoimmunity to the beta-cell that may lead to IDDM. C1 SWEDISH INST INFECT DIS CONTROL,STOCKHOLM,SWEDEN. UMEA UNIV,DEPT PEDIAT,UMEA,SWEDEN. CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. NR 17 TC 22 Z9 22 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1660 DUKE ST, ALEXANDRIA, VA 22314 SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD FEB PY 1997 VL 20 IS 2 BP 173 EP 175 DI 10.2337/diacare.20.2.173 PG 3 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA WC851 UT WOS:A1997WC85100010 PM 9118767 ER PT J AU Irwin, K Peterson, H Gayle, H AF Irwin, K Peterson, H Gayle, H TI AIDS turnaround: First remedy the adverse effects of the condom policy - Comment SO EUROPEAN JOURNAL OF CANCER PREVENTION LA English DT Letter C1 CTR DIS CONTROL & PREVENT,CTR CHRON DIS PREVENT & HLTH PROMOT,WOMENS HLTH & FERTIL BRANCH,ATLANTA,GA 30333. RP Irwin, K (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,NATL CTR HIV STD & TB PREVENT,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 5 TC 0 Z9 0 U1 0 U2 0 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0959-8278 J9 EUR J CANCER PREV JI Eur. J. Cancer Prev. PD FEB PY 1997 VL 6 IS 1 BP 97 EP 97 DI 10.1097/00008469-199702000-00017 PG 1 WC Oncology SC Oncology GA WZ378 UT WOS:A1997WZ37800017 ER PT J AU Skjeldestad, FE Nordbo, SA Hadgu, A AF Skjeldestad, FE Nordbo, SA Hadgu, A TI Sentinel surveillance of Chlamydia trachomatis infection in women terminating pregnancy SO GENITOURINARY MEDICINE LA English DT Article DE surveillance; Chlamydia trachomatis; induced abortion ID INDUCED-ABORTION; PREVALENCE; WISCONSIN; PROGRAM AB Aims: To evaluate demographic characteristics of women terminating their pregnancy for sentinel surveillance of Chlamydia trachomatis infection and to report changing prevalences of C trachomatis over time within this study population. Design: Screening for C trachomatis in women seeking induced abortion was introduced in 1984 at the Department of Gynecology, Regional Hospital, Trondheim, Norway. Over the study years our department has used a preceded medical record covering sociodemographic, medically relevant data, also recording outcome of the C trachomatis test. Throughout the study the Department of Microbiology applied cell culture, enzyme Immunoassay, and, during the most recent years a nucleic acid test to identify C trachomatis. Statistical methods: Chi square test for linear trend and unconditional logistic regression. Results: Over the study period, women having induced abortion were characterised by being most often single and more often at younger age. The overall age-adjusted prevalence of C trachomatis declined from 9.2% in 1985 to 3.6% in 1995, the major decline occurring from 1987 to 1991, and affected all age-groups simultaneously. There was a 60% decrease in odds ratio of having a C trachomatis infection from 1985 to 1991, and the crude and the adjusted odds ratios did not differ for any year examined. Conclusion: Women deciding on pregnancy termination have demographic characteristics that identify high-risk groups for C trachomatis infection. Despite these characteristics, which were relatively constant over the study period, the study population changed from being a high- to a low-prevalence population of C trachomatis. C1 UNIV TRONDHEIM HOSP,DEPT MICROBIOL,N-7006 TRONDHEIM,NORWAY. CTR DIS CONTROL & PREVENT,DIV STD PREVENT,ATLANTA,GA. RP Skjeldestad, FE (reprint author), UNIV TRONDHEIM HOSP,DEPT GYNECOL & OBSTET,N-7006 TRONDHEIM,NORWAY. NR 23 TC 6 Z9 6 U1 0 U2 1 PU BRITISH MED JOURNAL PUBL GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON, ENGLAND WC1H 9JR SN 0266-4348 J9 GENITOURIN MED JI Genitourin. Med. PD FEB PY 1997 VL 73 IS 1 BP 29 EP 32 PG 4 WC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Urology & Nephrology SC Public, Environmental & Occupational Health; Obstetrics & Gynecology; Urology & Nephrology GA WJ750 UT WOS:A1997WJ75000008 PM 9155552 ER PT J AU Conlon, RT AF Conlon, RT TI Introducing technology into the public STD clinic SO HEALTH EDUCATION & BEHAVIOR LA English DT Article AB Review of the literature on public health services shows that virtually no information is available on how the state-supported networks of STD clinics now function, what the possibilities are for achieving efficiency in service delivery, or the implications of local, state, and federal funding and staffing changes. This article describes models of STD services now offered and thus allows one to project impending changes in the public health STD clinic system. The description includes a brief recount of how the imposition of HIV testing and counseling has taxed clinic resources and has sharpned the need for more efficient, technology-supported management. The status of federal staff is also summarized, with consideration of how decreases in staff will affect partner notification, the cornerstone of traditional STD-clinic-based services. Data on clinic function and staffing trends frame suggestions for the placement of computer technology in the system. RP Conlon, RT (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR PREVENT SERV,DIV STD HIV PREVENT,BEHAV INTERVENT RES BRANCH,ATLANTA,GA 30333, USA. NR 13 TC 3 Z9 3 U1 1 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 SN 1090-1981 J9 HEALTH EDUC BEHAV JI Health Educ. Behav. PD FEB PY 1997 VL 24 IS 1 BP 12 EP 19 DI 10.1177/109019819702400104 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WP023 UT WOS:A1997WP02300002 PM 9112095 ER PT J AU Rogers, JF Killough, GG AF Rogers, JF Killough, GG TI Historical dose reconstruction project: Estimating the population at risk SO HEALTH PHYSICS LA English DT Article DE dose assessment; dose, population; exposure, radiation; health effects AB This paper discusses methods used to estimate the size and location of the populations that lived around the Feed Materials Production Center near Ross, Ohio, from 1950 through 1990, This information will support an historical dose reconstruction for environmental exposures to radionuclides from this facility that is currently being done by the Centers for Disease Control and Prevention through a contract with Radiological Assessments Corporation, Available sources of data include (1) the U.S. Census, Ohio Township data; (2) the U.S. Census, Ohio Township block data; and (3) U.S. Geological Survey topographical maps that show structures, A distribution of age and sex is estimated that, together with population estimates, will provide information needed to estimate collective dose rates over time and to examine the feasibility of studying the relationship between exposure to radionuclides released from the Feed Materials Production Center and adverse health outcomes. C1 CTR DIS CONTROL & PREVENT, NATL CTR ENVIRONM HLTH, RADIAT STUDIES BRANCH, ATLANTA, GA 30341 USA. HENDECAGON CORP, OAK RIDGE, TN 37830 USA. RADIOL ASSESSMENTS CORP, NEESES, SC 29107 USA. NR 15 TC 3 Z9 3 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD FEB PY 1997 VL 72 IS 2 BP 186 EP 194 DI 10.1097/00004032-199702000-00002 PG 9 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA WE857 UT WOS:A1997WE85700003 PM 9003704 ER PT J AU Gandhi, OP Wu, D Chen, JY Conover, DL AF Gandhi, OP Wu, D Chen, JY Conover, DL TI Induced current and SAR distributions for a worker model exposed to an RF dielectric heater under simulated workplace conditions SO HEALTH PHYSICS LA English DT Article DE radiation, nonionizing; dosimetry; electromagnetic fields; radiofrequency ID SEALERS AB We have used the finite-difference time-domain method to calculate the distributions of absorbed energy for a 1.34 x 1.34 x 1.4 cm resolution anatomically based model of the human body for exposure to leakage electromagnetic fields of a radiofrequency dielectric heater operating at 40.68 MHz. To simulate workplace conditions, the dielectric heater is assumed to be placed in a screen room and different operator postures, such as Standing or sitting on a wooden or metal stool with hands on sides or extended toward the radiofrequency heater, are considered. To obviate the problem of having to model a fairly large volume of the screen room of assumed dimensions 2.13 x 3.05 x 2.13 m, we have used a uniform finer grid of points for the finite-difference time-domain method for the closely coupled region consisting of the front region of the heater and the human model, while a newly developed expanding-grid finite-difference time-domain formulation is used elsewhere. This results in a saving of both the memory and computation times by almost a factor of four. The average rates of energy absorption are given for the whole body, selected parts of the body, and various organs. As expected, the foot currents and the rates of energy absorption are higher with the screen room for sitting postures where the upper parts of the body are in higher electromagnetic fields, and for hands extended toward the heater. C1 UNIV UTAH, DEPT ELECT ENGN, SALT LAKE CITY, UT 84112 USA. NIOSH, DIV BIOMED & BEHAV SCI, CINCINNATI, OH 45226 USA. FU NIEHS NIH HHS [ES 03329] NR 14 TC 6 Z9 6 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD FEB PY 1997 VL 72 IS 2 BP 236 EP 242 DI 10.1097/00004032-199702000-00006 PG 7 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA WE857 UT WOS:A1997WE85700007 PM 9003708 ER PT J AU Lahdenne, P Porcella, SF Hagman, KE Akins, DR Popova, TG Cox, DL Katona, LI Radolf, JD Norgard, MV AF Lahdenne, P Porcella, SF Hagman, KE Akins, DR Popova, TG Cox, DL Katona, LI Radolf, JD Norgard, MV TI Molecular characterization of a 6.6-kilodalton Borrelia burgdorferi outer membrane-associated lipoprotein (1p6.6) which appears to be downregulated during mammalian infection SO INFECTION AND IMMUNITY LA English DT Article ID LYME-DISEASE SPIROCHETE; SURFACE PROTEIN-A; IMMUNOLOGICAL CHARACTERIZATION; TREPONEMA-PALLIDUM; SEQUENCE-ANALYSIS; RHESUS-MONKEY; CIRCULAR PLASMID; IN-VIVO; EXPRESSION; MICE AB Isolated outer membranes of Borrelia burgdorferi 297 were utilized to obtain partial amino acid sequence information for a low-molecular-weight, outer membrane-associated polypeptide. Degenerate oligonucleotide primers based upon this information were used to amplify a 100-bp probe for detection of the corresponding full-length gene within a B. burgdorferi total genomic library, The relevant open reading frame (ORF) encoded a polypeptide comprised of a 17-amino-acid putative signal peptide terminated by LFVAC, a probable consensus sequence for lipoprotein modification, and a mature protein of 51 amino acids (predicted molecular mass of 5.8 kDa). The DNA sequences of the corresponding ORFs in B. burgdorferi 297 and B31 were identical; the corresponding ORF in strain N40 differed by only one nucleotide. Assuming conventional processing and acylation, the molecular weight of the lipoprotein, designated lp6.6, is about 6,600, The lp6.6 gene, which was localized to the 49-kb linear plasmid of B. burgdorferi, subsequently was cloned and expressed in Escherichia coli as a fusion protein with glutathione S-transferase. Immunoblot analysis with monoclonal antibody 240.7 revealed that lp6,6 was identical to a low-molecular-weight, highly conserved B. burgdorferi lipoprotein reported previously (L. I. Katona, G. Beck, and G. S. Habicht, Infect. Immun. 60: 1995-5003, 1992), Results of indirect immunofluorescence assays, growth inhibition assays, passive immunizations, and active immunizations indicated that this outer membrane-associated antigen is not surface exposed in B. burgdorferi, Particularly interesting was the finding that mice and rhesus monkeys chronically infected with B. burgdorferi failed to develop antibodies against this antigen, We propose that high-level expression of lp6.6 is associated with the arthropod phase of the spirochetal life cycle and that expression of the gene is downregulated during mammalian infection. C1 UNIV TEXAS,SW MED CTR,DEPT MICROBIOL,DALLAS,TX 75235. UNIV TEXAS,SW MED CTR,DEPT PEDIAT,DALLAS,TX 75235. UNIV TEXAS,SW MED CTR,DEPT INTERNAL MED,DALLAS,TX 75235. UNIV HELSINKI,CHILDRENS HOSP,FIN-00014 HELSINKI,FINLAND. CTR DIS CONTROL & PREVENT,DIV STD LAB RES,ATLANTA,GA 30333. SUNY STONY BROOK,DEPT PATHOL,STONY BROOK,NY 11794. FU NIAID NIH HHS [AI-29735]; NIAMS NIH HHS [AR-36028] NR 63 TC 47 Z9 47 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0019-9567 J9 INFECT IMMUN JI Infect. Immun. PD FEB PY 1997 VL 65 IS 2 BP 412 EP 421 PG 10 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WE900 UT WOS:A1997WE90000009 PM 9009290 ER PT J AU Thompson, BL Dwyer, DM Ussery, XT Denman, S Vacek, P Schwartz, B AF Thompson, BL Dwyer, DM Ussery, XT Denman, S Vacek, P Schwartz, B TI Handwashing and glove use in a long-term-care facility SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID RESISTANT STAPHYLOCOCCUS-AUREUS; INFECTION-CONTROL PROGRAMS; BODY SUBSTANCE ISOLATION; NURSING-HOME; UNIVERSAL PRECAUTIONS; NOSOCOMIAL INFECTIONS; HAND CONTAMINATION; UNIT; PREVENTION; TRANSMISSION AB OBJECTIVES: To determine glove use and handwashing practices, the factors associated with infection control practices, and the frequency of potential microbial transmission in a long-term-care facility (LTCF). DESIGN: Observational study of 230 staff-resident interactions in an LTCF. We recorded resident characteristics, type of activity, staff credentials, and movements of the staff member's hands, then used the LTCF's guidelines to judge appropriateness of glove use and handwashing. SETTING: 255-bed, university-based LTCF in Baltimore, Maryland. PARTICIPANTS: A systematic sample of staff-resident interactions. RESULTS: Gloves were worn in 139 (82%) of 170 interactions when indicated, but changed appropriately in only 21 (16%) of 132. Hands were washed when needed before an interaction in 27%, during an interaction in 0%, and after an interaction in 63%. Gloves were less likely to be used when caring for residents with gastrostomy tubes compared with other residents (relative risk, 0.85; 95% confidence interval, 0.73-0.98). Guidelines were followed more frequently during wound care than during other activities. Microbial transmission potentially could have occurred in 158 (82%) of 193 evaluable interactions. CONCLUSIONS: We documented marked deficiencies in glove use and handwashing, demonstrated the possible impact of these deficiencies, and identified factors associated with inadequate handwashing and glove use. This information can be used in future educational and research efforts to improve infection control practices. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,DIV FIELD EPIDEMIOL,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA 30341. MARYLAND DEPT HLTH & MENTAL HYG,EPIDEMIOL & DIS CONTROL PROGRAM,BALTIMORE,MD. JOHNS HOPKINS UNIV,SCH MED,BALTIMORE,MD. UNIV VERMONT,COLL MED,BIOMETRY FACIL,BURLINGTON,VT. NR 64 TC 100 Z9 100 U1 1 U2 4 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD FEB PY 1997 VL 18 IS 2 BP 97 EP 103 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WH325 UT WOS:A1997WH32500004 PM 9120250 ER PT J AU Ray, SM Erdman, DD Berschling, JD Cooper, JE Torok, TJ Blumberg, HM AF Ray, SM Erdman, DD Berschling, JD Cooper, JE Torok, TJ Blumberg, HM TI Nosocomial exposure to parvovirus B19: Low risk of transmission to healthcare workers SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 51st Annual Meeting of the American-Federation-for-Clinical-Research CY MAY, 1994 CL BALTIMORE, MD SP Amer Federat Clin Res ID HOSPITAL STAFF MEMBERS; ERYTHEMA-INFECTIOSUM; OUTBREAK; WARD; DISEASE; PATIENT AB OBJECTIVE: To evaluate the risk of nosocomial transmission of parvovirus B19 (B19) infection to healthcare workers (HCWs) exposed to patients with transient aplastic crisis (TAC) caused by acute B19 infection. DESIGN: Cohort study. SETTING: 1,000-bed, urban teaching hospital in Atlanta, Georgia. PARTICIPANTS: Eighty-seven exposed HCWs who cared for two patients with TAC prior to the time they were isolated and a comparison group of 88 unexposed HCWs from wards or clinics where the patients did not receive care. INTERVENTION: Self-administered questionnaire on hospital contact with index patients, B19 community risk factors, and signs and symptoms suggestive of B19 disease. Serology for B19-specific IgM and IgG antibodies measured by antibody-capture enzyme-linked immunosorbent assay. RESULTS: 1 (3.1%) of the 32 nonimmune exposed HCWs had serologic evidence of recent B19 infection compared to 3 (8.1%) of the 37 nonimmune HCWs in the com parison group (P=.6). In a subgroup analysis of exposed HCWs who cared for index patients during the time when the virus load was expected to be greatest, a recent infection rate of 5.8% (1/17) was found among nonimmune HCWs. CONCLUSIONS: The finding of similar rates of recent infection in nonimmune exposed and unexposed HCWs suggests that transmission to HCWs did not occur, despite failure to place the patients in isolation at the onset of hospitalization. C1 GRADY MEM HOSP,DEPT EPIDEMIOL,ATLANTA,GA. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. RP Ray, SM (reprint author), EMORY UNIV,SCH MED,DEPT MED,DIV INFECT DIS,69 BUTLER ST SE,ATLANTA,GA 30303, USA. NR 20 TC 15 Z9 15 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD FEB PY 1997 VL 18 IS 2 BP 109 EP 114 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WH325 UT WOS:A1997WH32500006 PM 9120238 ER PT J AU Layton, MC Calliste, SG Gomez, TM Patton, C Brooks, S AF Layton, MC Calliste, SG Gomez, TM Patton, C Brooks, S TI A mixed foodborne outbreak with Salmonella heidelberg and Campylobacter jejuni in a nursing home SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID ENTERITIDIS; POULTRY AB OBJECTIVE: To investigate a mixed Salmonella heidelberg and Campylobacter jejuni foodborne outbreak in a nursing home. DESIGN: Retrospective cohort study with a nested case-control design. Cases were defined by positive stool-culture results. Controls needed to be both asymptomatic and culture-negative. SETTING AND PATIENTS: Residents of a 580-bed nursing home in Brooklyn, New York. RESULTS: Of the 580 residents, 119 (21%) developed illness. Of the 93 symptomatic patients who submitted specimens, cultures were positive for S heidelberg in 24 (26%), C jejuni in 14 (15%), and both microorganisms in 25 (27%). Only the pureed diet was associated highly with infection by either Salmonella (odds ratio [OR], 17.6; 95% confidence interval [CI95], 4.8-68.7; P<.001), Campylobacter (OR, 13.3; CI95 3.2-59.2; P<.001), or both organisms (OR, 8.9; CI95, 2.7-30.3; P<.001). Among the 52 pureed foods served during the 5 days before the outbreak, five meat or poultry items were associated most strongly with culture positivity. Of these five meat items, only a chopped-liver salad was implicated by the two employees reporting illness. A reported food-handling error occurred when ground, cooked chicken livers were placed in a bowl containing raw chicken-liver juices. INTERVENTION: Recommendations for proper cleaning and sanitizing of kitchen equipment to prevent cross-contamination between raw and cooked foods. CONCLUSIONS: Mixed foodborne outbreaks occur rarely. During this outbreak, contamination of a single food item with multiple bacterial pathogens was the likely source of transmission. Improper food-handling techniques that promote growth of one microorganism also allow growth of other pathogens that may be present. Because different sources and routes of transmission may be implicated for different pathogens, specific preventive measures may vary depending on the organisms involved. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,DIV FIELD EPIDEMIOL,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. NEW YORK CITY DEPT HLTH,HLTH RES TRAINING PROGRAM,NEW YORK,NY 10013. CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA. ANIM & PLANT HLTH INSPECT SERV,USDA,RIVERDALE,MD. KINGSBROOK JEWISH MED CTR,MICROBIOL LAB,BROOKLYN,NY. RP Layton, MC (reprint author), NEW YORK CITY DEPT HLTH,BUR COMMUNICABLE DIS,125 WORTH ST,ROOM 300,BOX 22A,NEW YORK,NY 10013, USA. NR 16 TC 39 Z9 40 U1 0 U2 1 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD FEB PY 1997 VL 18 IS 2 BP 115 EP 121 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WH325 UT WOS:A1997WH32500007 PM 9120239 ER PT J AU BeckSague, C Jarvis, WR Martone, WJ AF BeckSague, C Jarvis, WR Martone, WJ TI Outbreak investigations SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID INFECTIONS AB Epidemic nosocomial infections are defined as hospital-acquired infections that represent an increase in incidence over expected rates. Epidemic-associated infections usually are clustered temporally or geographically, suggesting that the infections are from a common source or are secondary to increased person-to-person transmission. Epidemics are important, because they account for a substantial percentage of nosocomial infections. Furthermore, if infection control personnel thoroughly investigate outbreaks of nosocomial infections, they may identify new agents, reservoirs, or modes of transmission. RP BeckSague, C (reprint author), CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 12 TC 13 Z9 13 U1 0 U2 0 PU SLACK INC PI THOROFARE PA 6900 GROVE RD, THOROFARE, NJ 08086 SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD FEB PY 1997 VL 18 IS 2 BP 138 EP 145 PG 8 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA WH325 UT WOS:A1997WH32500013 PM 9120245 ER PT J AU Braden, CR AF Braden, CR TI Current concepts in Mycobacterium tuberculosis DNA fingerprinting SO INFECTIOUS DISEASES IN CLINICAL PRACTICE LA English DT Review ID LENGTH-POLYMORPHISM ANALYSIS; POLYMERASE CHAIN-REACTION; CROSS-CONTAMINATION; COMPLEX STRAINS; EPIDEMIOLOGY; TRANSMISSION; OUTBREAK; SEQUENCES; STABILITY; ELEMENTS RP Braden, CR (reprint author), CTR DIS CONTROL,NCHSTP,DTBE,MAILSTOP E-10,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 30 TC 4 Z9 4 U1 0 U2 0 PU WILLIAMS & WILKINS PI BALTIMORE PA 351 WEST CAMDEN ST, BALTIMORE, MD 21201-2436 SN 1056-9103 J9 INFECT DIS CLIN PRAC JI Infect. Dis. Clin. Pract. PD FEB PY 1997 VL 6 IS 2 BP 89 EP 95 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WK541 UT WOS:A1997WK54100004 ER PT J AU Lanphear, BP LeCessie, S Atkinson, WL Watelet, L AF Lanphear, BP LeCessie, S Atkinson, WL Watelet, L TI Association of livebirths and the resurgence of measles SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE measles; epidemic; epidemic potential; resurgence; immunization; herd immunity; children; livebirths; susceptible ID UNITED-STATES; HERD-IMMUNITY; OUTBREAK; TRANSMISSION; VACCINATION; POPULATION; PRESCHOOL; CHILDREN; DISEASE AB Background. The basis for the resurgence of measles in the US in 1989 and 1990 is not understood. This analysis was undertaken to test the hypothesis that an increase in the number of livebirths was associated with the resurgence of measles in the US. Methods. We undertook an ecologic analysis of 20 cities/counties in the US with documented rates of immunization among 2-year-old children. Results. Over the 6-year period 1985-1990, the numbers of livebirths and of susceptible preschool aged children increased by 18.5% and 17.7%, respectively. Livebirths, and the number and density of susceptible preschool-age children were significantly associated with the number and incidence of measles among preschool children (r = 0.83, P = 0.04). In a comparison between counties, numbers of livebirths were also significantly correlated with the mean number (r = 0.73, P = 0.0003) and incidence of measles cases (r = 0.51, P = 0.02). Mean immunization rates of 2-year-old children were also associated with the mean incidence of measles (r = -0.66, P = 0.0015, and r = -0.57, P = 0.009, respectively). In a logistic regression model, levels of immunization and susceptible density were independent predictors of measles epidemics among preschool children. Conclusions. These data suggest that the increase in livebirths, leading to an increase in the number and density of susceptible hosts, was associated with the resurgence of measles among preschool-age children. C1 UNIV ROCHESTER, SCH MED & DENT, DEPT COMMUNITY & PREVENT MED, ROCHESTER GEN HOSP, ROCHESTER, NY 14621 USA. LEIDEN UNIV, DEPT BIOSTAT, NL-2300 RA LEIDEN, NETHERLANDS. UNIV ROCHESTER, DEPT BIOSTAT, SCH MED & DENT, ROCHESTER, NY 14621 USA. CTR DIS CONTROL & PREVENT, NATL IMMUNIZATION PROGRAM, ATLANTA, GA 30333 USA. RP Lanphear, BP (reprint author), UNIV ROCHESTER, SCH MED & DENT, DEPT PEDIAT, ROCHESTER GEN HOSP, 1425 PORTLAND AVE, ROCHESTER, NY 14621 USA. FU BHP HRSA HHS [2T-32 PE-12002] NR 23 TC 1 Z9 1 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 FEB PY 1997 VL 26 IS 1 BP 204 EP 211 DI 10.1093/ije/26.1.204 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WQ668 UT WOS:A1997WQ66800024 PM 9126521 ER PT J AU Santelli, JS Brener, N Lowry, R Bhatt, A Zabin, L AF Santelli, JS Brener, N Lowry, R Bhatt, A Zabin, L TI Risk factors for multiple sexual partners among US adolescents SO JOURNAL OF ADOLESCENT HEALTH LA English DT Meeting Abstract C1 CDC,DIV ADOLESCENT & SCH HLTH,ATLANTA,GA 30333. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,BALTIMORE,MD 21218. NR 0 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1054-139X J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD FEB PY 1997 VL 20 IS 2 BP 127 EP 127 PG 1 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA WH833 UT WOS:A1997WH83300006 ER PT J AU Denniston, MM Bird, BR Kelley, KA AF Denniston, MM Bird, BR Kelley, KA TI Contrast of survey results between state and a cohort of nonstate mycobacteriology laboratories: Changes in laboratory practices SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article AB Based on the recommendations of a 1992 conference on tuberculosis, the Centers for Disease Control and Prevention (CDC) established programs for upgrading mycobacteriology laboratories by providing them with monies and focused training, In 1991, state public health laboratories were surveyed to determine the methods they were using for primary Mycobacterium tuberculosis testing and their turnaround times for reporting testing results, A similar survey of nonstate laboratories participating in the National Laboratory Training Network-sponsored, M. tuberculosis-focused training programs was conducted from May 1992 to June 1993. In 1994, follow-up surveys of both the state- and nonstate-laboratory cohorts were conducted with the questionnaire from the initial survey plus additional questions that asked about interventions and changes occurring in the laboratory since the original survey, Although both cohorts showed increases in the percentages of laboratories meeting the recommended turnaround times for reporting M. tuberculosis testing results and using the recommended rapid methods for testing, generally, the increases made by the state laboratories were greater. By June 1991, all state laboratories were using a rapid method for M. tuberculosis isolate identification compared with 88% of the nonstate laboratories, The percentage of laboratories identifying isolates within the recommended 21 days also increased more in the group of state laboratories than in the group of nonstate laboratories (state laboratories, 22 to 73%; nonstate laboratories, 55 to 59%), Responses from the follow-up survey showed large differences in the percentages of laboratories that received CDC funding (state laboratories, 100%; nonstate laboratories, 6%) and participated in M. tuberculosis training (state laboratories, 98%; nonstate laboratories, 45%), These results indicate that adequate funding and focused training are critical in maintaining state-of-the-art mycobacteriology laboratories. C1 CTR DIS CONTROL & PREVENT,PUBL HLTH PROGRAM OFF,DIV LAB SYST,LAB PRACTICE TRAINING BRANCH,ATLANTA,GA 30341. NR 8 TC 6 Z9 6 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD FEB PY 1997 VL 35 IS 2 BP 422 EP 426 PG 5 WC Microbiology SC Microbiology GA WD082 UT WOS:A1997WD08200018 PM 9003609 ER PT J AU Miller, JM Hair, JG Hebert, M Hebert, L Roberts, FJ AF Miller, JM Hair, JG Hebert, M Hebert, L Roberts, FJ TI Fulminating bacteremia and pneumonia due to Bacillus cereus SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID INFECTION AB We present two cases of rapidly progressing, fatal pneumonia caused by Bacillus cereus. These cases are interesting in that B. cereus, even from blood or sputum specimens, may often be considered a contaminant and receive inadequate attention. Also of interest was the fact that the two patients resided in the same area of the state, were welders by trade, and became ill within a few days of each other, yet there was no epidemiologic link between them. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,HOSP INFECT PROGRAM,ATLANTA,GA 30333. LOUISIANA REFERENCE LAB,BATON ROUGE,LA. BATON ROUGE GEN MED CTR,BATON ROUGE,LA. NR 11 TC 71 Z9 72 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD FEB PY 1997 VL 35 IS 2 BP 504 EP 507 PG 4 WC Microbiology SC Microbiology GA WD082 UT WOS:A1997WD08200037 PM 9003628 ER PT J AU Katz, JM Lu, XH Young, SA Galphin, JC AF Katz, JM Lu, XH Young, SA Galphin, JC TI Adjuvant activity of the heat-labile enterotoxin from enterotoxigenic Escherichia coli for oral administration of inactivated influenza virus vaccine SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 3rd International Conference on Options for the Control of Influenza CY MAY 04-09, 1996 CL CAIRNS, AUSTRALIA SP WHO, Austr Soc Microbiol, CSL Ltd, Pasteur Merieux Serums & Vaccins, Pasteur Merieux MSD Connaught Labs, SmithKline Beecham, Becton Dickinson, Evans Med, Glaxo Wellcome, Parke Davis, Wyeth Lederle Vaccines & Pediat, Chiron Biocine, Eisai Co Ltd, Nippon Glaxo, Solvay Duphar, Res Fdn Microbial Dis Osaka Univ ID CHOLERA-TOXIN; IMMUNOGLOBULIN-A; CONTROLLED TRIAL; MICE; IMMUNIZATION; HEMAGGLUTININ; INDUCTION; EFFICACY; IMMUNITY; ANTIGENS AB Alternative strategies for vaccination against influenza that elicit both systemic antibody and mucosal IgA responses are needed to improve the efficacy in protection against infection, This study demonstrated that oral delivery of inactivated influenza vaccine with the heat-labile enterotoxin (LT) from enterotoxigenic Escherichia coli elicited the spectrum of humoral and cell-mediated responses in BALB/c mice critical for the protection and recovery from influenza virus infection, Coadministration of LT with oral influenza vaccine increased antiviral serum IgG and mucosal IgA responses compared with administration of oral influenza vaccine alone, Serum hemagglutination-inhibition and neutralizing antibodies were also augmented by LT, The adjuvant potentiated protection from infection with influenza A H3N2 viruses in mouse lower and upper respiratory tracts, enabling the use of lower doses of oral vaccine, Coadministration of LT with oral inactivated influenza vaccine induced influenza virus-specific proliferative T cells, interleukin-2 production, and major histocompatibility complex class I-restricted cytotoxic T cells. C1 ST JUDE CHILDRENS RES HOSP, DEPT VIROL & MOL BIOL, MEMPHIS, TN 38105 USA. RP Katz, JM (reprint author), CTR DIS CONTROL & PREVENT, NATL CTR INFECT DIS, DIV VIRAL & RICKETTSIAL DIS, INFLUENZA BRANCH, ATLANTA, GA 30333 USA. NR 42 TC 67 Z9 70 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 IS 2 BP 352 EP 363 PG 12 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WF063 UT WOS:A1997WF06300015 PM 9203656 ER PT J AU Burkot, TR Schriefer, ME Larsen, SA AF Burkot, TR Schriefer, ME Larsen, SA TI Cross-reactivity to Borrelia burgdorferi proteins in serum samples from residents of a tropical country nonendemic for Lyme disease SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID LINKED-IMMUNOSORBENT-ASSAY; SERODIAGNOSIS AB Reports of Lyme disease from areas where the disease is not endemic have increased. Eighty-six human serum samples from Papua New Guinea (nonendemic for Lyme disease) were examined for the presence of IgG antibodies that recognize Borrelia burgdorferi antigens, using the currently recommended two-tiered system of analysis (sensitive ELISA with Western blot). The percentage of positive tests dropped from 50% to 10% when individual negative controls were included in the two-tiered analysis. Positive serum samples failed to inhibit the growth of B, burgdorferi in culture and did not yield positive reactions in the fluorescent treponemal antibody-absorption test. These characteristics, together with atypical Western blot antigen recognition patterns and the absence of known vectors, provide evidence that seropositive results for these persons are not the result of exposure to B. burgdorferi. Individual negative controls may minimize false-positive results for serologic tests for Lyme disease, and these tests must be interpreted in the context of clinical and epidemiologic data. C1 DIV SEXUALLY TRANSMITTED DIS,ATLANTA,GA. RP Burkot, TR (reprint author), CTR DIS CONTROL & PREVENT,DIV VECTOR BORNE INFECT DIS,POB 2087,FT COLLINS,CO 80522, USA. RI Burkot, Thomas/C-6838-2013 NR 15 TC 13 Z9 14 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 IS 2 BP 466 EP 469 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WF063 UT WOS:A1997WF06300034 PM 9203675 ER PT J AU Garcia, HH Gilman, RH Catacora, M Verastegui, M Gonzalez, AE Tsang, VCW Martinez, M Altamirano, J Trelles, L Cuba, JM Alvarado, M Alban, G Estrada, H RiosSaavedra, N Soto, M Torres, MP Boero, J Gavidia, C Barron, E Falcon, N Lopez, MT Pilcher, JB Evans, C Herrera, G Terashima, A Campos, P Cabrera, J Rocca, U AF Garcia, HH Gilman, RH Catacora, M Verastegui, M Gonzalez, AE Tsang, VCW Martinez, M Altamirano, J Trelles, L Cuba, JM Alvarado, M Alban, G Estrada, H RiosSaavedra, N Soto, M Torres, MP Boero, J Gavidia, C Barron, E Falcon, N Lopez, MT Pilcher, JB Evans, C Herrera, G Terashima, A Campos, P Cabrera, J Rocca, U TI Serologic evolution of neurocysticercosis patients after antiparasitic therapy SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID TAENIA-SOLIUM; CYSTICERCOSIS; PRAZIQUANTEL; COMMUNITY; EPILEPSY; MEXICO; BRAIN; BLOT AB Neurocysticercosis is the main cause of acquired epilepsy in developing countries and is an emerging disease in the United States. Introduction of the immunoblot assay provided a new tool for the diagnosis and monitoring of neurocysticercosis. This study analyzed the relationship between clinical characteristics of cerebral infection (number and type of lesions) plus the baseline response on immunoblot and the changes observed after therapy. Reaction to all 7 diagnostic bands was associated with severe infection (more lesions). Seventeen patients (35%) had no active lesions on computed tomography (CT) 3 months after therapy and were considered cured, Although most cured patients remained seropositive after 1 year, 3 became seronegative before 9 months. In these 3 cases, the lesions had resolved on CT at 3 months, Persistent seropositivity does not necessarily indicate active infection, Serologic follow-up will be clinically helpful only in rare cases in which early antibody disappearance occurs. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. JOHNS HOPKINS UNIV,BALTIMORE,MD. UNIV NACL MAYOR SAN MARCOS,LIMA 14,PERU. UNIV PERUANA CAYETANO HEREDIA,INST NACL CIENCIAS NEUROL,DEPT MICROBIOL,AB PRISMA,LIMA 31,PERU. OI Catacora, Manuel M./0000-0001-7193-0764; Gavidia, Cesar Miguel/0000-0003-3936-5077 FU NIAID NIH HHS [AI-35894, U01 AI035894]; Wellcome Trust [057434] NR 16 TC 55 Z9 57 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 IS 2 BP 486 EP 489 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WF063 UT WOS:A1997WF06300039 PM 9203680 ER PT J AU Afif, H Sutter, RW Kew, OM Fontaine, RE Pallansch, MA Goyal, MK Cochi, SL AF Afif, H Sutter, RW Kew, OM Fontaine, RE Pallansch, MA Goyal, MK Cochi, SL TI Outbreak of poliomyelitis in Gizan, Saudi Arabia: Cocirculation of wild type 1 polioviruses from three separate origins SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; ERADICATION; GENOTYPES; CHINA AB In 1989, a localized outbreak of 10 cases of poliomyelitis occurred in Saudi Arabia. Wild poliovirus type 1 was isolated from 5 patients. To determine the patterns of poliovirus circulation, partial nucleotide sequences of the poliovirus isolates were compared. These isolates were remarkably diverse. Two isolates were closely related to each other and to viruses isolated during the 1988 epidemic in Oman. Two other isolates were very similar to viruses found in Egypt, The fifth isolate was distantly related to the latter pair. The molecular data suggest that the 10 cases represented three separate outbreaks. The virologic findings underscore the potential for Saudi Arabia, which receives millions of guest workers and their families each year from countries in which polio is endemic, to be exposed to frequent importations of wild polioviruses. To restrict the circulation of imported polioviruses, Saudi Arabia must maintain high population immunity to poliovirus in all geopolitical divisions. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,INFORMAT SERV,ATLANTA,GA 30333. MINIST HLTH,FIELD EPIDEMIOL TRAINING PROGRAM,RIYADH,SAUDI ARABIA. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. DIRECTORATE GEN HLTH SERV,GIZAN,SAUDI ARABIA. NR 25 TC 6 Z9 6 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S71 EP S75 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000013 PM 9203695 ER PT J AU Alexander, JP Gary, HE Pallansch, MA AF Alexander, JP Gary, HE Pallansch, MA TI Duration of poliovirus excretion and fts implications for acute flaccid paralysis surveillance: A review of the literature SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 6th CDC-WHO Meeting on the Global Poliomyelitis Eradication Initiative CY JUL 24-26, 1995 CL ATLANTA, GA SP WHO, CDC ID POLIOMYELITIS AB Timely investigation of children with acute flaccid paralysis, with collection of stool specimens for virus isolation, is the primary strategy used to detect wild poliovirus circulation To determine the optimal timing of stool specimen collection, studies of wild and vaccine poliovirus excretion published between 1935 and 1995 were reviewed. Data were compiled from comparable studies, scatter plots of the data were created, and third-order regression lines were calculated. The data indicated that wild polioviruses were excreted by a majority of previously unvaccinated infants and young children for 3-4 weeks. The duration of viral shedding was reduced, however, among children who were previously vaccinated with inactivated poliovirus vaccine, who had preexisting antibodies to the infecting serotype, or who had previous intestinal infection with homologous poliovirus. These data suggest that the 14-day period after onset of paralysis is the interval with the highest probability of detecting wild poliovirus excretion in paralyzed children. RP Alexander, JP (reprint author), CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,MAILSTOP G-17,ATLANTA,GA 30333, USA. NR 39 TC 79 Z9 80 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S176 EP S182 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000031 PM 9203713 ER PT J AU Andrus, JK Banerjee, K Hull, BP Smith, JC Mochny, I AF Andrus, JK Banerjee, K Hull, BP Smith, JC Mochny, I TI Polio eradication in the World Health Organization South-East Asia Region by the year 2000: Midway assessment of progress and future challenges SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 6th CDC-WHO Meeting on the Global Poliomyelitis Eradication Initiative CY JUL 24-26, 1995 CL ATLANTA, GA SP WHO, CDC ID POLIOMYELITIS AB In the South-East Asia Region (SEAR) of WHO, paralytic poliomyelitis has decreased from 25,711 cases in 1988 to 3304 cases in 1995, representing an 87% reduction. By 1995, in 6 of 10 member countries--India, Bangladesh, Myanmar, Nepal, Indonesia, and Democratic People's Republic of Korea-polio remained endemic. Two countries, Sri Lanka and Thailand, appear close to polio eradication, and 2, Bhutan and Maldives, reported no cases during 1989-1995. Although reported rates of acute flaccid paralysis and the percentage of cases virologically investigated are low in some countries, no isolates of wild poliovirus type 2 have been reported outside India since 1993. By the end of 1996, all 8 countries in which polio is endemic will have conducted national immunization days for polio eradication. The major challenge for polio eradication in SEAR will be strengthening surveillance, because national immunization days alone cannot eradicate polio. C1 WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,CH-1211 GENEVA,SWITZERLAND. CTR DIS CONTROL & PREVENT,ATLANTA,GA. MINIST HLTH & FAMILY WELF,DEPT FAMILY WELF,MATERNAL CHILD HLTH DIV,NEW DELHI,INDIA. RP Andrus, JK (reprint author), WHO,SE ASIA REG OFF,EXPANDED PROGRAMME IMMUNIZAT,INDRAPRASTHA ESTATE,NEW DELHI 110002,INDIA. NR 13 TC 13 Z9 14 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S89 EP S96 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000017 PM 9203699 ER PT J AU Birmingham, ME Linkins, RW Hull, BP Hull, HF AF Birmingham, ME Linkins, RW Hull, BP Hull, HF TI Poliomyelitis surveillance: The compass for eradication SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article AB Effective disease surveillance is a key strategy of the global polio eradication initiative. In an effort to strengthen the quality of polio surveillance as a prerequisite to achieving and certifying eradication, surveillance assessments were conducted in 28 countries in the World Health Organization African, Eastern Mediterranean, and European Regions from 1992 to 1995 using a standard protocol and evaluation guidelines. Six general recommendations were made: Use surveillance data for public health decision-making and action, improve timeliness of information exchange and dissemination, standardize the data collected, ensure adequate surveillance infrastructure, improve local data analysis, and enhance teamwork among surveillance partners. The experience gained will position the Expanded Programme on Immunization to address the challenges of disease prevention in the 21st century. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA. RP Birmingham, ME (reprint author), WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,EXPANDED PROGRAMME IMMUNIZAT,20 AVE APPIA,CH-1211 GENEVA 27,SWITZERLAND. NR 10 TC 12 Z9 13 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S146 EP S150 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000025 PM 9203707 ER PT J AU Birmingham, ME Aylward, RB Cochi, SL Hull, HF AF Birmingham, ME Aylward, RB Cochi, SL Hull, HF TI National immunization days: State of the art SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID ORAL POLIOVIRUS VACCINE; POLIOMYELITIS; ERADICATION; DISEASE AB National immunization days (NIDs) are nationwide mass campaigns to deliver supplemental doses of oral poliovirus vaccine to interrupt the circulation of wild polioviruses. They constitute one of the critical strategies for global poliomyelitis eradication and should be implemented in all countries with widespread poliovirus transmission. The certification of wild poliovirus eradication from the Western Hemisphere in September 1994 verified the effectiveness of this aspect of the World Health Organization's (WHO) overall strategy for polio eradication by the year 2000. NIDs require careful advanced planning and orchestration by each country. WHO provides specific guidelines for NIDs regarding the season, target age group, duration, frequency, inclusion of other interventions, vaccine delivery strategies, and evaluation. With strong routine immunization programs and the effective implementation of NIDs, ''mop-up'' campaigns, and acute flaccid paralysis surveillance, the goal of global polio eradication will be achieved. C1 CTR DIS CONTROL & PREVENT,POLIO ERADICAT ACT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA. RP Birmingham, ME (reprint author), WHO,EXPANDED PROGRAMME IMMUNIZAT,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,20 AVE APPIA,CH-1211 GENEVA 27,SWITZERLAND. NR 38 TC 21 Z9 21 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S183 EP S188 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000032 PM 9203714 ER PT J AU Cochi, SL Hull, HF Sutter, RW Wilfert, CM Katz, SL AF Cochi, SL Hull, HF Sutter, RW Wilfert, CM Katz, SL TI Commentary: The unfolding story of global poliomyelitis eradication SO JOURNAL OF INFECTIOUS DISEASES LA English DT Editorial Material C1 DUKE UNIV,MED CTR,DEPT PEDIAT,DURHAM,NC. WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,CH-1211 GENEVA,SWITZERLAND. RP Cochi, SL (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM E61,ATLANTA,GA 30333, USA. NR 9 TC 9 Z9 9 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S1 EP S3 PG 3 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000001 PM 9203683 ER PT J AU Deming, MS Linkins, RW Jaiteh, KO AF Deming, MS Linkins, RW Jaiteh, KO TI The clinical efficacy of trivalent oral polio vaccine in The Gambia by season of vaccine administration SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID EPIDEMIC POLIOMYELITIS; ENDEMIC DISEASE; CHLOROQUINE; ROTAVIRUS AB An epidemic of poliomyelitis caused by poliovirus type 1 occurred in The Gambia in 1986. To determine if a relationship existed between the failure of trivalent oral poliovirus vaccine (OPV) to prevent poliomyelitis and the season when children were vaccinated, 46 children 1-7 years old with poliomyelitis who had received three card-documented doses of OPV were compared with 260 controls who had also received three card-documented doses. Controls were individually matched with children who had poliomyelitis by age, sex, and residence. Children with poliomyelitis were more likely to have received doses in the rainy season (odds ratio describing the linear trend of each additional dose in the rainy season, 1.7; 95% confidence interval, 1.05-2.9). This finding extends previous observations of seasonal difference in the immunogenicity of OPV in The Gambia by showing that season of administration was associated with increased risk of vaccine failure nationwide for a several-year period. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30341. MINIST HLTH SOCIAL WELF & WOMENS AFFAIRS,MED & HLTH DEPT,BANJUL,GAMBIA. WHO,GLOBAL PROGRAMME VACCINES,CH-1211 GENEVA,SWITZERLAND. RP Deming, MS (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,INT HLTH PROGRAM OFF,ATLANTA,GA 30341, USA. NR 13 TC 11 Z9 11 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S254 EP S257 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000043 PM 9203725 ER PT J AU Gary, BE Freeman, C Penaranda, S Maher, K Anderson, L Pallansch, MA AF Gary, BE Freeman, C Penaranda, S Maher, K Anderson, L Pallansch, MA TI Comparison of a monoclonal antibody-based IgM capture ELISA with a neutralization assay for assessing response to trivalent oral poliovirus vaccine SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID INFECTIONS; DIAGNOSIS; VIRUS AB Monoclone-based IgM capture ELISAs were developed for each of the three poliovirus serotypes and compared with a neutralization assay for detecting response to trivalent oral poliovirus vaccine among 224 infants. The IgM-based response rates were significantly higher than the neutralizing antibody-based rates: 958 versus 83% to poliovirus type 1, 99% versus 94% to poliovirus type 2, and 89% versus 59% to poliovirus type 3. IgM responses to the first vaccine dose were significantly associated between serotypes, suggesting that some of the discordance may reflect a heterotypic IgM response. When the response rates in 4 vaccine formulation groups were compared, group differences using the two assays were similar for poliovirus types I and 2 but not for type 3. Therefore, IgM results using these assays may not be adequate substitutes for neutralizing antibody results when determining vaccine response. RP Gary, BE (reprint author), CTR DIS CONTROL & PREVENT,DVRD,REVB,NATL CTR INFECT DIS,MS G17,ATLANTA,GA 30333, USA. NR 13 TC 0 Z9 1 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S264 EP S267 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000045 ER PT J AU Gary, HE Sanders, R Pallansch, MA AF Gary, HE Sanders, R Pallansch, MA TI A theoretical framework for evaluating the sensitivity of surveillance for detecting wild poliovirus .2. Factors affecting detection sensitivity in a population with circulating wild poliovirus SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article AB A basic framework for describing sensitivity of surveillance to detect poliovirus is extended from individuals to general populations (population sensitivity). Using the mathematical formulations for population sensitivity, the theoretical behavior of surveillance sensitivity under various conditions is analyzed. As a region nears the elimination of poliovirus, population sensitivity falls to a value lower than the case-to-infection ratio, regardless of the system proficiency. Also, a second stool specimen makes a substantial contribution to population sensitivity only in regions with relatively low specimen sensitivity and then only over a narrow range of population infection incidence. Estimates of the mean numbers of infected and uninfected acute flaccid paralysis cases investigated in a season are derived. These may serve as additional indicators of system operation but require the collection of 2 specimens per case. C1 WHO,REG OFF WESTERN PACIFIC,EXPANDED PROGRAMME IMMUNIZAT,MANILA,PHILIPPINES. RP Gary, HE (reprint author), CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,RESP & ENTER VIRUSES BRANCH,MS G17,ATLANTA,GA 30333, USA. NR 3 TC 6 Z9 6 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S141 EP S145 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000024 PM 9203706 ER PT J AU Gary, HE Sanders, R Pallansch, MA AF Gary, HE Sanders, R Pallansch, MA TI A theoretical framework for evaluating the sensitivity of surveillance for detecting wild poliovirus .1. Factors affecting detection sensitivity in a person with acute flaccid paralysis SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article AB Surveillance for cases of acute flaccid paralysis provides a means for detecting circulating wild poliovirus in a population and therefore is crucial to the global polio eradication effort, An initial step toward developing a more general framework for understanding the sensitivity of the acute flaccid paralysis surveillance system is presented by first specifying four categories of sensitivity involved: laboratory sensitivity, specimen sensitivity, person sensitivity, and population sensitivity, Using this framework, estimates for specimen sensitivity (the probability that virus will be detected in a specimen collected from an infected person) and the prevalence of infection are derived and applied to surveillance data from three regions. On the basis of the framework, our analysis indicates that a second specimen may significantly increase person sensitivity under some circumstances but provides little improvement under others. C1 WHO,REG OFF WESTERN PACIFIC,EXPANDED PROGRAMME IMMUNIZAT,MANILA,PHILIPPINES. RP Gary, HE (reprint author), CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,RESP & ENTER VIRUSES BRANCH,ATLANTA,GA 30333, USA. NR 5 TC 12 Z9 12 U1 0 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S135 EP S140 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000023 PM 9203705 ER PT J AU Hull, HF Birmingham, ME Melgaard, B Lee, JW AF Hull, HF Birmingham, ME Melgaard, B Lee, JW TI Progress toward global polio eradication SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; VACCINE; DISEASE; IMMUNOGENICITY AB Significant progress is being made towards the global eradication of poliomyelitis by the year 2000. The strategies recommended by the World Health Organization for polio eradication are as follows: maintaining high routine immunization coverage; conducting nationwide mass immunization campaigns; building effective, laboratory-based surveillance for acute flaccid paralysis; and conducting localized immunization campaigns directed at the final reservoirs of virus transmission. Sixty-three countries have conducted nationwide anti-polio immunization campaigns. Three hundred million children were immunized in these campaigns worldwide in 1995. The reported incidence of poliomyelitis has fallen by similar to 80% since the global target was set in 1988, and the geographic range of polio is being restricted. The major challenges for achieving eradication are establishing effective surveillance systems in all countries and mobilizing the resources needed to fully implement the recommended strategies in the 67 countries in which polio remains endemic. C1 WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,CH-1211 GENEVA 27,SWITZERLAND. CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. NR 37 TC 16 Z9 16 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S4 EP S9 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000002 PM 9203684 ER PT J AU IonNedelcu, N Strebel, PM Toma, F BiberiMoroeanu, S Combiescu, M Persu, A AubertCombiescu, A Plotkin, SA Sutter, RW AF IonNedelcu, N Strebel, PM Toma, F BiberiMoroeanu, S Combiescu, M Persu, A AubertCombiescu, A Plotkin, SA Sutter, RW TI Sequential and combined use of inactivated and oral poliovirus vaccines: Dolj district, Romania, 1992-1994 SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; IMMUNIZATION; RISK; DTP AB To determine the feasibility of a vaccination strategy that would reduce the risk of vaccine-associated paralysis while retaining a barrier against the spread of wild poliovirus, a 2-year project was undertaken using enhanced-potency inactivated poliovirus vaccine (IPV) administered at 2 and 3 months of age followed by doses of both IPV and oral poliovirus Vaccine (OPV) administered at 4 and 9 months of age, Vaccination coverage by 12 months of age with three or more doses of IPV and two doses of OPV among 16,566 infants eligible for vaccination was >95% and >80%, respectively. Among 51 children from whom blood samples were obtained 45 days after their third dose of IPV and first dose of OPV, 100% had serum neutralizing antibodies (reciprocal titer greater than or equal to 10) to all three poliovirus types. No cases of paralytic poliomyelitis due to either wild or vaccine-related strains were reported. The project demonstrated the feasibility, safety, and high immunogenicity of sequential use of IPV followed by OPV in Romania. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. MINIST HLTH,EXPANDED PROGRAMME IMMUNIZAT,NATL LAB CONTROL SERA & VACCINES,BUCHAREST,ROMANIA. CANTACUZINO INST,BUCHAREST,ROMANIA. PREVENT MED CTR,CRAIOVA,ROMANIA. PASTEUR MERIEUX SERUMS & VACCINS,LYON,FRANCE. NR 17 TC 7 Z9 7 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S241 EP S246 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000041 PM 9203723 ER PT J AU Izurieta, HS Biellik, RJ Kew, OM Valente, FL Chezzi, C Sutter, RW AF Izurieta, HS Biellik, RJ Kew, OM Valente, FL Chezzi, C Sutter, RW TI Poliomyelitis in Angola: Current status and implications for poliovirus eradication in southern Africa SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; OUTBREAK; NAMIBIA AB As part of emergency assistance to the Ministry of Health (MOH), national surveillance data for poliomyelitis and charts of cases at the national rehabilitation hospital were reviewed. Poliomyelitis patients admitted to Angola's main pediatric hospital were examined, A mean of 86 cases of poliomyelitis/year were reported in Angola during 1989-1994. Review of records from non-MOH sources uncovered another 74 cases, primarily from areas outside governmental control. Hospital chart reviews revealed that 80% of the cases were children <3 years of age, mainly unvaccinated. Molecular analyses of isolates from cases in Luanda and at the Angola-Namibia border suggest that these isolates are closely related and that greater than or equal to 2 strains of wild poliovirus type 1 are circulating currently in Angola. This investigation confirms that poliomyelitis has remained endemic in Angola since independence in 1975. It affects primarily young and unvaccinated children, Central of poliomyelitis in Angola is essential to expand the polio-free zone in southern Africa. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. WHO,HARARE,ZIMBABWE. MINIST SAUDE,PROGRAMA ALARGADO VACUNACOES,LUANDA,ANGOLA. UNIV WITWATERSRAND,NATL INST VIROL,ZA-2050 WITWATERSRAND,SOUTH AFRICA. NR 23 TC 8 Z9 8 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S24 EP S29 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000006 PM 9203688 ER PT J AU Modlin, JF Halsey, NA Thoms, ML Meschievitz, CK Patriarca, PA AF Modlin, JF Halsey, NA Thoms, ML Meschievitz, CK Patriarca, PA TI Humoral and mucosal immunity in infants induced by three sequential inactivated poliovirus vaccine - Live attenuated oral poliovirus vaccine immunization schedules SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy CY OCT 17-20, 1993 CL NEW ORLEANS, LA SP Amer Soc Microbiol ID ENHANCED-POTENCY; UNITED-STATES; POLIOMYELITIS; STRATEGIES; DISEASE AB The relative immunity induced by sequential administration of inactivated poliovirus vaccine (IPV) produced in human diploid cells and live attenuated oral poliovirus vaccine (OPV) was evaluated by randomization of 510 infants to receive IPV and OPV sequentially according to one of three experimental schedules, IPV only, or OPV only. The antibody response to two IPV doses was lower than expected. However, for each of the IPV-OPV sequential schedules, the first OPV dose significantly enhanced seroconversion rates and geometric mean microneutralization antibody titers. Three months after the final dose, 96%-99%, 99%-100%, and 81%-100% of infants had antibodies to poliovirus types 1, 2, and 3, respectively, and subjects with two or more prior OPV doses were significantly less likely than those with none or one prior OPV dose to excrete virus in feces after an OPV challenge. Sequential IPV-OPV immunization is now recommended for routine use in the United States. The optimal schedule consists of two IPV doses followed by two OPV doses. C1 DARTMOUTH COLL,SCH MED,DEPT MED,LEBANON,NH 03756. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT INT HLTH,BALTIMORE,MD. CONNAUGHT LABS LTD,SWIFTWATER,PA. CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. RP Modlin, JF (reprint author), DARTMOUTH COLL,HITCHCOCK MED CTR,INFECT DIS SECT,SCH MED,DEPT PEDIAT,LEBANON,NH 03756, USA. NR 28 TC 47 Z9 52 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S228 EP S234 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000039 PM 9203721 ER PT J AU Oblapenko, G Sutter, RW AF Oblapenko, G Sutter, RW TI Status of poliomyelitis eradication in Europe and the Central Asian Republics of the former Soviet Union SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID GENOTYPES AB In the European Region of the World Health Organization, all countries in which polio is endemic have adopted the following strategies: achievement of high routine vaccination coverage, implementation of supplemental immunization activities, and enhancement of surveillance for poliomyeIitis. In 1995, 205 cases of poliomyelitis were reported. Routine coverage among I-year-olds with three doses of poliovirus vaccine was 89% in 1995. Ten countries conducted national immunization days (NIDs). Twenty-four countries (48%) adopted acute flaccid paralysis (AFP) surveillance. Use of NIDs has decreased poliomyelitis incidence in the seven countries in which polio is endemic (Armenia, Azerbaijan, Kazakhstan, Turkey, Turkmenistan, Tajikistan, Uzbekistan) from 203 cases in 1994 to 47 in 1995, a 77% reduction. Full implementation of the strategies to achieve eradication in the countries in which polio is endemic, including those countries with epidemic poliovirus transmission during 1995, is likely to accomplish regional eradication of poliomyelitis by the year 2000 or earlier. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA. NR 27 TC 8 Z9 8 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S76 EP S81 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000014 PM 9203696 ER PT J AU Patriarca, PA Sutter, RW Oostvogel, PM AF Patriarca, PA Sutter, RW Oostvogel, PM TI Outbreaks of paralytic poliomyelitis, 1976-1995 SO JOURNAL OF INFECTIOUS DISEASES LA English DT Review ID ORAL POLIOVIRUS VACCINE; SOUTH-AFRICA; DEVELOPING-COUNTRIES; INFECTIOUS-DISEASES; CLINICAL EFFICACY; CASE CONFIRMATION; WILD POLIOVIRUS; NATAL KWAZULU; ERADICATION; EPIDEMIC AB During 1976-1995, 48 outbreaks of paralytic poliomyelitis with a cumulative total of similar to 17,000 cases were reported worldwide. Outbreaks occurred on most continents, affected from 0.1 to 52 persons per 100,000 total population (median, 4.4), lasted 2-25 months (median, 7), typically involved unvaccinated or inadequately vaccinated subgroups within highly immunized communities, and were primarily caused by poliovirus type 1 (74%). Cases in developing countries occurred predominantly among children <2 years of age, while those in industrialized countries tended to occur in older persons who had escaped natural infection earlier in life and who had not been vaccinated or had received poliovirus vaccine of inadequate potency. Partial genomic sequencing studies indicated that at least 15 outbreaks resulted from importation of wild polioviruses, primarily from the Indian subcontinent. These findings illustrate the potential for wide dissemination of wild poliovirus infection and underscore the critical need for maintaining high levels of immunity in all countries and for more aggressive vaccination efforts in areas in which polio is endemic. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA. NATL INST PUBL HLTH & ENVIRONM PROTECT,VIROL LAB,NL-3720 BA BILTHOVEN,NETHERLANDS. RP Patriarca, PA (reprint author), US FDA,CTR BIOL EVALUAT & RES,HRM 445,1401 ROCKVILLE PIKE,BETHESDA,MD 20852, USA. NR 116 TC 51 Z9 51 U1 1 U2 2 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S165 EP S172 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000029 PM 9203711 ER PT J AU Pinheiro, FP Kew, OM Hatch, MH daSilveira, CM deQuadros, CA AF Pinheiro, FP Kew, OM Hatch, MH daSilveira, CM deQuadros, CA TI Eradication of wild poliovirus from the Americas: Wild poliovirus surveillance - Laboratory issues SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PROBES AB The Pan American Regional Poliomyelitis Laboratory Network, developed to support the program to eradicate indigenous wild poliovirus transmission in the Americas, included 10 laboratories, distributed in eight countries in the Americas, organized according to the diagnostic procedures they regularly performed. All laboratories isolated and typed virus in stool specimens, several did intratypic differentiation by nucleic acid probe hybridization, and 2 sequenced wild poliovirus isolates for molecular epidemiologic studies. High performance of the network was maintained through comprehensive training of virologists, continuous monitoring of laboratory performance, and prompt investigation of problems. Recommended field and laboratory procedures were regularly reviewed and revised to optimize sensitivity, specificity, and diagnostic efficiency. Close integration of field and laboratory surveillance was achieved through frequent meetings between virologists and epidemiologists, effective communication of program priorities, and the distribution of weekly surveillance reports. C1 PAN AMER HLTH ORG,SPECIAL PROGRAM VACCINES & IMMUNIZAT,WASHINGTON,DC 20037. PAN AMER HLTH ORG,DIV DIS PREVENT & CONTROL,WASHINGTON,DC 20037. CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. NR 9 TC 13 Z9 13 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S43 EP S49 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000009 PM 9203691 ER PT J AU Posey, DL Linkins, RW Oliveria, MJC Monteiro, D Patriarca, PA AF Posey, DL Linkins, RW Oliveria, MJC Monteiro, D Patriarca, PA TI The effect of diarrhea on oral poliovirus vaccine failure in Brazil SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 33rd Interscience Conference on Antimicrobial Agents and Chemotherapy CY OCT 17-20, 1993 CL NEW ORLEANS, LA SP Amer Soc Microbiol ID DEVELOPING-COUNTRIES; SEROCONVERSION RATES; ANTIBODY-RESPONSE; GLOBAL PROBLEM; DISEASE; POLIOMYELITIS; IMMUNIZATION; CHILDREN; TROPICS; INFANTS AB The effect of diarrhea on oral poliovirus vaccine (OPV) failure was evaluated using data from Brazil, where 728 infants were immunized at birth (OPVI) and similar to 6 (OPV2), 10 (OPV3), and 14 (OPV4) weeks. Recent diarrhea history was significantly associated with increased vaccine failure only after OPV2 for poliovirus types 2 and 3. In multivariate models, controlling for breast feeding, season of vaccine administration (type 3 only), maternal antibody (type 3 only), and immunization campaign exposure (type 3 only) strengthened this effect. Diarrhea at OPV receipt was associated with vaccine failure to poliovirus types 1 and 3 only after OPV2. These data support the current recommendation that children with diarrhea receive OPV and be reimmunized once their illness resolves. Expanding this recommendation to include children with a recent diarrhea history should be considered. While the effect of diarrhea on vaccine failure may be limited to OPV2, programmatic realities may preclude dose-specific recommendations. C1 CTR DIS CONTROL & PREVENT,BIRTH DEFECTS & GENET DIS BRANCH,DIV BIRTH DEFECTS & DEV DISABIL,ATLANTA,GA 30333. CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. MINIST HLTH,BRASILIA,DF,BRAZIL. CENT LAB,RECIFE,PE,BRAZIL. NR 59 TC 36 Z9 38 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S258 EP S263 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000044 PM 9203726 ER PT J AU Prevots, DR Sutter, RW AF Prevots, DR Sutter, RW TI Assessment of Guillain-Barre syndrome mortality and morbidity in the United States: Implications for acute flaccid paralysis surveillance SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article AB To estimate age-specific incidences and assess the national morbidity and mortality burden for Guillain-Barre syndrome (GBS) in the United States, a national hospital discharge database compiled by the Commission on Professional and Hospital Activities (CPHA) and national death certificate data reported to the National Vital Statistics System were reviewed. During 1985-1991, 10,453 patients with GBS were discharged from CPHA-participating hospitals (estimated annual incidence, 3.0/100,000 population). The age-specific incidence of GBS increased with age from 1.5/100,000 in persons <15 years old to 8.6/100,000 in persons 70-79 years old. The total estimated number of GBS-related deaths from 1985 through 1990 was 3770 (95% confidence interval, 3506-4034), for an average of 628 GBS deaths per year. These rates suggest that the proposed national surveillance system for acute flaccid paralysis should capture at a minimum the 796 GBS cases in persons <15 years old. GBS remains a significant health burden among older adults in the United States, with a marked increase in risk after age 40. RP Prevots, DR (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333, USA. NR 19 TC 26 Z9 27 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S151 EP S155 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000026 PM 9203708 ER PT J AU Reichler, MR Abbas, A Kharabsheh, S Mahafzah, A Alexander, JP Rhodes, P Faouri, S Otoum, H Bloch, S Majid, MA Mulders, M Aslanian, R Hull, HF Pallansch, MA Patriarca, PA AF Reichler, MR Abbas, A Kharabsheh, S Mahafzah, A Alexander, JP Rhodes, P Faouri, S Otoum, H Bloch, S Majid, MA Mulders, M Aslanian, R Hull, HF Pallansch, MA Patriarca, PA TI Outbreak of paralytic poliomyelitis in a highly immunized population in Jordan SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 34th Interscience Conference on Antimicrobial Agents and Chemotherapy CY OCT 03-07, 1994 CL ORLANDO, FL ID WILD POLIOVIRUS TYPE-1; EPIDEMIOLOGY; CHILDREN; DISEASE; VACCINE; OMAN AB Between November 1991 and March 1992, 37 cases of paralytic poliomyelitis occurred in Jordan, where none had been reported since 1988. Of these, 17 (50%) of 33 patients had received at least three doses of oral poliovirus vaccine (OPV3). The first and 2 subsequent case-patients were children of Pakistani migrant workers, and the first 8 and a total of 27 (75%) case-patients resided in or near the Jordan Valley, A seroepidemiologic study of 987 children in all regions of Jordan was performed to assess OPV3 coverage and immune response to OPV. Although OPV3 coverage by 12 months of age was high (96%) in the general population, coverage was lower among Pakiutani (21%), Bedouin (63%), and Gypsy (9%) children (P <.001). Seroprevalences for poliovirus type 3 were 71% in the Jordan Valley versus 81% in other regions after 3 doses of OPV (P <.06) and 77% in the Jordan Valley versus 98% in other regions after 5 doses of OPV (P <.001), This outbreak demonstrates the importance of achieving high seroimmunity to infection in all geographic areas to prevent the reintroduction and spread of imported strains of wild poliovirus. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,NATL CTR INFECT DIS,ENTEROVIRUS BRANCH,ATLANTA,GA 30333. JORDAN UNIV HOSP,MINIST HLTH,DEPT LAB MED,DIS PREVENT & CONTROL DIRECTORATE,AMMAN,JORDAN. JORDAN UNIV HOSP,MINIST HLTH,DEPT LAB MED,JORDAN VACCINE INST,AMMAN,JORDAN. NATL INST PUBL HLTH & ENVIRONM PROTECT,VIROL LAB,NL-3720 BA BILTHOVEN,NETHERLANDS. WHO,EASTERN MEDITERRANEAN REG OFF,ALEXANDRIA,EGYPT. WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,CH-1211 GENEVA,SWITZERLAND. RP Reichler, MR (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 22 TC 16 Z9 16 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S62 EP S70 PG 9 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000012 PM 9203694 ER PT J AU Reichler, MR Kharabsheh, S Rhodes, P Otoum, H Bloch, S Majid, MA Pallansch, MA Patriarca, PA Cochi, SL AF Reichler, MR Kharabsheh, S Rhodes, P Otoum, H Bloch, S Majid, MA Pallansch, MA Patriarca, PA Cochi, SL TI Increased immunogenicity of oral poliovirus vaccine administered in mass vaccination campaigns compared with the routine vaccination program in Jordan SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; OUTBREAK; ERADICATION; CHILDREN AB To compare the immunogenicity of routine versus mass campaign doses of oral poliovirus vaccine (OPV), serum neutralizing antibodies were measured in 254 children before and after two mass vaccination campaigns in Jordan. Precampaign seroprevalences to poliovirus types 1, 2, and 3 in children who had received three, four, or five routine doses of OPV were compared with postcampaign seroprevalences in children who had received one, two, or three routine doses plus two mass campaign doses. Seroprevalences were consistently higher in subgroups that received two doses through mass campaigns than in subgroups that received all doses through the routine program, especially for poliovirus type 3. Geometric mean titers were also consistently higher for mass campaign subgroups, particularly for poliovirus type 3. The findings suggest that adding further doses of OPV to the routine schedule is unlikely to have as great an impact on the immune state of children as administering the same number of doses during mass campaigns. C1 MINIST HLTH,DIS PREVENT & CONTROL DIRECTORATE,AMMAN,JORDAN. MINIST HLTH,JORDAN VACCINE INST,AMMAN,JORDAN. CTR DIS CONTROL,ENTEROVIRUS BRANCH,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP Reichler, MR (reprint author), CTR DIS CONTROL,POLIO ERADICAT ACT,NATL IMMUNIZATION PROGRAM,NATL CTR INFECT DIS,MAILSTOP E-05,ATLANTA,GA 30333, USA. NR 24 TC 17 Z9 17 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S198 EP S204 PG 7 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000035 PM 9203717 ER PT J AU Sutter, RW Chudaiberdiev, YK Vaphakulov, SH Tursunova, D Oblapenko, G Iskandarov, TI AF Sutter, RW Chudaiberdiev, YK Vaphakulov, SH Tursunova, D Oblapenko, G Iskandarov, TI TI A large outbreak of poliomyelitis following temporary cessation of vaccination in Samarkand, Uzbekistan, 1993-1994 SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) CY SEP 17-22, 1995 CL SAN FRANCISCO, CA SP Amer Soc Microbiol AB Oral poliovirus vaccine (OPV) was not available in Samarkand, Uzbekistan, from November 1992 to August 1993. The ensuing outbreak of poliomyelitis was investigated: Patients with poliomyelitis were evaluated, the extent of poliovirus circulation was estimated, and the effectiveness of control measures was assessed. Between March 1993 and April 1994, 74 cases of paralytic disease attributable to poliovirus type 3 were reported. Cases originated from 63% of districts; 88% of cases were children less than or equal to 2 years old, and the highest attack rates were for infants 9-11 months (65/100,000) and 12-14 months (60/100,000). Most patients were either unvaccinated (45%) or inadequately vaccinated (23%). Limited quantities of OPV became available in September 1993 and were provided to infants (3 doses) and 1-year-olds (2 doses), controlling rapidly the outbreak in these age groups, but cases continued, primarily among older children, until April 1994. These findings suggest that control efforts should be guided by the age distribution of the children with poliomyelitis. C1 MINIST HLTH,TASHKENT,UZBEKISTAN. SAMARKAND MED INST,CHILDRENS INFECT DIS DEPT,SAMARKAND,UZBEKISTAN. WHO,REG OFF EUROPE,DK-2100 COPENHAGEN,DENMARK. RP Sutter, RW (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333, USA. NR 15 TC 6 Z9 6 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S82 EP S85 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000015 PM 9203697 ER PT J AU Sutter, RW Suleiman, AJM Malankar, PG Mehta, FR Medany, MA Arif, MAM Linkins, RW Pallansch, MA ElBualy, MS Robertson, SE AF Sutter, RW Suleiman, AJM Malankar, PG Mehta, FR Medany, MA Arif, MAM Linkins, RW Pallansch, MA ElBualy, MS Robertson, SE TI Sequential use of inactivated poliovirus vaccine followed by oral poliovirus vaccine in Oman SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article ID PARALYTIC POLIOMYELITIS; IMMUNIZATION; LIVE; IMMUNOGENICITY; RESPONSES AB Seroprevalence and geometric mean titers (GMTs) were compared at 6 and 10 months after vaccination with monovalent type 1 oral poliovirus vaccine (OPV) at 6 months and trivalent OPV at 7 and 9 months. Group 1 had received 4 doses of OPV, group 2 OPV at birth and 3 doses of OPV and inactivated poliovirus vaccine (IPV), and group 3 placebo at birth and 3 doses of IPV, A total of 547 infants completed the study, At 10 months, seroprevalence to poliovirus type 1 was 98%, 99%, and 98% in groups 1, 2, and 3; 100%, 100%, and 98% to poliovirus type 2; and 80%, 96%, and 91% to poliovirus type 3, Differences in seroprevalence among the groups were significant for poliovirus type 3 (P <.001), Between 6 and 10 months, significant increases in seroprevalence and GMTs occurred for poliovirus type 1 but not for types 2 and 3, Two OPV doses following 3 IPV doses did not significantly increase seroprevalence or raise GMTs for poliovirus types 2 and 3; however, significant increases were found for poliovirus type 1, which may have benefitted from monovalent type I administration. C1 CTR DIS CONTROL & PREVENT,CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,CH-1211 GENEVA,SWITZERLAND. MINIST HLTH,MUSCAT,OMAN. RP Sutter, RW (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM E34,CTR INFECT DIS,1600 CLIFTON RD NE,ATLANTA,GA 30333, USA. NR 25 TC 8 Z9 8 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S235 EP S240 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000040 PM 9203722 ER PT J AU Zhang, J Yu, JJ Linkins, RW Zhang, RZ Wang, KA Cochi, SL AF Zhang, J Yu, JJ Linkins, RW Zhang, RZ Wang, KA Cochi, SL TI Effect of target age of supplemental immunization campaigns on poliomyelitis occurrence in China SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 6th CDC-WHO Meeting on the Global Poliomyelitis Eradication Initiative CY JUL 24-26, 1995 CL ATLANTA, GA SP WHO, CDC ID ERADICATION AB The World Health Organization recommends conducting supplemental immunization activities to eradicate poliomyelitis by the year 2000. Although effective in eliminating poliomyelitis from the Americas, supplemental campaigns require substantial resources. To assess differential campaign effectiveness in eliminating this disease, poliomyelitis occurrence was compared in counties in China that targeted children <3 versus <4 years of age. Counties that targeted children <3 years of age reported poliomyelitis more frequently after the campaigns. This association was observed even after accounting for the effects of previous poliomyelitis occurrence, urban versus rural setting, and population density. While several limitations emphasize the preliminary nature of these findings, these data support targeting the widest possible age group of susceptible children to ensure maximum effectiveness in eliminating poliomyelitis. Thus, while reducing the target age of these activities may result in considerable resource savings, such campaigns may not be as effective in eliminating poliomyelitis. C1 CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,ATLANTA,GA 30333. MINIST PUBL HLTH,CHINESE ACAD PREVENT MED,BEIJING,PEOPLES R CHINA. MINIST PUBL HLTH,DIS CONTROL DEPT,EXPANDED PROGRAMME IMMUNIZAT DIV,BEIJING,PEOPLES R CHINA. NR 9 TC 3 Z9 3 U1 1 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD FEB PY 1997 VL 175 SU 1 BP S210 EP S214 PG 5 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WG180 UT WOS:A1997WG18000037 PM 9203719 ER PT J AU Kiefer, M Moss, CE AF Kiefer, M Moss, CE TI Laser generated air contaminants released during laser cutting of fabrics and polymers SO JOURNAL OF LASER APPLICATIONS LA English DT Article DE laser generated air contaminants (LGACs); laser safety; ventilation AB Environmental monitoring was conducted at an industrial facility to qualitatively identify the major contaminants generated while cutting fabrics and polymers with a 25 W CO2 continuous beam laser. Carbon monoxide, hydrogen cyanide, and particulates were also assessed, and a bulk sample of residue from the laser exhaust duct was analyzed for inorganic acids, pH, and volatile organic compounds. Samples were collected while cutting vinyl, acrylics, woven fabrics, felt, Formica(R), and Plexiglass(R). The laser parameters were standardized to allow for meaningful comparison of results for each target material. The volatile organic compound samples were collected in multibed sorbent tubes with subsequent analysis via thermal desorption and gas chromatography/mass spectroscopy. Depending on the material being cut, a wide variety of compounds were detected. The highest relative concentrations of volatile compounds were found during laser cutting of felt fabrics. The lowest concentrations and fewest number of compounds were from woven fabrics. The compounds detected included hydrochloric acid, aldehydes, benzene, vinyl chloride, various acrylates, acrylonitrile, acetonitrile, styrene, furans, phenol, and butyl cellosolve. Methyl methacrylate was a significant peak detected during the laser cutting of acrylic ester polymers, Plexiglass, and polyvinyl chloride with adhesive backing. Carbon monoxide was not detected above background (2 ppm) during any of the laser cutting trials. Hydrogen cyanide was detected during the laser cutting of felt (15 ppm) and Formica(R) (8-10 ppm). Particles greater than or equal to 0.3 mu m in diameter (mu md) generated during the laser cutting exceeded background particle levels by a factor of ten or more. Most compounds detected in the thermal desorption air samples were also detected in the bulk sample, and the residue was acidic (pH = 3). Area samples collected outside the laser enclosure suggested the local exhaust ventilation system sufficiently contained the air contaminants. RP Kiefer, M (reprint author), CTR DIS CONTROL & PREVENT,NIOSH,CINCINNATI,OH 45226, USA. NR 13 TC 2 Z9 2 U1 1 U2 6 PU LASER INST AMER PI ORLANDO PA 12424 RESEARCH PARKWAY SUITE 125, ORLANDO, FL 32826 SN 1042-346X J9 J LASER APPL JI J. Laser Appl. PD FEB PY 1997 VL 9 IS 1 BP 7 EP 13 PG 7 WC Materials Science, Multidisciplinary; Optics; Physics, Applied SC Materials Science; Optics; Physics GA WL173 UT WOS:A1997WL17300003 ER PT J AU Belliot, G Laveran, H Monroe, SS AF Belliot, G Laveran, H Monroe, SS TI Outbreak of gastroenteritis in military recruits associated with serotype 3 astrovirus infection SO JOURNAL OF MEDICAL VIROLOGY LA English DT Article DE astrovirus; RT-PCR; immune EM ID POLYMERASE CHAIN-REACTION; INFANTILE GASTROENTERITIS; STRUCTURAL PROTEIN; RNA SEQUENCE; CELL-LINE; VIRUSES; IDENTIFICATION; IMMUNOASSAY; PREVALENCE; DIARRHEA AB A serotype 3 astrovirus was identified in stool samples from an outbreak of acute gastroenteritis that occurred among military recruits in France. Sixteen stools samples and eight pairs of acute- and convalescent-phase serum were collected from affected individuals. Astrovirus was detected in two stool samples by electron microscopy and in four stool samples by reverse transcriptase-polymerase chain reaction (RT-PCR). Seroconversion to the astrovirus present in one stool was detected in seven patients by using solid-phase immune electron microscopy (SPIEM) and dot blot. For three patients, the serological results were consistent with the PCR results, indicating that astrovirus was a cause of gastroenteritis in these young adults. This study describes the characterization of the serotype 3 astrovirus associated with this outbreak. The virus has a buoyant density in cesium chloride of 1.365 gm/ml and contains two proteins immunoprecipitated with rabbit serum. Only the larger protein was recognized by immunoblotting using a convalescent-phase human serum. The protein composition of this virus differs from that reported for serotype 1 astrovirus, indicating heterogeneity in the capsid composition among astrovirus serotypes. (C) 1997 Wiley-Liss, Inc.* C1 CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. FAC MED,SERV HYG HOSP,CLERMONT FERRAN,FRANCE. OI Monroe, Stephan/0000-0002-5424-716X NR 38 TC 60 Z9 62 U1 0 U2 0 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0146-6615 J9 J MED VIROL JI J. Med. Virol. PD FEB PY 1997 VL 51 IS 2 BP 101 EP 106 DI 10.1002/(SICI)1096-9071(199702)51:2<101::AID-JMV3>3.0.CO;2-B PG 6 WC Virology SC Virology GA WF863 UT WOS:A1997WF86300003 PM 9021539 ER PT J AU Park, JY Peters, CJ Rollin, PE Ksiazek, TG Gray, B Waites, KB Stephensen, CB AF Park, JY Peters, CJ Rollin, PE Ksiazek, TG Gray, B Waites, KB Stephensen, CB TI Development of a reverse transcription-polymerase chain reaction assay for diagnosis of lymphocytic choriomeningitis virus infection and its use in a prospective surveillance study SO JOURNAL OF MEDICAL VIROLOGY LA English DT Article DE arenavirus; serum antibody; meningitis; encephalitis ID CALLITRICHID HEPATITIS; LASSA FEVER; PREVALENCE; POPULATION; ARENAVIRUS AB Lymphocytic choriomeningitis virus (LCMV), which is one of several arenaviruses that are pathogenic for humans, causes encephalitis and meningitis in man. In this study, single-stage and nested reverse transcription-polymerase chain reaction (RT-PCR) assays were developed that targeted the GPC and N genes of LCMV. Both assays detected <1 TCID50 unit of LCMV. These assays were used to measure the incidence of LCMV infection by testing cerebrospinal fluid (CSF) samples with greater than or equal to 10 leukocytes/mu l collected over 1 year from patients undergoing lumbar puncture for diagnostic reasons at two Birmingham hospitals. Samples were tested for the presence of LCMV RNA by using the RT-PCR assay and for LCMV-specific IgM antibody by using an ELISA assay. None of the specimens collected from 813 patients was positive by either assay. Although no cases of acute infection were detected, 4% (11/272) of serum collected from a subset of patients was positive for LCMV-specific IgG. A significantly greater rate of seropositivity was found among subjects over 60 years of age (9.4%; P < 0.025) than was found in younger subjects (2.4% at 30-59 years of age; 0% at <30 years of age). These data suggest that serious central nervous system disease due to LCMV infection is not common in this population. The high rate of seropositivity in those over 60 years of age suggest that infection was once more common. (C) 1997 Wiley-Liss, Inc. C1 UNIV ALABAMA,SCH PUBL HLTH,DEPT INT HLTH,BIRMINGHAM,AL 35294. CTR DIS CONTROL,DIV VIRAL & RICKETTSIAL DIS,SPECIAL PATHOGEN BRANCH,ATLANTA,GA 30333. UNIV ALABAMA,SCH MED,DEPT PEDIAT,BIRMINGHAM,AL 35294. UNIV ALABAMA,DEPT PATHOL,BIRMINGHAM,AL 35294. FU NCRR NIH HHS [P40 RR00463] NR 34 TC 29 Z9 30 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0146-6615 J9 J MED VIROL JI J. Med. Virol. PD FEB PY 1997 VL 51 IS 2 BP 107 EP 114 DI 10.1002/(SICI)1096-9071(199702)51:2<107::AID-JMV4>3.0.CO;2-B PG 8 WC Virology SC Virology GA WF863 UT WOS:A1997WF86300004 PM 9021540 ER PT J AU Croppo, GP Visvesvara, GS Leitch, GJ Wallace, S DeGroote, MA AF Croppo, GP Visvesvara, GS Leitch, GJ Wallace, S DeGroote, MA TI Western blot and immunofluorescence analysis of a human isolate of Encephalitozoon cuniculi established in culture from the urine of a patient with AIDS SO JOURNAL OF PARASITOLOGY LA English DT Article ID CROSS-REACTIVE ANTIGENS; INFECTION; HELLEM; IDENTIFICATION; ANTIBODIES; DIAGNOSIS; ELISA AB Microsporidia spores, identified as Encephalitozoon cuniculi (CDC:V282), were isolated from the urine of a patient with acquired immunodeficiency syndrome and disseminated microsporidiosis, established in continuous culture on monkey kidney cells (E6), and antiserum was produced in rabbits. Immunoblot studies that used the patient serum and the rabbit sera against CDC:V282, Encephalitozoon hellem (CDC:0291:V213), and Encephalitozoon intestinalis (CDC:V297) revealed that CDC:V282 and the rabbit isolate of E. cuniculi (ECLD) reacted intensely with the patient's serum and the rabbit anti-CDC:V282, producing a number of bands ranging from 200 to 15 kDa. By contrast, the heterologous antigens (CDC:0291:V213 and CDCV297) reacted minimally. Both CDC:V282 and ECLD isolates of E. cuniculi reacted minimally with the rabbit anti-E. hellem and the rabbit anti-E. intestinalis sera. In the immunofluorescence test, performed on the lung biopsy section of the patient, the rabbit anti-CDC:V282 serum reacted extensively with the spores in the tissue section and produced bright apple green fluorescence. These studies demonstrated that the human (CDC:282) and the rabbit (ECLD) isolates of E. cuniculi were similar in their antigenic profiles but differed considerably from E. hellem and E. intestinalis, and that the patient's serum reacted specifically, strongly, and with equal intensity, with the 2 isolates of E. cuniculi. RP Croppo, GP (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. FU NCRR NIH HHS [RR03034] NR 30 TC 17 Z9 17 U1 0 U2 3 PU AMER SOC PARASITOLOGISTS PI LAWRENCE PA 810 EAST 10TH STREET, LAWRENCE, KS 66044 SN 0022-3395 J9 J PARASITOL JI J. Parasitol. PD FEB PY 1997 VL 83 IS 1 BP 66 EP 69 DI 10.2307/3284318 PG 4 WC Parasitology SC Parasitology GA WK025 UT WOS:A1997WK02500011 PM 9057698 ER PT J AU Prince, MM Stayner, LT Smith, RJ Gilbert, SJ AF Prince, MM Stayner, LT Smith, RJ Gilbert, SJ TI A re-examination of risk estimates from the NIOSH occupational noise and hearing survey (ONHS) SO JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA LA English DT Article AB This paper describes a new analysis of data from the 1968-72 National Institute for Occupational Safety & Health (NIOSH) Occupational Noise and Hearing Survey (ONHS). The population consisted of 1172 (792 noise-exposed and 380 ''controls'') predominately white male workers from a cross section of industries within the United States. The analysis focused on how risk estimates vary according to various model assumptions, including shape of the dose-response curve and the amount of noise exposure among low-noise exposed workers (or controls). Logistic regression models were used to describe the risk of hearing handicap in relation to age, occupational noise exposure, and duration exposed. Excess risk estimates were generated for several definitions of hearing handicap. Hearing handicap is usually denoted as an average hearing threshold level (HTL) of greater than 25 dB for both ears at selected frequencies. The frequencies included in the biaural averages were (1) the articulation-weighted average over 1-4 kHz, (2) the unweighted average over 0.5, 1, and 2 kHz, and (3) the unweighted average over 1, 2, and 3 kHz. The results show that excess risk estimates for time-weighted average sound levels below 85 dB were sensitive to statistical model form and assumptions regarding the sound level to which the ''control'' group was exposed. The choice of frequencies used in the hearing handicap definition affected the magnitude of excess risk estimates, which depended on age and duration of exposure. Although data were limited below 85 dB, an age-stratified analysis provided evidence of excess risks at levels ranging from 80 to 84 dB, 85-89 dB, and 90-102 dB. Due to uncertainty in quantifying risks below 85 dB, new data collection efforts should focus on better characterization of dose-response and longitudinal hearing surveys that include workers exposed to 8-hour time-weighted noise levels below 85 dB. Results are compared to excess risk estimates generated using methods given by ANSI S3.44-1996. RP Prince, MM (reprint author), NIOSH,EDUC & INFORMAT DIV,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 29 TC 42 Z9 46 U1 0 U2 2 PU AMER INST PHYSICS PI WOODBURY PA CIRCULATION FULFILLMENT DIV, 500 SUNNYSIDE BLVD, WOODBURY, NY 11797-2999 SN 0001-4966 J9 J ACOUST SOC AM JI J. Acoust. Soc. Am. PD FEB PY 1997 VL 101 IS 2 BP 950 EP 963 DI 10.1121/1.418053 PG 14 WC Acoustics; Audiology & Speech-Language Pathology SC Acoustics; Audiology & Speech-Language Pathology GA WH323 UT WOS:A1997WH32300032 PM 9035391 ER PT J AU Noah, DL Kramer, CM Verbsky, MP Rooney, JA Smith, KA Childs, JE AF Noah, DL Kramer, CM Verbsky, MP Rooney, JA Smith, KA Childs, JE TI Survey of veterinary professionals and other veterinary conference attendees for antibodies to Bartonella henselae and B-quintana SO JOURNAL OF THE AMERICAN VETERINARY MEDICAL ASSOCIATION LA English DT Article ID CAT-SCRATCH-DISEASE; HUMAN-IMMUNODEFICIENCY-VIRUS; BACILLARY ANGIOMATOSIS; SP-NOV; CONNECTICUT; PREVALENCE; PELIOSIS; AGENT AB Objective-To determine serologic and epidemiologic characteristics of an occupational group potentially at risk for Bartonella sp infection. Design-Epidemiologic survey. Sample Population-351 veterinarians, veterinary technicians, and other individuals attending a veterinary conference in Ohio. Procedure-A serum sample was obtained from each individual and tested for antibodies to Bartonella was administered regarding demographic, occupational, and exposure information. Results-25 (7.1%) individuals were seropositive for B henselae or B quintana. Forty-seven, of whom 5 were seropositive, reported a history of illness consistent with cat-scratch disease and 18, of whom 3 were seropositive, reported a previous diagnosis of cat-scratch disease. Of the variables analyzed, only years of experience with cats was correlated with seropositivity. Clinical Implications-The overall seroprevalence for 2 species of Bartonella in this occupational group was only slightly higher than that reported from other surveys. Seroprevalences among veterinarians, veterinary technicians, hospital staff, and others were essentially identical. Small sample groups, high percentage of cat ownership among participants, unknown duration of seropositivity, and unknown prevalence of infection among cats were potential confounders. C1 CTR DIS CONTROL & PREVENT,VIRAL & RICKETTSIAL ZOONOSES BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. OHIO STATE UNIV,COLL VET MED,DEPT VET PREVENT MED,COLUMBUS,OH 43210. OHIO DEPT HLTH,COLUMBUS,OH 43266. RI Childs, James/B-4002-2012 NR 20 TC 31 Z9 32 U1 0 U2 0 PU AMER VETERINARY MEDICAL ASSOC PI SCHAUMBURG PA 1931 N MEACHAM RD SUITE 100, SCHAUMBURG, IL 60173-4360 SN 0003-1488 J9 J AM VET MED ASSOC JI J. Am. Vet. Med. Assoc. PD FEB 1 PY 1997 VL 210 IS 3 BP 342 EP 344 PG 3 WC Veterinary Sciences SC Veterinary Sciences GA WE832 UT WOS:A1997WE83200015 PM 9057914 ER PT J AU Ravkov, EV Nichol, ST Compans, RW AF Ravkov, EV Nichol, ST Compans, RW TI Polarized entry and release in epithelial cells of Black Creek Canal virus, a new world hantavirus SO JOURNAL OF VIROLOGY LA English DT Article ID PULMONARY SYNDROME; SIGMODON-HISPIDUS; INFECTION; DISEASE; LOUISIANA; ANTIBODY; ILLNESS; SITE AB Black Creek Canal (BCC) virus is a newly identified hantavirus from Florida which is carried by the cotton rat (Sigmodon hispidus) and is associated with hantavirus pulmonary syndrome (HPS). We have investigated the interaction of BCC virus with polarized epithelial cells to examine whether entry and release of this virus occur at specific plasma membrane domains. The polarized Vero C1008 monkey kidney cell line was grown on permeable filters and infected with BCC virus either through the apical or basolateral surface. As shown by indirect immunofluorescence and radioimmunoprecipitation analysis, cells infected through the apical surface demonstrated a high level of susceptibility to BCC virus infection. In contrast, Vero C1008 cells infected basolaterally exhibited a barely detectable level of BCC virus-synthesized proteins. Titration of virus from apical and basolateral media of infected cells has demonstrated that virus titers released from the apical surface are about 1,200-fold greater than the titer of virus released into the basolateral media. The site of BCC virus release from polarized cells is, therefore, different from that previously described for release of other members of the family Bunyaviridae and may reflect one of the determinants of hantavirus pathogenesis, In addition, we have shown that BCC viral glycoproteins are expressed at the plasma membrane on the apical surface of polarized cells, Electron microscopy studies of the infected cells revealed evidence of BCC virus budding at the plasma membrane. This strongly indicates that, in contrast to most other members of the Bunyaviridae, BCC virus is assembled at the plasma membrane. Since the same site of virus assembly was recently described for Sin Nombre virus, it is likely that all of the new American hantaviruses associated with HPS utilize this same type of virus maturation. C1 EMORY UNIV, SCH MED, DEPT MICROBIOL & IMMUNOL, ATLANTA, GA 30322 USA. CTR DIS CONTROL, DIV SPECIAL PATHOGENS, ATLANTA, GA 30333 USA. RI Compans, Richard/I-4087-2013 OI Compans, Richard/0000-0003-2360-335X FU NIAID NIH HHS [AI 12680] NR 31 TC 51 Z9 53 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0022-538X J9 J VIROL JI J. Virol. PD FEB PY 1997 VL 71 IS 2 BP 1147 EP 1154 PG 8 WC Virology SC Virology GA WC305 UT WOS:A1997WC30500036 PM 8995636 ER PT J AU Thompson, BL DeLeon, RP Kieke, B Velebil, P Wingo, PA AF Thompson, BL DeLeon, RP Kieke, B Velebil, P Wingo, PA TI Trends in hospitalizations for abnormal uterine bleeding in the United States: 1980-1992 SO JOURNAL OF WOMENS HEALTH LA English DT Article ID HYSTERECTOMY; MENORRHAGIA; CURETTAGE; DILATATION; HYSTEROSCOPY; ACCURACY AB We examined trends in hospital discharges, length of hospital stay, and procedures performed for abnormal uterine bleeding from 1980 through 1992. We used data from the National Hospital Discharge Survey. Discharges involving patients with reproductive tract cancers or pregnancy-related diagnoses were excluded. The overall discharge rate for abnormal uterine bleeding decreased 66% during the study period, from 56 discharges per 10,000 women in 1980 to 19 per 10,000 in 1992. The discharge rate declined significantly for hospitalizations during which hysterectomy was not performed and remained relatively stable for hospitalizations with hysterectomy. Discharge rates decreased among all age and race groups and in all geographic regions. The percentage of discharges following hysterectomy steadily increased from 25% in 1980 to 72% in 1992. The average length of stay decreased significantly only for discharges for stays during which hysterectomy was performed, from 7.6 days in 1980 to 3.7 days in 1992. During the study period, abnormal uterine bleeding contributed to more than 5 million hospitalizations, 2 million hysterectomies, and 20 million hospital days. Our findings are consistent with a decreased likelihood of hospitalization for abnormal uterine bleeding if hysterectomy was not performed and shorter hospital stays for women undergoing hysterectomy for bleeding. These findings highlight the impact of abnormal uterine bleeding on the U.S. health care system. C1 CTR DIS CONTROL & PREVENT,DIV REPROD HLTH,WOMENS HLTH & FERTIL BRANCH,FERTIL & EPIDEMIOL SECT,ATLANTA,GA. KLEMM ANAL GRP,ATLANTA,GA. NR 42 TC 8 Z9 8 U1 1 U2 2 PU MARY ANN LIEBERT INC PUBL PI LARCHMONT PA 2 MADISON AVENUE, LARCHMONT, NY 10538 SN 1059-7115 J9 J WOMENS HEALTH JI J. Womens Health PD FEB PY 1997 VL 6 IS 1 BP 73 EP 81 DI 10.1089/jwh.1997.6.73 PG 9 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 XF110 UT WOS:A1997XF11000017 PM 9065376 ER PT J AU Newman, MJ Todd, CW Lee, EM Balusubramanian, M Didier, PJ Katz, JM AF Newman, MJ Todd, CW Lee, EM Balusubramanian, M Didier, PJ Katz, JM TI Increasing the immunogenicity of a trivalent influenza virus vaccine with adjuvant-active nonionic block copolymers for potential use in the elderly SO MECHANISMS OF AGEING AND DEVELOPMENT LA English DT Article; Proceedings Paper CT First International Conference on Immunology and Aging CY JUN 16-19, 1996 CL INST ADVANCED STUD IMMUNOL AGING, WA HO INST ADVANCED STUD IMMUNOL AGING DE influenza vaccine; adjuvant; nonionic block copolymer ID ANTIBODY-RESPONSES; ENHANCEMENT; ADULTS; MEMORY; SERUM; AGE AB High molecular weight nonionic block copolymers consisting of a large hydrophobic core made from repeat oxypropylene units and smaller hydrophilic blocks of oxyethylene repeat units were evaluated as adjuvants in experimental influenza virus vaccine formulations. The goal was to identify a copolymer that would increase the immunogenicity of the commercial Fluogen trivalent influenza virus vaccine. Vaccine experiments done using BALB/c mice provided data that allowed us to identify a copolymer that increased both antibody titers specific for total virus proteins as well as antibodies with hemagglutination inhibition (HAI) activity. This copolymer, termed CRL1005, increased the production of IgG(1), IgG(2a) and IgG(2b) which suggested it increased the activity of both Type-1 and Type-2 T-helper lymphocytes. The CRL1005 copolymer was tested further in rhesus monkeys with similar results. Levels of antibodies specific for total virus protein preparations were increased as were HAI antibody titers following vaccination with the copolymer-supplemented Fluogen vaccine. Thus, the CRL1005 copolymer adjuvant appears to be compatible for use with the current generation of inactivated viron-based influenza vaccines and useful for increasing the immunogenicity. A more potent influenza virus vaccine could well be mole efficacious in the aged segment of our population than current vaccines. (C) 1997 Elsevier Science Ireland Ltd. C1 CYTRX CORP,NORCROSS,GA 30092. TULANE UNIV,DELTA REG PRIMATE RES CTR,COVINGTON,LA 70433. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. RP Newman, MJ (reprint author), VAXCEL INC,154 TECHNOL PKWY,NORCROSS,GA 30092, USA. NR 33 TC 23 Z9 25 U1 0 U2 0 PU ELSEVIER SCI IRELAND LTD PI CLARE PA CUSTOMER RELATIONS MANAGER, BAY 15, SHANNON INDUSTRIAL ESTATE CO, CLARE, IRELAND SN 0047-6374 J9 MECH AGEING DEV JI Mech. Ageing. Dev. PD FEB PY 1997 VL 93 IS 1-3 BP 189 EP 203 DI 10.1016/S0047-6374(96)01811-8 PG 15 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA WM993 UT WOS:A1997WM99300020 PM 9089583 ER PT J AU Williams, RJ Cox, NJ Regnery, HL Noah, DL Khan, AS Miller, JM Copley, GB Ice, JS Wright, JA AF Williams, RJ Cox, NJ Regnery, HL Noah, DL Khan, AS Miller, JM Copley, GB Ice, JS Wright, JA TI Meeting the challenge of emerging pathogens: The role of the United States Air Force in global influenza surveillance SO MILITARY MEDICINE LA English DT Article AB Influenza virus is one of the most ubiquitous organisms on the planet, causing illness in much of the population each year. The dynamic nature of the influenza virus requires similarly dynamic surveillance and prevention initiatives. The efforts of national surveillance programs, overseen by the World Health Organization and administered by institutions such as the U.S. Centers for Disease Control and Prevention, the U.S. armed forces, and 60 to 70 collaborating laboratories, annually culminate in the development of effective influenza vaccines. The U.S. Air Force's contribution is via Project Gargle, through which bases in various locations worldwide conduct active surveillance and submit throat swab specimens for virus isolation and characterization; the results of these laboratory analyses help determine the composition of the following year's influenza vaccine, These collaborative efforts have resulted in an identical or close antigenic match between vaccine and epidemic strains in 8 of the last 9 influenza seasons. RP Williams, RJ (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,SPECIAL PATHOGENS BRANCH,1600 CLIFTON RD NE,ATLANTA,GA 30329, USA. NR 10 TC 16 Z9 16 U1 0 U2 0 PU ASSN MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 SN 0026-4075 J9 MIL MED JI Milit. Med. PD FEB PY 1997 VL 162 IS 2 BP 82 EP 86 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WG392 UT WOS:A1997WG39200006 PM 9038023 ER PT J AU Duerr, A Warren, D Smith, D Nagachinta, T AF Duerr, A Warren, D Smith, D Nagachinta, T TI Contraceptives and HIV transmission SO NATURE MEDICINE LA English DT Letter C1 USAID, CONRAD PROGRAM, ATLANTA, GA USA. RP Duerr, A (reprint author), CTR DIS CONTROL & PREVENT, ATLANTA, GA 30341 USA. NR 0 TC 6 Z9 6 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1078-8956 EI 1546-170X J9 NAT MED JI Nat. Med. PD FEB PY 1997 VL 3 IS 2 BP 124 EP 124 DI 10.1038/nm0297-124a PG 1 WC Biochemistry & Molecular Biology; Cell Biology; Medicine, Research & Experimental SC Biochemistry & Molecular Biology; Cell Biology; Research & Experimental Medicine GA WF088 UT WOS:A1997WF08800002 PM 9018220 ER PT J AU Murphy, EL Fridey, J Smith, JW Engstrom, J Sacher, RA Miller, K Gibble, J Stevens, J Thomson, R Hansma, D Kaplan, J Khabbaz, R Nemo, G Williams, AE Nass, C Jackson, CM Ownby, H Kleinman, S Hutching, S Busch, MP Evans, C Gilcher, RO Schreiber, GB Sacher, R Luban, N Hollingsworth, CG Nemo, GJ AF Murphy, EL Fridey, J Smith, JW Engstrom, J Sacher, RA Miller, K Gibble, J Stevens, J Thomson, R Hansma, D Kaplan, J Khabbaz, R Nemo, G Williams, AE Nass, C Jackson, CM Ownby, H Kleinman, S Hutching, S Busch, MP Evans, C Gilcher, RO Schreiber, GB Sacher, R Luban, N Hollingsworth, CG Nemo, GJ TI HTLV-associated myelopathy in a cohort of HTLV-I and HTLV-II-infected blood donors SO NEUROLOGY LA English DT Article ID VIRUS TYPE-I; TROPICAL SPASTIC PARAPARESIS; CHRONIC PROGRESSIVE MYELOPATHY; UNITED-STATES; DRUG-ABUSERS; ANTIBODIES; RISK; TRANSFUSION; ZAIRE; FLUID AB Objective: HTLV-I-associated myelopathy (HAM) is a slowly progressive spastic paraparesis caused by infection with human T-lymphotropic virus type I (HTLV-I). The prevalence of HAM among those infected with HTLV-I is poorly defined, and the association of a similar myelopathy with HTLV-II infection has not been confirmed. Design: Cross-sectional examination of HTLV-I, HTLV-II, and control subjects from the baseline visit of a cohort study. Setting/subjects: Persons testing HTLV seropositive at the time of blood donation at five U.S. blood centers, their seropositive sex partners, and a matched control group of HTLV seronegative blood donors. Measurements: HTLV-I and HTLV-II were differentiated by serology and/or polymerase chain reaction. All subjects received systematic neurologic screening examinations. Results: A diagnosis of myelopathy was confirmed in four of 166 HTLV-I subjects (2.4%, 95% confidence interval 0.7%, 6.1%) and in one of 404 HTLV-II subjects (0.25%, 95% confidence interval 0.0%, 0.6%). None of the 798 controls had a similar myelopathy, although one had longstanding typical multiple sclerosis. Conclusions: Our data also suggest that HAM occurs more frequently among HTLV-I-infected subjects than reported by previous studies, The HTLV-II infected myelopathy patient identified in this cohort, together with three other case reports in the literature, implies a pathogenic role for this human retrovirus. The diagnosis of HTLV-associated myelopathy should be considered in cases of spastic paraparesis or neurogenic bladder when risk factors for HTLV-I or HTLV-II infection are present. C1 BLOOD BANK,SAN BERNARDINO,CA. BLOOD BANK,RIVERSIDE,CA. OKLAHOMA BLOOD INST,OKLAHOMA CITY,OK. GEORGETOWN UNIV,SCH MED,WASHINGTON,DC. WESTAT CORP,ROCKVILLE,MD. AMER RED CROSS CHESAPEAKE & POTOMAC REG,BALTIMORE,MD. AMER RED CROSS SE MICHIGAN,DETROIT,MI. CTR DIS CONTROL & PREVENT,ATLANTA,GA. UNIV CALIF LOS ANGELES,MED CTR,LOS ANGELES,CA 90024. UNIV CALIF SAN FRANCISCO,IRWIN MEM BLOOD CTR,SAN FRANCISCO,CA 94143. NHLBI,NIH,BETHESDA,MD. RP Murphy, EL (reprint author), UNIV CALIF SAN FRANCISCO,DEPT LAB MED,BOX 0884,SAN FRANCISCO,CA 94143, USA. FU NHLBI NIH HHS [N01-HB-97077, N01-HB-97078, N01-HB-97079] NR 36 TC 89 Z9 93 U1 0 U2 1 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0028-3878 J9 NEUROLOGY JI Neurology PD FEB PY 1997 VL 48 IS 2 BP 315 EP 320 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA WH535 UT WOS:A1997WH53500004 PM 9040713 ER PT J AU Taylor, D Chavez, G Chabra, A Boggess, J AF Taylor, D Chavez, G Chabra, A Boggess, J TI Risk factors for adult paternity in births to adolescents SO OBSTETRICS AND GYNECOLOGY LA English DT Article ID FATHERS; PREGNANCY; INFANTS; MOTHERS AB Objective: To examine the risk factors for adult (aged 20 years and older) paternity in births to teenagers (14-17 years of age). Methods: This was a population-based, retrospective cohort analysis of 27,215 adolescent mothers residing in California who had a live singleton birth during 1993. Adjusted risks for adult paternity by paternal and maternal characteristics were derived from comparisons of adult-teen and teen-teen couples. Results: Adult fathers, who were responsible for 49.2% of births to teenage mothers, were a mean of 6.4 years older than the mother. The most important risk factors for adult paternity were as follows: father's (odds ratio [OR] 5.19; 95% confidence interval [CI] 4.43, 6.08) or mother's (OR 1.33; 95% CI 1.14, 1.55) educational attainment of at least 3 years lower than expected for their age, two or more previous live births (OR 3.34; 95% CI 2.48, 4.53), mother's birthplace outside the United States (OR 2.33; 95% CI 2.11, 2.58), father's (OR 2.16; 95% CI 1.98, 2.36) br mother's (OR 1.28; 95% CI 1.15, 1.42) educational attainment 1-2 years lower than expected for their age, one previous live birth (OR 1.92; 95% CI 1.75, 2.12), and Asian (OR 1.29; 95% CI 1.04, 1.62) or African American race (OR 1.25; 95% CI 1.06, 1.46) of the father. Conclusions: Teenage pregnancy prevention programs must address adult paternity, which contributed to almost half of the births in our study. These programs should consider education adequacy, cultural beliefs and practices, previous live births, and race and ethnicity when designing programs to decrease the number of adults involved in teenage births. Copyright (C) 1997 by The American College of Obstetricians and Gynecologists. C1 CALIF DEPT HLTH SERV,MATERNAL & CHILD HLTH BRANCH,SACRAMENTO,CA. CALIF DEPT HLTH SERV,OFF FAMILY PLANNING,SACRAMENTO,CA. CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV REPROD HLTH,ATLANTA,GA. NR 14 TC 17 Z9 17 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 0029-7844 J9 OBSTET GYNECOL JI Obstet. Gynecol. PD FEB PY 1997 VL 89 IS 2 BP 199 EP 205 DI 10.1016/S0029-7844(96)00481-4 PG 7 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WE576 UT WOS:A1997WE57600008 PM 9015020 ER PT J AU McJunkin, JE Khan, R delosReyes, EC Parsons, DL Minnich, LL Ashley, RG Tsai, TF AF McJunkin, JE Khan, R delosReyes, EC Parsons, DL Minnich, LL Ashley, RG Tsai, TF TI Treatment of severe La Crosse encephalitis with intravenous ribavirin following diagnosis by brain biopsy SO PEDIATRICS LA English DT Article ID VIRUS-INFECTION; THERAPY; FEVER; INHIBITION C1 WOMENS & CHILDRENS HOSP,CHARLESTON AREA MED CTR,CHARLESTON,WV 25304. CTR DIS CONTROL & PREVENT,FT COLLINS,CO 80521. RP McJunkin, JE (reprint author), ROBERT C BYRD HLTH SCI CTR,W VIRGINIA CHARLESTON DIV,830 PENNSYLVANIA AVE,SUITE 104,CHARLESTON,WV 25302, USA. NR 31 TC 43 Z9 44 U1 0 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD FEB PY 1997 VL 99 IS 2 BP 261 EP 267 DI 10.1542/peds.99.2.261 PG 7 WC Pediatrics SC Pediatrics GA WE302 UT WOS:A1997WE30200025 PM 9024460 ER PT J AU Berlin, CM McCarver, DG Notterman, DA Ward, RM Weismann, DN Wilson, GS Wilson, JT Bennett, DR Mulinare, J Hoskins, IA Kaufman, P Rieder, MJ Troendle, G Yaffe, SJ Cote, CJ Szefler, SJ Smolinske, SC AF Berlin, CM McCarver, DG Notterman, DA Ward, RM Weismann, DN Wilson, GS Wilson, JT Bennett, DR Mulinare, J Hoskins, IA Kaufman, P Rieder, MJ Troendle, G Yaffe, SJ Cote, CJ Szefler, SJ Smolinske, SC TI ''Inactive'' ingredients in pharmaceutical products: Update (subject review) SO PEDIATRICS LA English DT Review ID BIRTH-WEIGHT INFANTS; INDUCED HISTAMINE-RELEASE; BENZYL ALCOHOL TOXICITY; PROPYLENE-GLYCOL; BENZALKONIUM CHLORIDE; DOUBLE-BLIND; ADVERSE REACTIONS; CHILDHOOD ASTHMA; DRUG ADDITIVES; INTRAVENTRICULAR HEMORRHAGE AB Because of an increasing number of reports of adverse reactions associated with pharmaceutical excipients, in 1985 the Committee on Drugs issued a position statement(1) recommending that the Food and Drug Administration mandate labeling of over-the-counter and prescription formulations to include a qualitative list of inactive ingredients. However, labeling of inactive ingredients remains voluntary. Adverse reactions continue to be reported, although some are no longer considered clinically significant, and other new reactions have emerged. The original statement, therefore, has been updated and its information expanded. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. US FDA,ROCKVILLE,MD 20857. NIH,BETHESDA,MD 20892. RP Berlin, CM (reprint author), AMER MED ASSOC,US PHARMACOPEIA,515 N STATE ST,CHICAGO,IL 60610, USA. NR 187 TC 82 Z9 84 U1 2 U2 8 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD FEB PY 1997 VL 99 IS 2 BP 268 EP 278 PG 11 WC Pediatrics SC Pediatrics GA WE302 UT WOS:A1997WE30200026 ER PT J AU Halsey, NA Chesney, PJ Gerber, MA Gromisch, DS Kohl, S Marcy, SM Marks, MI Murray, DL Overall, JC Pickering, LK Whitley, RJ Yogev, R Peter, G Hall, CB Hadler, S Breiman, R Hardegree, MC Jacobs, RF MacDonald, NE Orenstein, WA Rabinovich, NR Schwartz, B AF Halsey, NA Chesney, PJ Gerber, MA Gromisch, DS Kohl, S Marcy, SM Marks, MI Murray, DL Overall, JC Pickering, LK Whitley, RJ Yogev, R Peter, G Hall, CB Hadler, S Breiman, R Hardegree, MC Jacobs, RF MacDonald, NE Orenstein, WA Rabinovich, NR Schwartz, B TI Acellular pertussis vaccine: Recommendations for use as the initial series in infants and children SO PEDIATRICS LA English DT Article ID EFFICACY; TETANUS; TRIAL AB In 1991 and 1992, the US Food and Drug Administration approved two acellular pertussis vaccines combined with diphtheria and tetanus toxoids for use as the fourth and fifth doses after the initial three-dose primary series with the standard whole-cell pertussis vaccine administered at 2, 4, and 6 months of age. Recently completed trials of acellular pertussis vaccines conducted in Europe have documented the efficacy of these vaccines when administered as a primary series in infancy. Based on these studies, two acellular pertussis vaccines, Tripedia (Connaught Laboratories, Swiftwater, PA) and ACEL-IMUNE (Wyeth-Lederle Laboratories, Pearl River, NY), were licensed by the Food and Drug Administration for the initial three-dose series. Additional acellular pertussis vaccines are likely to be licensed for use in infants in the future. The recommendations in this statement supplement previous American Academy of Pediatrics guidelines for the use of acellular pertussis vaccines.(1-4) C1 US FDA,ROCKVILLE,MD 20857. NIH,BETHESDA,MD 20892. RP Halsey, NA (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 22 TC 20 Z9 21 U1 0 U2 0 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD FEB PY 1997 VL 99 IS 2 BP 282 EP 288 PG 7 WC Pediatrics SC Pediatrics GA WE302 UT WOS:A1997WE30200028 ER PT J AU Halsey, NA Chesney, PJ Gerber, MA Gromisch, DS Kohl, S Marcy, SM Marks, MI Murray, DL Overall, JC Pickering, LK Whitley, RJ Yogev, R Peter, G Hall, CB Breiman, R Hadler, SC Hardegree, MC Jacobs, RF MacDonald, NE Orenstein, WA Rabinovich, NR Schwartz, B McCracken, GH Kaplan, SL Jorgensen, JH AF Halsey, NA Chesney, PJ Gerber, MA Gromisch, DS Kohl, S Marcy, SM Marks, MI Murray, DL Overall, JC Pickering, LK Whitley, RJ Yogev, R Peter, G Hall, CB Breiman, R Hadler, SC Hardegree, MC Jacobs, RF MacDonald, NE Orenstein, WA Rabinovich, NR Schwartz, B McCracken, GH Kaplan, SL Jorgensen, JH TI Therapy for children with invasive pneumococcal infections SO PEDIATRICS LA English DT Article ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; BETA-LACTAM ANTIBIOTICS; EXPERIMENTAL PENICILLIN-RESISTANT; HIGH-LEVEL PENICILLIN; SICKLE-CELL DISEASE; BACTERIAL-MENINGITIS; CEREBROSPINAL-FLUID; UNITED-STATES; ANTIMICROBIAL RESISTANCE; HAEMOPHILUS-INFLUENZAE AB This statement provides guidelines for therapy of children with serious infections possibly caused by Streptococcus pneumoniae. Resistance of invasive pneumococcal strains to penicillin, cefotaxime, and ceftriaxone has increased over the past few years. Reports of failures of cefotaxime or ceftriaxone in the treatment of children with meningitis caused by resistant S pneumoniae necessitates a revision of Academy recommendations. For nonmeningeal infections, modifications of the initial therapy need to be considered only for patients who are critically ill and those who have a severe underlying or potentially immunocompromising condition or patients from whom a highly resistant strain is isolated. Because vancomycin is the only antibiotic to which all S pneumoniae strains are susceptible, its use should be restricted to minimize the emergence of vancomycin-resistant organisms. Patients with probable aseptic (viral) meningitis should not be treated with vancomycin. These recommendations are subject to change as new information becomes available. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. US FDA,ROCKVILLE,MD 20857. NIH,BETHESDA,MD 20892. NR 82 TC 115 Z9 121 U1 1 U2 1 PU AMER ACAD PEDIATRICS PI ELK GROVE VILLAGE PA 141 NORTH-WEST POINT BLVD, ELK GROVE VILLAGE, IL 60007-1098 SN 0031-4005 J9 PEDIATRICS JI Pediatrics PD FEB PY 1997 VL 99 IS 2 BP 289 EP 299 PG 11 WC Pediatrics SC Pediatrics GA WE302 UT WOS:A1997WE30200029 ER PT J AU Lubin, JH Tomasek, L Edling, C Hornung, RW Howe, G Kunz, E Kusiak, RA Morrison, HI Radford, EP Samet, JM Tirmarche, M Woodward, A Yao, SX AF Lubin, JH Tomasek, L Edling, C Hornung, RW Howe, G Kunz, E Kusiak, RA Morrison, HI Radford, EP Samet, JM Tirmarche, M Woodward, A Yao, SX TI Estimating lung cancer mortality from residential radon using data for low exposures of miners SO RADIATION RESEARCH LA English DT Article ID URANIUM MINERS; DOSE-RATE; ONCOGENIC TRANSFORMATION; DAUGHTER EXPOSURES; COHORT; PROGENY; WORKERS; RISK; DEPENDENCE; NEUTRONS AB Some recent estimates of lung cancer risk from exposure to radon progeny in homes have been based on models developed from a pooled analysis of 11 cohorts of underground miners exposed to radon. While some miners were exposed to over 10,000 working level months (WLM), mean exposure among exposed miners was 162 WLM, about 10 times the exposure from lifetime residence in an average house and about three times the exposure from lifetime residence at the ''action level'' suggested by the U.S. Environmental Protection Agency. The extrapolation of lung cancer risk from the higher exposures in the miners to the generally lower exposures in the home is a substantial source of uncertainty in the assessment of the risk of indoor radon. Using the pooled data for the miners, analyses of lung cancer risk were carried out on data restricted to lower exposures, either <50 WLM or <100 WLM. In the pooled data, there were 115 lung cancer cases among workers with no occupational WLM exposure and 2,674 among exposed miners, with 353 and 562 lung cancer cases in miners with <50 WLM and <100 WLM, respectively. Relative risks (RRs) for categories of WLM based on deciles exhibited a statistically significant increasing trend with exposure in each of the restricted data sets. In the restricted data, there was little evidence of departures from a linear excess relative risk model in cumulative exposure, although power to assess alternative exposure-response trends was limited. The general patterns of declining excess RR per WLM with attained age, time since exposure and exposure rate seen in the unrestricted data were similar to the patterns found in the restricted data. Risk models based on the unrestricted data for miners provided an excellent fit to the restricted data, suggesting substantial internal validity in the projection of risk from miners with high exposures to those with low exposures. Estimates of attributable risk for lung cancer (10-14%) in the U.S. from residential radon based on models from the unrestricted data were similar to estimates based on the data for miners receiving low exposures. (C) 1997 by Radiation Research Society. C1 NATL RADIAT PROTECT INST,PRAGUE 100000,CZECH REPUBLIC. UPPSALA UNIV,DEPT OCCUPAT MED,UPPSALA,SWEDEN. NIOSH,CINCINNATI,OH 45226. COLUMBIA UNIV,SCH PUBL HLTH,DIV EPIDEMIOL,NEW YORK,NY 10032. MINIST LABOR,HLTH & SAFETY STUDIES UNIT,OCCUPAT HLTH BRANCH,TORONTO,ON M7A 1T7,CANADA. HLTH CANADA,CANC BUR,OTTAWA,ON K1A 0L2,CANADA. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,DEPT EPIDEMIOL,BALTIMORE,MD 21205. INST PROTECT & NUCL SAFETY,HUMAN HLTH PROTECT & DOSIMETRY DEPT,F-92265 FONTENAY ROSES,FRANCE. WELLINGTON SCH MED,DEPT PUBL HLTH,WELLINGTON,NEW ZEALAND. CHINA NATL NONFERROUS MET IND CORP,YUNNAN TIN CORP,INST LABOR PROTECT,GEJIU,YUNNAN,PEOPLES R CHINA. RP Lubin, JH (reprint author), NCI,BIOSTAT BRANCH,EPIDEMIOL & BIOSTAT PROGRAM,6130 EXECUT BLVD,EPN-403,BETHESDA,MD 20892, USA. OI Woodward, Alistair/0000-0001-5425-6018 NR 34 TC 66 Z9 76 U1 1 U2 3 PU RADIATION RESEARCH SOC PI OAK BROOK PA 2021 SPRING RD, STE 600, OAK BROOK, IL 60521 SN 0033-7587 J9 RADIAT RES JI Radiat. Res. PD FEB PY 1997 VL 147 IS 2 BP 126 EP 134 DI 10.2307/3579412 PG 9 WC Biology; Biophysics; Radiology, Nuclear Medicine & Medical Imaging SC Life Sciences & Biomedicine - Other Topics; Biophysics; Radiology, Nuclear Medicine & Medical Imaging GA WE917 UT WOS:A1997WE91700002 PM 9008203 ER PT J AU Gunn, RA Veinbergs, E Friedman, LS AF Gunn, RA Veinbergs, E Friedman, LS TI Adolescent health care providers - Establishing a dialogue and assessing sexually transmitted disease prevention practices SO SEXUALLY TRANSMITTED DISEASES LA English DT Article ID CHAIN-REACTION; DIAGNOSIS C1 UNIV CALIF SAN DIEGO,SCH MED,DEPT PEDIAT,DIV ADOLESCENT MED,SAN DIEGO,CA 92103. DEPT HLTH SERV,COMMUNITY HLTH SERV,DIV COMMUNITY DIS CONTROL,SAN DIEGO,CA. RP Gunn, RA (reprint author), CTR DIS CONTROL & PREVENT,MPH,DIV STD PREVENT,INFORMAT SERV OFF,NATL CTR HIV,STD,ATLANTA,GA 30333, USA. NR 7 TC 13 Z9 13 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 0148-5717 J9 SEX TRANSM DIS JI Sex. Transm. Dis. PD FEB PY 1997 VL 24 IS 2 BP 90 EP 93 DI 10.1097/00007435-199702000-00006 PG 4 WC Infectious Diseases SC Infectious Diseases GA WG447 UT WOS:A1997WG44700006 PM 9111754 ER PT J AU Song, RG Shulman, SA AF Song, RG Shulman, SA TI Variance components in the two-way nested model with incomplete nesting information SO TECHNOMETRICS LA English DT Article DE missing nesting information; prespecified weights; unbiased estimators AB When part of the nesting information in a two-way nested model is missing, there has been no way to use all of the data in the analysis of variance components. Discarding the data with missing nesting information loses useful information, and in some circumstances, this approach cannot separate variance components from one another. To make use of the data with missing nesting information, computable sums of squares for the data with missing nesting information can be linearly combined with sums of squares for the data with complete nesting information. Prespecified weights are needed for the combination. Different estimates are obtained by using different weights. Because all of these estimators are unbiased, variances and covariances of these estimators are derived and used to compare these estimators. In addition, a simulation study is conducted to provide evidence for the reliability of the variances and covariances formulas. Finally, as an application, the proposed methods are applied to the analysis of a proficiency testing program. C1 NIOSH,US DEPT HLTH & HUMAN SERV,PUBL HLTH SERV,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226. RP Song, RG (reprint author), NIOSH,COMP SCI CORP,CINCINNATI,OH 45226, USA. NR 6 TC 0 Z9 0 U1 0 U2 0 PU AMER STATISTICAL ASSOC PI ALEXANDRIA PA 1429 DUKE ST, ALEXANDRIA, VA 22314 SN 0040-1706 J9 TECHNOMETRICS JI Technometrics PD FEB PY 1997 VL 39 IS 1 BP 71 EP 80 PG 10 WC Statistics & Probability SC Mathematics GA WE555 UT WOS:A1997WE55500012 ER PT J AU Cornel, MC Erickson, JD AF Cornel, MC Erickson, JD TI Comparison of national policies on periconceptional use of folic acid to prevent spina bifida and anencephaly (SBA) SO TERATOLOGY LA English DT Article C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. INT CLEARINGHOUSE BIRTH DEFECTS MONITORING SYST,ROME,ITALY. UNIV GRONINGEN,DEPT MED GENET,NL-9713 AW GRONINGEN,NETHERLANDS. NR 18 TC 54 Z9 58 U1 0 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0040-3709 J9 TERATOLOGY JI Teratology PD FEB PY 1997 VL 55 IS 2 BP 134 EP 137 PG 4 WC Developmental Biology; Toxicology SC Developmental Biology; Toxicology GA WW965 UT WOS:A1997WW96500003 PM 9143094 ER PT J AU Lipscomb, JC Garret, CM Snawder, JE AF Lipscomb, JC Garret, CM Snawder, JE TI Cytochrome p450-dependent metabolism of trichloroethylene: Interindividual differences in humans SO TOXICOLOGY AND APPLIED PHARMACOLOGY LA English DT Article ID HUMAN LIVER; DICHLOROACETIC ACID; PEROXISOME PROLIFERATION; TRICHLOROACETIC-ACID; RAT-LIVER; ETHANOL; HEPATOTOXICITY; ENHANCEMENT; MICROSOMES; BENZENE AB Trichloroethylene (TRI) is an industrial solvent with a history of use in anesthesia, and is a common groundwater contaminant. Cytochrome P450 (CYP)-dependent metabolism of TRI produces chloral hydrate (CH) and is rate limiting in the ultimate production of trichloro- and/or dichloroacetic acid from TRI. Exposure of rodents to TRI results in lung and liver tumors (mice) and nephrotoxicity (rats). The toxicity is exacerbated by pretreatment of mice with CYP inducers. We report significant variability in TRI metabolism in a sample of 23 human hepatic microsomal samples and demonstrate the dependence of TRI metabolism on CYP2E1. K-m values in this limited sample population are not normally distributed, We have correlated microsomal CH formation with the activity toward routine CYP2E1 substrates and with immunologically detectable CYP2E1 protein. Further, TRI metabolism in microsomes from lymphoblastoid cell lines expressing CYP2E1, CYP1A1, CYP1A2, or CYP3A4 indicated minimal involvement of the latter forms, with CYP2E1 catalyzing more than 60% of total microsomal TRI metabolism, These results indicate that humans are not uniform in their capacity for CYP-dependent metabolism of TRI and increased CYP2E1 activity may increase susceptibility to TRI-induced toxicity in the human. (C) 1997 Academic Press. C1 GEOCENTERS INC,WRIGHT PATTERSON AFB,OH 45433. NIOSH,TAFT LAB,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226. RP Lipscomb, JC (reprint author), USAF,ARMSTRONG LAB,OL,HSC,AFMC,OET,TOXICOL DIV,OCCUPAT & ENVIRONM HLTH DIRECTORATE,2856 G ST,WRIGHT PATTERSON AFB,OH 45433, USA. NR 39 TC 60 Z9 60 U1 0 U2 2 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0041-008X J9 TOXICOL APPL PHARM JI Toxicol. Appl. Pharmacol. PD FEB PY 1997 VL 142 IS 2 BP 311 EP 318 DI 10.1006/taap.1996.8040 PG 8 WC Pharmacology & Pharmacy; Toxicology SC Pharmacology & Pharmacy; Toxicology GA WK174 UT WOS:A1997WK17400012 PM 9070354 ER PT J AU Shoji, M Abe, K Nawroth, PP Rickles, FR AF Shoji, M Abe, K Nawroth, PP Rickles, FR TI Molecular mechanisms linking thrombosis and angiogenesis in cancer SO TRENDS IN CARDIOVASCULAR MEDICINE LA English DT Article ID ENDOTHELIAL GROWTH-FACTOR; FACTOR GENE-EXPRESSION; PROTEIN-KINASE-C; TISSUE FACTOR GENE; VASCULAR-PERMEABILITY FACTOR; TYROSINE PHOSPHORYLATION; TRANSCRIPTION FACTOR; LIPOPOLYSACCHARIDE INDUCTION; C-REL/P65 HETERODIMERS; TUMOR ANGIOGENESIS AB In this brief review, the authors concentrate on selected issues related to the newly described role of tissue factor (TF), the major activator of mammalian blood coagulation, as a regulator of angiogenesis and of tumor growth and metastasis. Previously, TF had been considered strictly as the primary activator of the coagulation cascade; however, it has recently been demonstrated that overexpression of the TF gene in murine tumor cells leads to increased transcription of the gene for vascular permeability factor/vascular endothelial growth factor (VEGF), a proangiogenic factor and decreased transcription of the gene for thrombospondin (TSP), an antiangiogenic factor Conversely, underexpression of TF leads to decreased VEGF and increased TSP transcription. When grown in mice and compared With low TF-producing tumor cells, high TF-producing tumor cells stimulate angiogenesis by approximately twofold. This effect of TF appears to be independent of its clot-promoting procoagulant activity (PCA) and suggests that TF regulates the angiogenic properties of tumor cells by altering the production of growth regulatory molecules (for example, VEGF) that can act on vascular endothelial cells (VECs). There is substantial preliminary evidence that the regulation of tumor angiogenesis can be mediated by TF via both fibrin clotting-dependent and fibrin clotting-independent mechanisms. (C) 1997, Elsevier Science Ltd. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. UNIV HEIDELBERG,MED KLIN 1,HEIDELBERG,GERMANY. RP Shoji, M (reprint author), EMORY UNIV,SCH MED,DEPT MED,ATLANTA,GA 30333, USA. NR 96 TC 46 Z9 47 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1050-1738 J9 TRENDS CARDIOVAS MED JI Trends Cardiovasc. Med. PD FEB PY 1997 VL 7 IS 2 BP 52 EP 59 DI 10.1016/S1050-1738(96)00142-9 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA WN572 UT WOS:A1997WN57200003 PM 21235864 ER PT J AU Simasathien, S Migasena, S Bellini, W Samakoses, R Pitisuttitham, P Bupodom, W Heath, J Anderson, L Bennett, J AF Simasathien, S Migasena, S Bellini, W Samakoses, R Pitisuttitham, P Bupodom, W Heath, J Anderson, L Bennett, J TI Measles vaccination of Thai infants by intranasal and subcutaneous routes: Possible interference from respiratory infections SO VACCINE LA English DT Article DE measles; vaccine; intranasal ID EDMONSTON-ZAGREB; SUCCESSFUL IMMUNIZATION; ENZYME IMMUNOASSAYS; 6-MONTH-OLD INFANTS; MATERNAL ANTIBODY; IMMUNOGENICITY; CHILDREN; VACCINES; VIRUS; MORTALITY AB Reactogenicity and seroresponses were studied after standard doses of Edmonston-Zagreb measles vaccine were given intranasally (in.) and subcutaneously (s.c.) to 6-month-old Thai children, Few children given i.n. vaccine (2/31), but most (13/21) given s.c. vaccine, seroconverted. All but 1 of 51 children were seropositive after receiving vaccine s.c. at 9 months-of-age. Upper respiratory infection (URI) outbreaks with onsets in the week following vaccination occurred after each vaccination session and were equally common in all groups URIs following i.n. vaccination at 6 months may have adversely affected response to i.n. vaccine, while URIs after s.c. vaccination at 9 months adversely affected final geometric mean antibody titers. I.n. measles vaccination does not appear to be an acceptable route for routine vaccination. (C) 1997 Elsevier Science Ltd. C1 MAHIDOL UNIV,VACCINE TRIAL CTR,BANGKOK 10700,THAILAND. CDC,NCID,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333. EMORY UNIV,CARTER CTR,TASK FORCE CHILD SURVIVAL & DEV,ATLANTA,GA 30322. RP Simasathien, S (reprint author), PRAMONGKUTKLAO HOSP,BANGKOK,THAILAND. NR 34 TC 9 Z9 10 U1 1 U2 1 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD, OXON, ENGLAND OX5 1GB SN 0264-410X J9 VACCINE JI Vaccine PD FEB PY 1997 VL 15 IS 3 BP 329 EP 334 DI 10.1016/S0264-410X(97)00104-7 PG 6 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA WM344 UT WOS:A1997WM34400015 PM 9139495 ER PT J AU Preziosi, MP Yam, A Ndiaye, M Simaga, A Simondon, F Wassilak, SGF AF Preziosi, MP Yam, A Ndiaye, M Simaga, A Simondon, F Wassilak, SGF TI Practical experiences in obtaining informed consent for a vaccine trial in rural Africa SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID ETHICS C1 INST FRANCAIS RECH SCI DEV & COOPERAT,DAKAR,SENEGAL. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. NR 21 TC 53 Z9 54 U1 0 U2 3 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JAN 30 PY 1997 VL 336 IS 5 BP 370 EP 373 DI 10.1056/NEJM199701303360511 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WG233 UT WOS:A1997WG23300011 PM 9011793 ER PT J AU Mead, PS Finelli, L LambertFair, MA Champ, D Townes, J Hutwagner, L Barrett, T Spitalny, K Mintz, E AF Mead, PS Finelli, L LambertFair, MA Champ, D Townes, J Hutwagner, L Barrett, T Spitalny, K Mintz, E TI Risk factors for sporadic infection with Escherichia coli O157:H7 SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID HEMOLYTIC UREMIC SYNDROME; EXACT CONFIDENCE-LIMITS; COMMON ODDS RATIO; CANADA AB Background: Little is known about risk factors for sporadic infection with Escherichia coli O157:H7. In response to a sharp increase in reported cases in New Jersey during July 1994, we conducted a case-control study to identify principal sources of infection and contributing practices. Methods: Standardized questionnaires were used to evaluate (1) potential exposures of case patients and matched controls and (2) knowledge, attitudes, and practices of food preparers in case and control households. Patient isolates were subtyped by pulsed-field gel electrophoresis. Results: Patients with E coli O157:H7 infection (N=23; median age, 9 years; 55% female) ss ere more likely than healthy controls to have eaten a hamburger in the week preceding illness (matched odds ratio, undefined; P<.001); 80% of the hamburgers eaten by ill persons were prepared at home. Food preparers in case households were less likely than those in control households to report washing their hands (odds ratio, 8.5; P<.005) and work surfaces (odds ratio, 10.5; P<.05) after handling raw ground beef. Pulsed-field gel electrophoresis yielded 17 unique subtypes among the 23 patient isolates, indicating multiple sources of infection. Conclusions: Hamburgers prepared at home are an important source of sporadic E coli O157:H7 infection. We estimate that adequate hand washing by food preparers could have prevented 34% of E coli O157:H7 infections in the study population. C1 CTR DIS CONTROL & PREVENT,BIOSTAT & INFORMAT MANAGEMENT BRANCH,NATL CTR INFECT DIS,ATLANTA,GA 30333. DEPT HLTH,TRENTON,NJ. RP Mead, PS (reprint author), CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,NATL CTR INFECT DIS,MS A-38,ATLANTA,GA 30333, USA. NR 15 TC 81 Z9 84 U1 0 U2 13 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 27 PY 1997 VL 157 IS 2 BP 204 EP 208 DI 10.1001/archinte.157.2.204 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA WD844 UT WOS:A1997WD84400008 PM 9009977 ER PT J AU Lee, TK Gensheimer, KF Johnson, RH Bandy, U Hanlon, CA Trimarchi, CV Morse, D Hunter, JL Moser, JM Smith, KA Halpin, TJ AF Lee, TK Gensheimer, KF Johnson, RH Bandy, U Hanlon, CA Trimarchi, CV Morse, D Hunter, JL Moser, JM Smith, KA Halpin, TJ TI Update: Raccoon rabies epizootic - United States, 1996 (Reprinted from MMWR, vol 45, pg 1117-1120, 1997) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 VERMONT DEPT HLTH,BURLINGTON,VT 05402. STATE RHODE ISL & PROVIDENCE PLANTAT DEPT HLTH,PROVIDENCE,RI. NEW YORK STATE DEPT HLTH,ALBANY,NY 12237. N CAROLINA DEPT ENVIRONM HLTH & NAT RESOURCES,RALEIGH,NC 27611. OHIO DEPT HLTH,COLUMBUS,OH 43266. CDC,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,VIRAL & RICKETTSIAL ZOONOSES BRANCH,ATLANTA,GA 30333. RP Lee, TK (reprint author), MAINE DEPT HUMAN SERV,AUGUSTA,ME 04333, USA. NR 8 TC 1 Z9 1 U1 1 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 22 PY 1997 VL 277 IS 4 BP 282 EP 283 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WC458 UT WOS:A1997WC45800011 ER PT J AU Siciliano, L Morrow, PL Carney, J AF Siciliano, L Morrow, PL Carney, J TI Hypothermia-related deaths - Vermont, October 1994 February 1996 (Reprinted from MMWR, vol 45, pg 1093-1095, 1996) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 VERMONT DEPT HLTH,BURLINGTON,VT 05402. CDC,NATL CTR ENVIRONM HLTH,DIV ENVIRONM HAZARDS & HLTH EFFECTS,ATLANTA,GA 30333. NR 4 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 22 PY 1997 VL 277 IS 4 BP 283 EP 284 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WC458 UT WOS:A1997WC45800012 ER PT J AU Sutter, RW Strebel, PM Miller, MA Hadler, SC AF Sutter, RW Strebel, PM Miller, MA Hadler, SC TI Inactivated poliovirus vaccine and vaccine-associated paralytic poliomyelitis - Reply SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID UNITED-STATES; AGAMMAGLOBULINEMIA; DISEASE RP Sutter, RW (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 6 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 22 PY 1997 VL 277 IS 4 BP 295 EP 295 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WC458 UT WOS:A1997WC45800017 ER PT J AU Gwinn, M Mei, JV Spruill, CL Dobbs, TL Hannon, WH LaLota, M AF Gwinn, M Mei, JV Spruill, CL Dobbs, TL Hannon, WH LaLota, M TI Hospital variation in intrapartum use of zidovudine SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter C1 FLORIDA DEPT HLTH & REHABIL SERV,TALLAHASSEE,FL 32399. RP Gwinn, M (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 2 TC 2 Z9 2 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 22 PY 1997 VL 277 IS 4 BP 299 EP 299 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WC458 UT WOS:A1997WC45800026 PM 9002490 ER PT J AU CroninStubbs, D Beckett, LA Scherr, PA Field, TS Chown, MJ Pilgrim, DM Bennett, DA Evans, DA AF CroninStubbs, D Beckett, LA Scherr, PA Field, TS Chown, MJ Pilgrim, DM Bennett, DA Evans, DA TI Weight loss in people with Alzheimer's disease: A prospective population based analysis SO BMJ-BRITISH MEDICAL JOURNAL LA English DT Article C1 CTR DIS CONTROL & PREVENT, HLTH CARE & AGING STUDIES BRANCH, ATLANTA, GA USA. HARVARD UNIV, SCH MED, DIV MED, BOSTON, MA USA. HARVARD UNIV, SCH MED, HARVARD COMMUNITY HLTH PLAN, BOSTON, MA USA. RP CroninStubbs, D (reprint author), RUSH INST AGING, 1645 W JACKSON BLVD, SUITE 675, CHICAGO, IL 60612 USA. FU NIA NIH HHS [AG-10161, N01-AG-02107, N01-AG-12106] NR 5 TC 78 Z9 80 U1 0 U2 1 PU BMJ PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 1756-1833 J9 BMJ-BRIT MED J JI BMJ-British Medical Journal PD JAN 18 PY 1997 VL 314 IS 7075 BP 178 EP 179 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WD911 UT WOS:A1997WD91100024 PM 9022430 ER PT J AU Sattin, RW AF Sattin, RW TI Preventing injurious falls SO LANCET LA English DT Editorial Material ID RISK; PERSPECTIVE; COMMUNITY RP Sattin, RW (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA 30333, USA. NR 8 TC 7 Z9 7 U1 0 U2 1 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD JAN 18 PY 1997 VL 349 IS 9046 BP 150 EP 150 DI 10.1016/S0140-6736(05)60975-0 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WC861 UT WOS:A1997WC86100006 PM 9111536 ER PT J AU Herwaldt, BL Taylor, PW Gorenflot, AF AF Herwaldt, BL Taylor, PW Gorenflot, AF TI Babesiosis in Missouri - Response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 CAPE GIRARDEAU PHYS ASSOCIATES,CAPE GIRARDEAU,MO 63703. UNIV MONTPELLIER,F-34060 MONTPELLIER,FRANCE. RP Herwaldt, BL (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30341, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JAN 15 PY 1997 VL 126 IS 2 BP 172 EP 172 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WD298 UT WOS:A1997WD29800017 ER PT J AU Schwartz, DA Doebbeling, BN Merchant, JA Barrett, DH Black, DW Burmeister, LF Clarke, WR Falter, KH Hall, DB Jones, MF Saag, KG Snyders, TL Thorne, PS Torner, JC Wolson, RF Ballas, ZK Barrash, J Casale, TB Chrischilles, E Falk, H Hansen, MD Kathol, RG Kelly, JR Pfohl, BM Piette, WW Quinlisk, P Rohrer, JE Sprince, NL Talby, PM Zwerling, C AF Schwartz, DA Doebbeling, BN Merchant, JA Barrett, DH Black, DW Burmeister, LF Clarke, WR Falter, KH Hall, DB Jones, MF Saag, KG Snyders, TL Thorne, PS Torner, JC Wolson, RF Ballas, ZK Barrash, J Casale, TB Chrischilles, E Falk, H Hansen, MD Kathol, RG Kelly, JR Pfohl, BM Piette, WW Quinlisk, P Rohrer, JE Sprince, NL Talby, PM Zwerling, C TI Self-reported illness and health status among gulf war veterans - A population-based study SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID DIFFERENTIAL RECALL; BIAS; QUESTIONNAIRE; IMPACT; SCALE AB Objective.-To assess the prevalence of self-reported symptoms and illnesses among military personnel deployed during the Persian Gulf War (PGW) and to compare the prevalence of these conditions with the prevalence among military personnel on active duly at the same time, but not deployed to the Persian Gulf (non-PGW). Design.-Cross-sectional telephone interview survey of PGW and non-PGM, military personnel. The study instrument consisted of validated questions, validated questionnaires, and investigator-derived questions designed to assess relevant medical and psychiatric conditions. Setting.-Population-based sample of military personnel from Iowa. Study Participants.-A total of 4886 study subjects were randomly selected from 1 of 4 study domains (PGW regular military, PGW National Guard/Reserve, non-PGW regular military, and non-PGW National Guard/Reserve), stratifying for age, sex, race, rank, and branch of military service. Main Outcome Measures.-Self-reported symptoms and symptoms of medical illnesses and psychiatric conditions. Results.-Overall, 3695 eligible study subjects (76%) and 91% of the located subjects completed the telephone interview. Compared with non-PGW military personnel, PGW military personnel reported a significantly higher prevalence of symptoms of depression (17.0% vs 10.9%; Cochran-Mantel-Haenszel test statistic, P<.001), posttraumatic stress disorder (PTSD) (1.9% vs 0.8%, P=.007), chronic fatigue (1.3% vs 0.3%, P<.001), cognitive dysfunction (18.7% vs 7.6%, P<.001), bronchitis (3.7% vs 2.7%, P<.001), asthma (7.2% vs 4.1%, P=.004), fibromyalgia (19.2% vs 9.6%, P<.001), alcohol abuse (17.4% vs 12.6%, P=.02), anxiety (4.0% vs 1.8%, P<.001), and sexual discomfort (respondent, 1.5% vs 1.1%, P=.009; respondent's female partner, 5.1% vs 2.4%, P<.001). Assessment of health-related quality of life demonstrated diminished mental and physical functioning scores for PGW military personnel. In almost all cases, larger differences between PGW and non-PGW military personnel were observed in the National Guard/Reserve comparison. Within the PGW military study population, compared with veterans in the regular military, Veterans in the National Guard/Reserve only reported more symptoms of chronic fatigue (2.9% vs 1.0%, P=.03) and alcohol abuse (19.4% vs 17.0%, P=.004). Conclusions.-Military personnel who participated in the PGW have a higher self-reported prevalence of medical and psychiatric conditions than contemporary military personnel who were not deployed to the Persian Gulf. These findings establish the need to further investigate the potential etiologic, clinical, pathogenic, and public health implications of the increased prevalence of multiple medical and psychiatric conditions in populations of military personnel deployed to the Persian Gulf. C1 CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333. IOWA DEPT PUBL HLTH,DES MOINES,IA 50319. RP Schwartz, DA (reprint author), UNIV IOWA,COLL MED,DEPT INTERNAL MED,SE318 GH,IOWA CITY,IA 52242, USA. RI Doebbeling, Bradley/C-6620-2009; Casale, Thomas/K-4334-2013 OI Casale, Thomas/0000-0002-3149-7377 NR 47 TC 362 Z9 363 U1 1 U2 15 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 15 PY 1997 VL 277 IS 3 BP 238 EP 245 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA WB446 UT WOS:A1997WB44600026 ER PT J AU McDonnell, S Kirkland, KB Hlady, WG Aristeguieta, C Hopkins, RS Monroe, SS Glass, RI AF McDonnell, S Kirkland, KB Hlady, WG Aristeguieta, C Hopkins, RS Monroe, SS Glass, RI TI Failure of cooking to prevent shellfish-associated viral gastroenteritis SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 17-20, 1995 CL SAN FRANCISCO, CA SP Amer Soc Microbiol ID NORWALK VIRUS; NONBACTERIAL GASTROENTERITIS; RAW OYSTERS; OUTBREAKS; CONSUMPTION; HEPATITIS; AGENT; RISK AB Background: In January 1995, Florida experienced the largest outbreak of oyster-associated gastroenteritis ever reported. Methods: We interviewed both the cohort of persons from 38 gatherings where illness was reported and a sample of harvesters and harvest-area residents. Oysters were traced by means of tags and dealer records, and water quality measures in harvest areas were reviewed. We examined stool specimens for small round structured viruses by means of electron microscopy and amplification of RNA by reverse-transcriptase polymerase chain reaction. We also tested serum specimens for antibodies to Norwalk virus. Results: Of 223 oyster eaters, 58% (129/223) became ill, compared with 3% (2/76) of non-oyster eaters (relative risk, 22; 95% confidence interval, 5.6-87.0). Most oyster eaters (67% [149/223]) ate only cooked (grilled, stewed, or fried) oysters. Oyster eaters who reported eating only thoroughly cooked oysters were as likely to become ill as those who ate raw oysters (relative risk, 0.68; 95% confidence interval, 0.45-1.0;P=.1). In 29 clusters, implicated oysters were from Apalachicola Bay, Florida. A community outbreak occurred in 2 bayside communities before the oyster harvest, leading to an increase in the reportedly common practice of overboard dumping of feces. Small round structured viruses were identified in the stool specimens of 2 harvest-area residents and 9 persons from 8 clusters. Results of water qualify tests for fecal coliforms were within acceptable limits. Conclusions: This large outbreak of gastroenteritis associated with oysters may have resulted from overboard dumping of feces during a community outbreak of diarrheal illness. Our findings of acceptable water quality measures for fecal contamination and the lack of appreciable protective effect from cooking leave the consumer with no assurance of safety. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,DIV FIELD EPIDEMIOL,ATLANTA,GA. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. FLORIDA DEPT HLTH & REHABIL SERV,PROGRAM EPIDEMIOL,TALLAHASSEE,FL 32399. UNIV MIAMI,DEPT FAMILY & COMMUNITY MED,MIAMI,FL 33152. OI Monroe, Stephan/0000-0002-5424-716X NR 32 TC 52 Z9 58 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JAN 13 PY 1997 VL 157 IS 1 BP 111 EP 116 DI 10.1001/archinte.157.1.111 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WB827 UT WOS:A1997WB82700013 PM 8996048 ER PT J AU Stoll, BJ Glass, RI AF Stoll, BJ Glass, RI TI Potential antitussive effects of a computer antivirus program SO LANCET LA English DT Letter C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,RES BRANCH,ATLANTA,GA. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. RP Stoll, BJ (reprint author), EMORY UNIV,GRADY MEM HOSP,SCH MED,DEPT PAEDIAT,BOX 26015,ATLANTA,GA 30335, USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD JAN 11 PY 1997 VL 349 IS 9045 BP 140 EP 140 DI 10.1016/S0140-6736(05)60933-6 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA WB800 UT WOS:A1997WB80000072 PM 8996457 ER PT J AU Dalton, CB Austin, CC Sobel, J Hayes, PS Bibb, WF Graves, LM Swaminathan, B Proctor, ME Griffin, PM AF Dalton, CB Austin, CC Sobel, J Hayes, PS Bibb, WF Graves, LM Swaminathan, B Proctor, ME Griffin, PM TI An outbreak of gastroenteritis and fever due to Listeria monocytogenes in milk SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID MULTILOCUS ENZYME ELECTROPHORESIS; FIELD GEL-ELECTROPHORESIS; EPIDEMIC LISTERIOSIS; CHOCOLATE MILK; FOOD; INCUBATION; GROWTH; ADULTS AB Background After an outbreak of gastroenteritis and fever among persons who attended a picnic in Illinois, chocolate milk served at the picnic was found to be contaminated with Listeria monocytogenes. Methods In investigating this outbreak, we interviewed the people who attended the picnic about what they ate and their symptoms. Surveillance for invasive listeriosis was initiated in the states that receive milk from the implicated dairy. Stool and milk samples were cultured for L. monocytogenes. Serum samples were tested for IgG antibody to listeriolysin O. Results Forty-five persons had symptoms that met the case definition for illness due to L. monocytogenes, and cultures of stool from 11 persons yielded the organism. Illness in the week after the picnic was associated with the consumption of chocolate milk. The most common symptoms were diarrhea (present in 79 percent of the cases) and fever (72 percent). Four persons were hospitalized. The median incubation period for infection was 20 hours (range, 9 to 32), and persons who became ill had elevated levels of antibody to listeriolysin O. Isolates from stool specimens from patients who became ill after the picnic, from sterile sites in three additional patients identified by surveillance, from the implicated chocolate milk, and from a tank drain at the dairy were all serotype 1/2b and were indistinguishable on multilocus enzyme electrophoresis, ribotyping, and DNA macrorestriction analysis. Conclusions L. monocytogenes is a cause of gastroenteritis with fever, and sporadic cases of invasive listeriosis may be due to unrecognized outbreaks caused by contaminated food. (C) 1997, Massachusetts Medical Society. C1 CTR DIS CONTROL & PREVENT,FOODBORNE & DIARRHEAL DIS BRANCH,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA. CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,ATLANTA,GA. ILLINOIS DEPT PUBL HLTH,DIV INFECT DIS,SPRINGFIELD,IL 62761. WISCONSIN DEPT HLTH & SOCIAL SERV,BUR PUBL HLTH,MADISON,WI. RI Ducey, Thomas/A-6493-2011 NR 34 TC 311 Z9 334 U1 4 U2 19 PU MASS MEDICAL SOC PI BOSTON PA 10 SHATTUCK, BOSTON, MA 02115 SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JAN 9 PY 1997 VL 336 IS 2 BP 100 EP 105 DI 10.1056/NEJM199701093360204 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA WC481 UT WOS:A1997WC48100004 PM 8988887 ER PT J AU Mosley, D Komatsu, K Vaz, V Vertz, D England, B Ampel, NM AF Mosley, D Komatsu, K Vaz, V Vertz, D England, B Ampel, NM TI Coccidioidomycosis - Arizona, 1990-1995 (Reprinted from MMWR, vol 45, pg 1069-1073, 1996) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 UNIV ARIZONA,TUCSON,AZ. VET AFFAIRS MED CTR,ATLANTA,GA 30033. CDC,SURVEILLANCE BRANCH,DIV HIV AIDS PREVENT,NATL CTR HIV STD & TB PREVENT,ATLANTA,GA 30333. CDC,CHILDHOOD & RESP DIS BRANCH,DIV BACTERIAL & MYCOT DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. RP Mosley, D (reprint author), ARIZONA DEPT HLTH SERV,PHOENIX,AZ 85007, 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 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 8 PY 1997 VL 277 IS 2 BP 104 EP 105 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WA650 UT WOS:A1997WA65000009 ER PT J AU Steele, G Bixler, D Yonker, M Schultz, M Atterbury, G Allen, S Davis, J Haupt, T Sedmak, G Cheney, L Villarente, L Ackman, D Bernstein, P Kirshenbaum, R Kondracki, S Balzano, G Switzer, S Brady, G Smith, P AF Steele, G Bixler, D Yonker, M Schultz, M Atterbury, G Allen, S Davis, J Haupt, T Sedmak, G Cheney, L Villarente, L Ackman, D Bernstein, P Kirshenbaum, R Kondracki, S Balzano, G Switzer, S Brady, G Smith, P TI Update: Influenza activity - United States, 1996-97 season (Reprinted from MMWR, vol 45, pg 1102-1105, 1996) SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Reprint C1 INDIANA STATE DEPT HLTH,VIROL LAB,INDIANAPOLIS,IN 46202. INDIANA UNIV,MED CTR,INDIANAPOLIS,IN. JOB CORPS,INDIANAPOLIS,IN. WISCONSIN DEPT HLTH & SOCIAL SERV,DIV HLTH,MADISON,WI 53707. CITY MILWAUKEE HLTH DEPT,MILWAUKEE,WI. MONROE COMMUNITY HOSP,ROCHESTER,NY. DEWITT NURSING HOME,NEW YORK,NY. NEW YORK STATE DEPT HLTH,BUR COMMUNICABLE DIS CONTROL,ALBANY,NY 12237. CDC,INFLUENZA BR,ATLANTA,GA 30333. CDC,WHO,COLLABORAT CTR SURVEILL EPIDEMIOL & CONTROL INFL,DIV VIRAL & RCKETTSIAL DIS,ATLANTA,GA 30333. RP Steele, G (reprint author), INDIANA STATE DEPT HLTH,EPIDEMIOL RESOURCE CTR,INDIANAPOLIS,IN 46202, USA. NR 6 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 8 PY 1997 VL 277 IS 2 BP 105 EP 106 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WA650 UT WOS:A1997WA65000010 ER PT J AU Liu, S Siegel, PZ Brewer, RD Mokdad, AH Sleet, DA Serdula, M AF Liu, S Siegel, PZ Brewer, RD Mokdad, AH Sleet, DA Serdula, M TI Prevalence of alcohol-impaired driving - Results from a national self-reported survey of health behaviors SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID RISK FACTOR SURVEILLANCE AB Objective.-To estimate how frequently adults in the United States drive while impaired by alcohol. Design.-Telephone survey. Setting-The 49 states (and the District of Columbia) that participated in the Behavioral Risk Factor Surveillance System (BRFSS) in 1993. Participants.-A total of 102 263 noninstitutionalized adults aged 18 years or older. Main Outcome Measures.-The percentage of respondents who reported alcohol-impaired driving; number of episodes of alcohol-impaired driving per 1 000 adult population; and total number of episodes of alcohol-impaired driving-each by age, sex, race, level of education, and state. Results.-Overall, 2.5% of adults reported an estimated 123 million episodes of alcohol-impaired driving in 1993, This corresponds to 655 episodes of alcohol-impaired driving for each 1000 adults (range among states per 1000 adults, 165-1550). Alcohol-impaired driving was most frequent among men aged 21 to 34 years (1739 episodes per 1 000 adults) and was nearly as frequent among men aged 18 to 20 years (1623 episodes per 1000 adults), despite legislation in all states that prohibited the sale of alcohol to persons younger than age 21 years in 1993. Conclusions.-Alcohol-impaired driving is common even among underage persons. Strict enforcement of laws that discourage alcohol-impaired driving is needed along with community and patient education to reduce the prevalence of alcohol-impaired driving and prevent injuries and deaths from alcohol-related motor vehicle crashes. Data From the BRFSS, an ongoing source of national and state-specific data on the number of episodes of alcohol-impaired driving, are potentially useful for monitoring trends and evaluating the effect of future efforts to reduce alcohol-impaired driving. C1 CTR DIS CONTROL & PREVENT,DIV UNINTENT INJURY PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA 30341. CTR DIS CONTROL,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV NUTR & PHYS ACT,ATLANTA,GA 30333. CTR DIS CONTROL,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,DIV ADULT & COMMUNITY HLTH,ATLANTA,GA 30333. RI Liu, Simin/I-3689-2014 OI Liu, Simin/0000-0003-2098-3844 NR 24 TC 67 Z9 67 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD JAN 8 PY 1997 VL 277 IS 2 BP 122 EP 125 DI 10.1001/jama.277.2.122 PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA WA650 UT WOS:A1997WA65000031 PM 8990336 ER PT J AU Swartley, JS Marfin, AA Edupuganti, S Liu, LJ Cieslak, P Perkins, B Wenger, JD Stephens, DS AF Swartley, JS Marfin, AA Edupuganti, S Liu, LJ Cieslak, P Perkins, B Wenger, JD Stephens, DS TI Capsule switching of Neisseria meningitidis SO PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA LA English DT Article ID FIELD GEL-ELECTROPHORESIS; POLYSIALIC ACID CAPSULE; OUTER-MEMBRANE PROTEIN; CMP-NEUNAC SYNTHETASE; GROUP-B; MENINGOCOCCAL POLYSACCHARIDES; CHEMICAL PROPERTIES; SEROGROUP-B; EPIDEMIC; GENES AB The different sialic acid (serogroups B, C, Y, and W-135) and nonsialic acid (serogroup A) capsular polysaccharides expressed by Neisseria meningitidis are major virulence factors and are used as epidemiologic markers and vaccine targets. However, the identification of meningococcal isolates with similar genetic markers but expressing different capsular polysaccharides suggests that meningococcal clones can switch the type of capsule they express. We identified, except for capsule, isogenic serogroups B [(alpha 2-->8)-linked polysialic acid] and C [(alpha 2-->9)-linked polysialic acid] meningococcal isolates from an outbreak of meningococcal disease in the U. S. Pacific Northwest. We used these isolates and prototype serogroup A, B, C, Y, and W-135 strains to define the capsular biosynthetic and transport operons of the major meningococcal serogroups and to show that switching from the B to C capsule in the outbreak strain was the result of allelic exchange of the polysialyltransferase. Capsule switching was probably the result of transformation and horizontal DNA exchange in vivo of a serogroup C capsule biosynthetic operon. These findings indicate that closely related virulent meningococcal clones may not be recognized by traditional serogroup-based surveillance and can escape vaccine-induced or natural protective immunity by capsule switching. Capsule switching may be an important virulence mechanism of meningococci and other encapsulated bacterial pathogens. As vaccine development progresses and broader immunization with capsular polysaccharide conjugate vaccines becomes a reality, the ability to switch capsular types may have important implications for the impact of these vaccines. C1 EMORY UNIV,SCH MED,DEPT MED,ATLANTA,GA 30303. EMORY UNIV,SCH MED,DEPT IMMUNOL & MICROBIOL,ATLANTA,GA 30303. VET ADM MED CTR,RES SERV,LABS MICROBIAL PATHOGENESIS,ATLANTA,GA 30303. OREGON HLTH SCI UNIV,DEPT MED,PORTLAND,OR 97232. OREGON DEPT HUMAN RESOURCES,HLTH DIV,PORTLAND,OR 97232. CTR DIS CONTROL & PREVENT,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. RI Stephens, David/A-8788-2012 FU NIAID NIH HHS [AI40247] NR 42 TC 262 Z9 272 U1 3 U2 12 PU NATL ACAD SCIENCES PI WASHINGTON PA 2101 CONSTITUTION AVE NW, WASHINGTON, DC 20418 SN 0027-8424 J9 P NATL ACAD SCI USA JI Proc. Natl. Acad. Sci. U. S. A. PD JAN 7 PY 1997 VL 94 IS 1 BP 271 EP 276 DI 10.1073/pnas.94.1.271 PG 6 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA WC347 UT WOS:A1997WC34700050 PM 8990198 ER PT J AU Abulrahi, HA Bohlega, EA Fontaine, RE AlSeghayer, SM AlRuwais, AA AF Abulrahi, HA Bohlega, EA Fontaine, RE AlSeghayer, SM AlRuwais, AA TI Plasmodium falciparum malaria transmitted in hospital through heparin locks SO LANCET LA English DT Article AB Background After a community investigation had implicated hospital admission as a shared feature of a cluster of acute Plasmodium falciparum malaria (AFM) cases in Riyadh, Saudi Arabia, we began an in-hospital investigation to determine the method of transmission. Methods We investigated all AFM patients admitted to one paediatric hospital for any reason from December, 1991, to April, 1992. We classified AFM as locally acquired (LAFM) if during the month before AFM onset the patient had not visited a malarious area, and as hospital acquired (HAFM) if the LAFM patient had been admitted to hospital during that month. We compared exposures of HAFM cases with those of other patients sampled from the same wards. We observed nursing practices and investigated by anonymous questionnaire how nurses administered parenteral drugs. Findings Of 21 LAFM cases, 20 (95%) had a previous hospital admission (exposure admission) compared with 15 (25%) of 61 other patients (p<0.001; chi(2) test). During the exposure admission, all HAFM patients had occupied the same room as, or a room adjacent to, an AFM patient; 14 (23%) of 60 other patients occupied the same room or rooms adjacent to an AFM patient (p<0.001, chi(2)). 90% of HAFM patients received infusions through a heparin lock during the exposure admission, compared with 49% of 120 general patients (p<0.001, chi(2)). 10% of nurses admitted to using one syringe for more than one heparin lock and 50% filled syringes with enough heparin for three to ten heparin locks. Interpretation P falciparum was transmitted between patients when single syringes were used on heparin locks of sequential patients. This practice would easily transmit other blood-borne agents. C1 MINIST HLTH,SAUDI ARABIAN FIELD EPIDEMIOL TRAINING PROGRAM,RIYADH 11442,SAUDI ARABIA. MINIST HLTH,GEN DIRECTORATE INFECT & PARASIT DIS,MALARIA DEPT,RIYADH 11442,SAUDI ARABIA. CTR DIS CONTROL & PREVENT,EPIDEMIOL PROGRAM OFF,DIV INT HLTH,ATLANTA,GA. NR 9 TC 46 Z9 47 U1 0 U2 1 PU LANCET LTD PI LONDON PA 42 BEDFORD SQUARE, LONDON, ENGLAND WC1B 3SL SN 0140-6736 J9 LANCET JI Lancet PD JAN 4 PY 1997 VL 349 IS 9044 BP 23 EP 25 DI 10.1016/S0140-6736(96)03508-8 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA WA725 UT WOS:A1997WA72500013 PM 8988119 ER PT J AU Hendon, H AF Hendon, H GP AMER METEOROL SOC TI Interannual variability of the Australian summer monsoon and its relationship to intraseasonal activity SO 22ND CONFERENCE ON HURRICANES AND TROPICAL METEOROLOGY LA English DT Proceedings Paper CT 22nd Conference on Hurricanes and Tropical Meteorology CY MAY 19-23, 1997 CL FT COLLINS, CO SP Amer Meteorol Soc RP Hendon, H (reprint author), UNIV COLORADO,CDC,CIRES,CAMPUS BOX 449,BOULDER,CO 80309, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER METEOROLOGICAL SOC PI BOSTON PA 45 BEACON ST, BOSTON, MA 02108 PY 1997 BP 635 EP 636 PG 2 WC Meteorology & Atmospheric Sciences SC Meteorology & Atmospheric Sciences GA BK02K UT WOS:A1997BK02K00308 ER PT J AU Rosenberg, ML Fenley, MA Johnson, D Short, L AF Rosenberg, ML Fenley, MA Johnson, D Short, L TI Bridging prevention and practice: Public health and family violence SO ACADEMIC MEDICINE LA English DT Article AB Public health approaches the primary prevention of family violence by focusing on surveillance, the identification of risk factors, and the development, evaluation, and dissemination of interventions. Physicians and other health care providers are crucial in this process because they are in a unique position to identify at-risk individuals and populations and to implement both broad-based and targeted preventive and intervention initiatives. Incorporating public health principles into medical education and medical practice not only can reduce the severity of this epidemic by strengthening efforts in early detection and expert intervention but also can create effective primary prevention, an important necessary step towards eradicating every disease or condition. This article discusses the role of public health professionals in preventing family and intimate violence. It notes specific findings from public health research, including the cycle of violence and the need to incorporate issues of abuse across the life span, and other factors, into medical education. Addressing family and intimate violence in a caring and sensitive manner is difficult, and incorporating public health principles into medical education and medical practitioners and public health professionals. This new partnership represents both an important challenge and a unique opportunity to understand family and intimate violence and thus to develop and evaluate effective short- and long-term solutions. C1 CDC,NATL CTR INJURY PREVENT & CONTROL,OFF DIRECTOR,ATLANTA,GA 30341. CDC,DIV VIOLENCE PREVENT,FAMILY & INTIMATE VIOLENCE PREVENT TEAM,ATLANTA,GA 30341. NR 11 TC 13 Z9 13 U1 2 U2 8 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 1997 VL 72 IS 1 SU S BP S13 EP S18 PG 6 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA WE235 UT WOS:A1997WE23500005 PM 9008583 ER PT J AU Short, LM Cotton, D Hodgson, CS AF Short, LM Cotton, D Hodgson, CS TI Evaluation of the module on domestic violence at the UCLA School of Medicine SO ACADEMIC MEDICINE LA English DT Article AB Physicians and other hospital staff have a unique opportunity to assist victims of abuse. It is imperative that they develop the skills necessary to to identify and diagnose cases and provide the support and referral services needed to help victims end the cycle of violence. This paper describes a comprehensive evaluation of the instructional design, implementation, and learning outcomes of the Domestic Violence Module at the University of California, Los Angeles (UCLA) School of Medicine to determine the effectiveness of this curriculum in helping medical students develop such skills. Expert reviewers found it to be an innovative, well-planned curriculum, and students and faculty tutors expressed a great deal of interest in and satisfaction with the course as a whole. However, the different evaluation components identified the same areas for improvement: (1) students need more opportunity to practice skills and receive feedback during the module, (2) there is inconsistency across classes in what is learned, and (3) tutors need better preparation sessions. The student outcomes reflected these needs and therefore suggest that the study may be useful in determining the components of an effective curriculum. After the training, the students reported significant increases in their feelings of self-efficacy and in their intentions, especially in comparison with a group of control students. Therefore, the module seems to be successful in inspiring medical students to work with victims of abuse. C1 MACRO INT INC,ATLANTA,GA. UNIV CALIF LOS ANGELES,SCH MED,LOS ANGELES,CA. RP Short, LM (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INJURY PREVENT & CONTROL,DIV VIOLENCE PREVENT,ATLANTA,GA 30341, USA. NR 3 TC 24 Z9 25 U1 0 U2 4 PU HANLEY & BELFUS INC PI PHILADELPHIA PA 210 S 13TH ST, PHILADELPHIA, PA 19107 SN 1040-2446 J9 ACAD MED JI Acad. Med. PD JAN PY 1997 VL 72 IS 1 SU S BP S75 EP S92 PG 18 WC Education, Scientific Disciplines; Health Care Sciences & Services SC Education & Educational Research; Health Care Sciences & Services GA WE235 UT WOS:A1997WE23500012 PM 9008590 ER PT J AU Dreyer, G Noroes, J Addiss, D AF Dreyer, G Noroes, J Addiss, D TI The silent burden of sexual disability associated with lymphatic filariasis SO ACTA TROPICA LA English DT Article DE lymphatic filariasis; sexual disability; elephantiasis ID BANCROFTIAN FILARIASIS; ADULTICIDAL EFFICACY; HYDROCELE C1 UNIV FED PERNAMBUCO,HOSP CLIN,DIV UROL,RECIFE,PE,BRAZIL. CTR DIS CONTROL,NATL CTR INFECT DIS,DIV PARASIT DIS,ATLANTA,GA 30333. RP Dreyer, G (reprint author), FIOCRUZ MS,DEPT PARASITOL,CTR PESQUISAS AGGEU MAGALHAES,AV MORAES REGO S-N,CIDADE UNIV,BR-50670420 RECIFE,PE,BRAZIL. NR 16 TC 47 Z9 48 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0001-706X J9 ACTA TROP JI Acta Trop. PD JAN PY 1997 VL 63 IS 1 BP 57 EP 60 DI 10.1016/S0001-706X(96)00604-3 PG 4 WC Parasitology; Tropical Medicine SC Parasitology; Tropical Medicine GA WM903 UT WOS:A1997WM90300005 PM 9083585 ER PT J AU Mertz, GJ Hjelle, BL Bryan, RT AF Mertz, GJ Hjelle, BL Bryan, RT TI Hantavirus infection SO ADVANCES IN INTERNAL MEDICINE, VOL 42 SE ADVANCES IN INTERNAL MEDICINE LA English DT Review ID SOUTHWESTERN UNITED-STATES; KOREAN HEMORRHAGIC-FEVER; HANTAAN VIRUS-INFECTION; RENAL SYNDROME VIRUSES; 4 CORNERS HANTAVIRUS; WHITE-FOOTED MOUSE; CREEK-CANAL-VIRUS; PULMONARY-SYNDROME; NEPHROPATHIA-EPIDEMICA; GENETIC IDENTIFICATION C1 UNIV NEW MEXICO,CTR CANC,SCH MED,BIOMED RES FACIL,ALBUQUERQUE,NM 87131. CTR DIS CONTROL & PREVENT,SW FIELD ACTIV,HANTAVIRUS PROJECT,ATLANTA,GA 30333. RP Mertz, GJ (reprint author), UNIV NEW MEXICO,SCH MED,DIV INFECT DIS,ALBUQUERQUE,NM 87131, USA. FU NIAID NIH HHS [R01 AI 36336] NR 158 TC 57 Z9 57 U1 0 U2 1 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146 SN 0065-2822 J9 ADV INTERNAL MED JI Adv.Intern.Med. PY 1997 VL 42 BP 369 EP 421 PG 53 WC Medicine, General & Internal SC General & Internal Medicine GA BH96D UT WOS:A1997BH96D00011 PM 9048125 ER PT B AU Waters, TR PutzAnderson, V Baron, S AF Waters, TR PutzAnderson, V Baron, S BE Das, B Karwowski, W TI Ergonomic tools for evaluating manual material handling jobs SO ADVANCES IN OCCUPATIONAL ERGONOMICS AND SAFETY 1997 LA English DT Proceedings Paper CT Annual International Occupational Ergonomics and Safety Conference CY JUN 01-04, 1997 CL WASHINGTON, DC SP Int Soc Occupat Ergon & Safety AB Assessment of the physical demands of potentially hazardous manual material handling (MMH) activities is fundamental to the prevention of occupationally-related low back pain (LBP), a problem costing the nation billions of dollars annually. Although there are a variety of ergonomic assessment methods available for assessing MMH activities, there is a lack of practical information to assist users in choosing the most appropriate assessment methods for a particular job. The purpose of this paper is to review currently available assessment methods and to present the results of a case study of a physically-demanding repetitive manual lifting job in two grocery warehouses. The case study will provide a framework for a comparison of the methods. RP Waters, TR (reprint author), NIOSH,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU I O S PRESS PI AMSTERDAM PA VAN DIEMENSTRAAT 94, 1013 CN AMSTERDAM, NETHERLANDS BN 90-5199-349-8 PY 1997 BP 83 EP 86 PG 4 WC Engineering, Industrial; Ergonomics; Public, Environmental & Occupational Health SC Engineering; Public, Environmental & Occupational Health GA BJ61S UT WOS:A1997BJ61S00017 ER PT B AU Tanaka, S Wild, DK Cameron, L AF Tanaka, S Wild, DK Cameron, L BE Das, B Karwowski, W TI Prevalence of tendinitis and related disorders among US workers based on an analysis of the 1988 National Health Interview Survey Data SO ADVANCES IN OCCUPATIONAL ERGONOMICS AND SAFETY 1997 LA English DT Proceedings Paper CT Annual International Occupational Ergonomics and Safety Conference CY JUN 01-04, 1997 CL WASHINGTON, DC SP Int Soc Occupat Ergon & Safety AB The Occupational Health Supplement Data of 1988 National Health Interview Survey were analyzed for tendinitis and related disorders by using the Survey Data Analysis (SUDAAN) software. Among the 30,090 respondents who had worked anytime during the previous 12 months, 0.26% (95% confidence interval: 0.18; 0.34) reported that they experienced a ''prolonged hand discomfort'' which was called tendinitis, synovitis, tenosynovitis, de Quervain's disease, or epicondylitis, by a medical person. By means of a statistical weighting scheme, this was extrapolated to a national estimate of approximately 335,000 persons (95% CI: 233,000; 439,000) reporting one of these disorders for that year. Of these, 44% or 147,000 reported that their medical person said that the condition was work-related. Combined with the previously estimated 356,000 cases of work-related carpal tunnel syndrome, we estimate that in 1988 there were approximately 503,000 cases of hand/wrist cumulative trauma disorders among 127 million U.S. workers (prevalence of 0.4%). RP Tanaka, S (reprint author), NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDIES,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU I O S PRESS PI AMSTERDAM PA VAN DIEMENSTRAAT 94, 1013 CN AMSTERDAM, NETHERLANDS BN 90-5199-349-8 PY 1997 BP 391 EP 394 PG 4 WC Engineering, Industrial; Ergonomics; Public, Environmental & Occupational Health SC Engineering; Public, Environmental & Occupational Health GA BJ61S UT WOS:A1997BJ61S00088 ER PT J AU Mastro, TD Kunanusont, C Dondero, TJ Wasi, C AF Mastro, TD Kunanusont, C Dondero, TJ Wasi, C TI Why do HIV-1 subtypes segregate among persons with different risk behaviors in South Africa and Thailand? SO AIDS LA English DT Editorial Material DE HIV; South Africa; Africa; Thailand; Asia; heterosexual transmission; homosexual transmission; molecular epidemiology; HIV-1 subtypes ID NORTHERN THAILAND; DRUG-USERS; TRANSMISSION; INFECTION; EPIDEMIOLOGY; PROBABILITY; BANGKOK; INDIA; MEN C1 CTR DIS CONTROL & PREVENT,NATL CTR HIV STD & TB PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. MINIST PUBL HLTH,DEPT COMMUNICABLE DIS CONTROL,AIDS DIV,NONTHABURI,THAILAND. MAHIDOL UNIV,SIRIRAJ HOSP,FAC MED,DEPT MICROBIOL,BANGKOK 10700,THAILAND. RP Mastro, TD (reprint author), HIV AIDS COLLABORAT,88-7 SOI BAMRASNARADURA,TIVANON RD,NONTHABURI 11000,THAILAND. NR 40 TC 38 Z9 38 U1 0 U2 2 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PD JAN PY 1997 VL 11 IS 1 BP 113 EP 116 DI 10.1097/00002030-199701000-00017 PG 4 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA WB212 UT WOS:A1997WB21200017 PM 9110084 ER PT J AU Reggy, A Simonds, RJ Rogers, M AF Reggy, A Simonds, RJ Rogers, M TI Preventing perinatal HIV transmission SO AIDS LA English DT Article DE HIV; vertical transmission; pregnancy; viral load; zidovudine; prevention; intervention ID HUMAN-IMMUNODEFICIENCY-VIRUS; MOTHER-TO-CHILD; VERTICAL TRANSMISSION; ZIDOVUDINE TREATMENT; INFANT TRANSMISSION; COMBINATION THERAPY; AIDS VACCINES; TYPE-1 HIV-1; VIRAL LOAD; VITAMIN-A RP Reggy, A (reprint author), CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,NATL CTR HIV STD & TB PREVENT,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 84 TC 4 Z9 5 U1 0 U2 2 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PY 1997 VL 11 SU A BP S61 EP S67 PG 7 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA YJ012 UT WOS:A1997YJ01200009 PM 9451968 ER PT J AU Rogers, MF vanGriensven, GJP AF Rogers, MF vanGriensven, GJP TI Epidemiology - Overview SO AIDS LA English DT Editorial Material C1 DEPT PUBL HLTH,MUNICIPAL HLTH SERV,AMSTERDAM,NETHERLANDS. RP Rogers, MF (reprint author), CTR DIS CONTROL & PREVENT,EPIDEMIOL BRANCH,DIV HIV AIDS,ATLANTA,GA 30329, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0269-9370 J9 AIDS JI Aids PY 1997 VL 11 SU A BP S55 EP S56 PG 2 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA YJ012 UT WOS:A1997YJ01200007 PM 9451966 ER PT J AU Peterson, DE AF Peterson, DE TI Emerging infections: Not just a few needles in the haystack SO AMERICAN FAMILY PHYSICIAN LA English DT Editorial Material RP Peterson, DE (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,OFF DIRECTOR,ATLANTA,GA 30333, USA. NR 3 TC 0 Z9 0 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JAN PY 1997 VL 55 IS 1 BP 36 EP & PG 2 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA WC032 UT WOS:A1997WC03200003 PM 9012286 ER PT J AU Averhoff, FM Williams, WW Hadler, SC AF Averhoff, FM Williams, WW Hadler, SC TI Immunization of adolescents SO AMERICAN FAMILY PHYSICIAN LA English DT Article ID HEPATITIS-B; IMMUNITY; VACCINE; TETANUS AB This report concerning the immunization of adolescents (i.e., persons 11 to 21 years of age, as defined by the American Medical Association [AMA] and the American Academy of Pediatrics [AAP]) is a supplement to previous publications (i.e., MMWR 1994;43[No. RR-1]1-38; the AAP 1994 Red Book: Report of the Committee on Infectious Diseases; Summary of Policy Recommendations for Periodic Health Examination, August 1996 from the American Academy of Family Physicians; and AMA Guidelines for Adolescent Preventive Services: Recommendations and Rationale). This report presents a new strategy to improve the delivery of vaccination services to adolescents and to integrate recommendations for vaccination with other preventive services provided to adolescents. This new strategy emphasizes vaccination of adolescents 11 to 12 years of age by establishing a routine visit to their health care providers. Specifically, the purposes of this visit are to (1) vaccinate adolescents who have not been previously vaccinated with varicella virus vaccine, hepatitis B vaccine, or the second dose of the measles, mumps and rubella vaccine; (2) provide a booster dose of tetanus and diphtheria toxoids; (3) administer other vaccines that may be recommended for certain adolescents, and (4) provide other recommended preventive services. The recommendations for vaccination of adolescents are based on new or current information for each vaccine. RP Averhoff, FM (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZAT PROGRAM,EPIDEMIOL & SURVEILLANCE DIV,ATLANTA,GA 30333, USA. NR 30 TC 7 Z9 7 U1 0 U2 0 PU AMER ACAD FAMILY PHYSICIANS PI KANSAS CITY PA 8880 WARD PARKWAY, KANSAS CITY, MO 64114-2797 SN 0002-838X J9 AM FAM PHYSICIAN JI Am. Fam. Physician PD JAN PY 1997 VL 55 IS 1 BP 159 EP 167 PG 9 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA WC032 UT WOS:A1997WC03200015 PM 9012275 ER PT J AU Esche, CA Groff, JH AF Esche, CA Groff, JH TI ELPAT Program report: Background current status (October 1996) SO AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL LA English DT Article RP Esche, CA (reprint author), NIOSH,CTR DIS CONTROL & PREVENT,DIV PHYS SCI & ENGN,QUAL ASSURANCE & STAT ACT,US PHS,DHHS,CINCINNATI,OH 45226, USA. NR 19 TC 0 Z9 0 U1 0 U2 0 PU AMER INDUSTRIAL HYGIENE ASSOC PI FAIRFAX PA 2700 PROSPERITY AVE #250, FAIRFAX, VA 22031-4307 SN 0002-8894 J9 AM IND HYG ASSOC J JI Am. Ind. Hyg. Assoc. J. PD JAN PY 1997 VL 58 IS 1 BP 59 EP 63 PG 5 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WC312 UT WOS:A1997WC31200012 PM 9018839 ER PT J AU Stamler, J Briefel, RR Milas, C Grandits, GA Caggiula, AW AF Stamler, J Briefel, RR Milas, C Grandits, GA Caggiula, AW TI Relation of changes in dietary lipids and weight, trial years 1-6, to changes in blood lipids in the special intervention and usual care groups in the Multiple Risk Factor Intervention Trial SO AMERICAN JOURNAL OF CLINICAL NUTRITION LA English DT Article DE dietary lipid intake; body weight; changes in blood lipids ID CORONARY HEART-DISEASE; HYPERTENSION; CHOLESTEROL AB For men in the special intervention (SI) group of the Multiple Risk Factor Intervention Trial, the average decrease in serum total cholesterol was 16.9 mg/dL (6.7%); for men in the usual care (UC) group, the average decrease was 9.7 mg/dL (3.8%). The difference between the two groups for plasma total cholesterol was 6.2 mg/dL. Plasma low-density-lipoprotein (LDL) cholesterol decreased 10.6 mg/dL (6.6%) in SI men and 5.4 mg/dL (3.4%) in UC men. Mean weight losses were 3.0 lb (1.36 kg) and 0.1 lb (0.05 kg) for SI and UC men, respectively. Change in blood total cholesterol was directly related to baseline concentration; for men with serum total cholesterol greater than or equal to 220 mg/dL, those in the SI group decreased their total cholesterol by 7.8% (design goal: 10%) and those in the UC group by 4.8% (expected: 0%). Change in dietary Lipid intake (summarized by the Keys score) for SI men was significantly related to changes in blood total cholesterol, LDL cholesterol, and triglyceride, but not to change in high-density lipoprotein (HDL) cholesterol. Controlled for weight change, coefficients for Keys score change were smaller but remained significantly related to each blood lipid except HDL cholesterol. Weight loss was associated with favorable effects on all blood lipids. Influences of change in diet and weight on blood lipids were quantitatively less for hypertensive men for serum total cholesterol, HDL cholesterol, and triglyceride than for nonhypertensive men. Nonsmokers had greater decreases than smokers in blood total cholesterol, LDL cholesterol, and triglyceride. C1 UNIV MINNESOTA, SCH PUBL HLTH, DIV BIOSTAT, MINNEAPOLIS, MN 55414 USA. UNIV PITTSBURGH, GRAD SCH PUBL HLTH, PITTSBURGH, PA 15260 USA. CTR DIS CONTROL & PREVENT, NATL CTR HLTH STAT, HYATTSVILLE, MD 20782 USA. NORTHWESTERN UNIV, DEPT PREVENT MED, CHICAGO, IL 60611 USA. NR 33 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC NUTRITION-ASN PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0002-9165 EI 1938-3207 J9 AM J CLIN NUTR JI Am. J. Clin. Nutr. PD JAN PY 1997 VL 65 SU 1 BP 272 EP 288 PG 17 WC Nutrition & Dietetics SC Nutrition & Dietetics GA WB202 UT WOS:A1997WB20200009 ER PT J AU Brackbill, RM MacGowan, RJ Rugg, D AF Brackbill, RM MacGowan, RJ Rugg, D TI HIV infection risk behaviors and methadone treatment: Client-reported HIV infection in a follow-up study of injecting drug users in New England SO AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE LA English DT Article DE follow-up studies; human immunodeficiency virus; incidence; intravenous drug users; methadone treatment; risk factors; sexual behavior ID HUMAN-IMMUNODEFICIENCY-VIRUS; OUT-OF-TREATMENT; SAN-FRANCISCO; SEROCONVERSION; VALIDITY; TRANSMISSION; PREVALENCE; REDUCTION; COCAINE AB There is wide variation in reported risk factors for HN incidence among injecting drug users by community. Available HIV seroprevalence and incidence data indicate that nearly 60% of HIV infection is associated with injecting drug use in Connecticut and 48% in Massachusetts. Using 12-month follow-up data on 354 initially HIV-negative New England (Massachusetts and Connecticut) methadone treatment clients, we assessed the association between baseline drug use practices, sexual behavior, partner behaviors, and client-reported HIV infection during follow-up. Variables that predicted client-reported positive HN antibody test results were modeled by Cox proportional hazards regression. HN infection among those tested was 14.2 per 100 person years (PY) [95% Confidence interval (CI) = 9.5 to 21.3] For each injection the relative risk (RR) was 1.1 (95% CI = 1.1 to 1.2), for males 3.0 (95% CI = 1.2 to 7.3), for blacks 5.0 (95% CI = 1.6 to 15.5), for Hispanics 3.6 (95% CI = 1.2 to 10.5). Men who used more than one unclean needle per day and had an HN-infected steady partner had an RR of 28.4 (95% CI = 4.4 to 176.4). For women, using speedball (RR = 6.1, 95% CI = 1.2 to 38.8) and being black (RR = 4.4, 95% CI = 1.0 to 19.8) predicted self-reported HIV infection; having a steady partner who ever injected increased this risk substantially (RR = 65.3, 95%, CI = 4.0 to 1046.5). These findings for IDUs in Massachusetts and Connecticut indicate that risk factors for HIV infection for men are consistent with expected transmission by unclean needles with an HIV-infected partner, but a preference for using speedball predicted HIV infection among women IDUs. RP Brackbill, RM (reprint author), CTR DIS CONTROL & PREVENT,1600 CLIFTON RD,E-44,ATLANTA,GA 30333, USA. NR 29 TC 9 Z9 9 U1 1 U2 1 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 SN 0095-2990 J9 AM J DRUG ALCOHOL AB JI Am. J. Drug Alcohol Abuse PY 1997 VL 23 IS 3 BP 397 EP 411 DI 10.3109/00952999709016885 PG 15 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA XN734 UT WOS:A1997XN73400005 PM 9261488 ER PT J AU Stevenson, RE Schwartz, CE Du, YZ Adams, MJ AF Stevenson, RE Schwartz, CE Du, YZ Adams, MJ TI Differences in methylenetetrahydrofolate reductase genotype frequencies, between whites and blacks SO AMERICAN JOURNAL OF HUMAN GENETICS LA English DT Letter ID RISK FACTOR C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. RP Stevenson, RE (reprint author), JC SELF RES INST HUMAN GENET,1 GREGOR MENDEL CIRCLE,GREENWOOD,SC 29646, USA. NR 6 TC 88 Z9 89 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 0002-9297 J9 AM J HUM GENET JI Am. J. Hum. Genet. PD JAN PY 1997 VL 60 IS 1 BP 229 EP 230 PG 2 WC Genetics & Heredity SC Genetics & Heredity GA WA818 UT WOS:A1997WA81800030 PM 8981967 ER PT J AU Lalich, NR Sestito, JP AF Lalich, NR Sestito, JP TI Occupational health surveillance: Contributions from the National Health Interview Survey SO AMERICAN JOURNAL OF INDUSTRIAL MEDICINE LA English DT Editorial Material DE occupational health; surveillance; National Health Interview Survey; carpal tunnel syndrome; back pain; dermatitis; injuries; lung diseases ID CARPAL-TUNNEL-SYNDROME; UNITED-STATES; CIGARETTE-SMOKING; BACK PAIN; PREVALENCE; WORKERS; INJURY; RISK RP Lalich, NR (reprint author), NIOSH,DIV SURVEILLANCE HAZARD EVALUAT & FIELD STUDIES,SURVEILLANCE BRANCH,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 19 TC 12 Z9 12 U1 0 U2 1 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0271-3586 J9 AM J IND MED JI Am. J. Ind. Med. PD JAN PY 1997 VL 31 IS 1 BP 1 EP 3 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WA066 UT WOS:A1997WA06600001 PM 8986247 ER PT J AU Mannino, DM AF Mannino, DM TI Sarcoidosis mortality in the United States - Reply SO AMERICAN JOURNAL OF MEDICINE LA English DT Letter RP Mannino, DM (reprint author), CTR DIS CONTROL,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30333, USA. OI Mannino, David/0000-0003-3646-7828 NR 1 TC 0 Z9 0 U1 0 U2 0 PU EXCERPTA MEDICA INC PI NEW YORK PA 245 WEST 17TH STREET, NEW YORK, NY 10011 SN 0002-9343 J9 AM J MED JI Am. J. Med. PD JAN PY 1997 VL 102 IS 1 BP 131 EP 132 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA WD957 UT WOS:A1997WD95700026 ER PT J AU Kaufman, RH Adam, E Icenogle, J Lawson, H Lee, N Reeves, KO Irwin, J Simon, T Press, M Uhler, R Entman, C Reeves, WC AF Kaufman, RH Adam, E Icenogle, J Lawson, H Lee, N Reeves, KO Irwin, J Simon, T Press, M Uhler, R Entman, C Reeves, WC TI Relevance of human papillomavirus screening in management of cervical intraepithelial neoplasia SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE human papillomavirus; cervical intraepithelial neoplasia; screening ID ATYPICAL SQUAMOUS CELLS; UNDETERMINED SIGNIFICANCE; INFECTION; CANCER; WOMEN; RISK; COLPOSCOPY; GRADE; HPV AB OBJECTIVE: To evaluate the utility of human papillomavirus detection in identifying women with abnormal Papanicolaou smears who can be safely followed up with cytologic study only, we conducted a study to determine the sensitivity, specificity, and negative and positive predictive values of a Food and Drug Administration-approved human papillomavirus test kit for detection of cervical intraepithelial neoplasia in colposcopically directed biopsy specimens. STUDY DESIGN: We enrolled women with abnormal Papanicolaou smears referred to a colposcopy clinic serving indigent patients. All 1128 women had a referral Papanicolaou smear, a clinic Papanicolaou smear, and a sample for human papillomavirus deoxyribonucleic acid test; 1075 underwent colposcopically directed biopsies and endocervical curettage. We used the HPV Profile kit for human papillomavirus testing. RESULTS: Of 486 women with low-grade squamous intraepithelial lesions on Papanicolaou smear, 35.4% had high-risk human papillomavirus deoxyribonucleic acid detected, and of 592 with high-grade lesions, 44.4% had high-risk human papillomavirus detected. Among 527 women with biopsy specimens showing cervical intraepithelial neoplasia and in 267 with cervical intraepithelial neoplasia grades 2 or 3, 38.7% and 56.2% had high-risk human papillomavirus deoxyribonucleic acid detected. However, the sensitivity of human papillomavirus deoxyribonucleic acid detection to identify biopsy-confirmed cervical intraepithelial neoplasia grades 2 or 3 was 55.7%, and the positive predictive value of the test was only 34.9%. CONCLUSION: Human papillomavirus appears to be causally associated with cervical cancer but human papillomavirus screening does not appear to be of value to identify women with abnormal Papanicolaou smears who can be safely followed up with cytologic study alone. C1 BAYLOR COLL MED,DEPT VIROL,HOUSTON,TX 77030. CTR DIS CONTROL & PREVENT,ATLANTA,GA. RP Kaufman, RH (reprint author), BAYLOR COLL MED,DEPT OBSTET & GYNECOL,6550 FANNIN,SUITE 701,HOUSTON,TX 77030, USA. FU PHS HHS [200-92-0537] NR 24 TC 56 Z9 58 U1 2 U2 3 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD JAN PY 1997 VL 176 IS 1 BP 87 EP 92 DI 10.1016/S0002-9378(97)80017-8 PN 1 PG 6 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WF178 UT WOS:A1997WF17800015 PM 9024095 ER PT J AU Hillis, SD Owens, LM Marchbanks, PA Amsterdam, LE MacKenzie, WR AF Hillis, SD Owens, LM Marchbanks, PA Amsterdam, LE MacKenzie, WR TI Recurrent chlamydial infections increase the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE Chlamydia trachomatis; pelvic inflammatory disease; ectopic pregnancy; recurrent infection; Neisseria gonorrhoeae ID TRACHOMATIS; TRENDS; WOMEN; MODEL AB OBJECTIVE: We examined whether the risks of hospitalization for ectopic pregnancy and pelvic inflammatory disease increase with increasing numbers of chlamydial infections. STUDY DESIGN: A retrospective cohort design was used to evaluate the risks of hospitalization for ectopic pregnancy or pelvic inflammatory among 11,000 Wisconsin women who had one or more chlamydial infections between 1985 and 1992. Logistic regression was used to evaluate the strength of association between recurrent infection and sequelae. RESULTS: After adjustment in multivariate analyses, we observed elevated risks of ectopic pregnancy among women who had had two (odds ratio 2.1, 95% confidence interval 1.3 to 3.4) and three or more chlamydial infections (odds ratio 4.5, 95% confidence interval 1.8 to 5.3). These groups were also at increased risk for pelvic inflammatory (two infections: odds ratio 4.0, 95% confidence interval 1.6 to 9.9; three or more infections: odds ratio 6.4, 95% confidence interval 2.2 to 18.4). CONCLUSIONS: A unique prevention opportunity occurs at the diagnosis of any chlamydial infection because women with subsequent recurrences are at increased risk for reproductive sequelae. C1 CTR DIS CONTROL & PREVENT,EPIDEMIOL PROGRAM OFF,CTR HLTH STAT,ATLANTA,GA 30333. WISCONSIN DEPT HLTH & SOCIAL SERV,BUR HLTH PUBL HLTH,MADISON,WI. RP Hillis, SD (reprint author), CTR DIS CONTROL & PREVENT,NCCDPHP K34,DRH,CTR HLTH STAT,1600 CLIFTON RD,ATLANTA,GA 30333, USA. RI Mac Kenzie, William /F-1528-2013 OI Mac Kenzie, William /0000-0001-7723-0339 NR 21 TC 173 Z9 182 U1 1 U2 3 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD JAN PY 1997 VL 176 IS 1 BP 103 EP 107 DI 10.1016/S0002-9378(97)80020-8 PN 1 PG 5 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WF178 UT WOS:A1997WF17800018 PM 9024098 ER PT J AU Gilmour, E Ellerbrock, TV Koulos, JP Chiasson, MA Williamson, J Kuhn, L Wright, TC AF Gilmour, E Ellerbrock, TV Koulos, JP Chiasson, MA Williamson, J Kuhn, L Wright, TC TI Measuring cervical ectopy: Direct visual assessment versus computerized planimetry SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY LA English DT Article DE cervix; ectopy; human immunodeficiency virus; reliability; measurement ID HUMAN-IMMUNODEFICIENCY-VIRUS AB OBJECTIVE: Cervical ectopy has been identified as a possible risk factor for heterosexual transmission of human immunodeficiency virus. To accurately assess the importance of cervical ectopy,;methods for measuring ectopy with precision need to be developed. The objective of this study was to evaluate the reliability of two methods of measuring cervical ectopy: direct visual assessment and computerized planimetry. STUDY DESIGN: Cervical photographs of 85 women without cervical disease were assessed for cervical ectopy by three raters using direct visual assessment and a computer planimetry method. Agreement between the two methods, among the three raters, and among measurements by each rater over time was calculated with use of intraclass correlation coefficients, where 1.0 represents perfect agreement and 0 represents no agreement except by chance. RESULTS: The intraclass correlation coefficient among the three raters (interrater agreement) was 0.58 for direct visual assessment without application of acetic acid to the cervix compared with 0.72 for direct visual assessment with acetic acid and 0.82 for computerized planimetry with acetic acid. The intraclass correlation coefficient among measurements by each rater over time (intrarater agreement) was 0.66 for direct visual assessment without acetic acid compared with 0.77 for direct visual assessment and 0.83 for computerized planimetry after application of acetic acid. When acetic acid was used, the intraclass correlation coefficient between the two methods was 0.69. CONCLUSIONS: Computerized planimetry of cervical photographs may provide the most consistent estimate of the percent of ectopy. However, if time and resources make the use of computer planimetry difficult, direct visual assessment after application of 5% acetic acid appears to provide comparable estimates. C1 COLUMBIA UNIV COLL PHYS & SURG,DEPT PATHOL,NEW YORK,NY 10032. COLUMBIA UNIV COLL PHYS & SURG,DEPT OBSTET & GYNECOL,NEW YORK,NY 10032. CTR DIS CONTROL & PREVENT,NATL CTR HIV,SEXUALLY TRANSMITTED DIS,ATLANTA,GA. NEW YORK CITY DEPT HLTH,BUR DIS INTERVENT RES,NEW YORK,NY 10013. EMORY UNIV,ROLLINS SCH PUBL HLTH,DEPT BIOSTAT,ATLANTA,GA 30322. FU PHS HHS [CCU 206822] NR 9 TC 13 Z9 13 U1 0 U2 1 PU MOSBY-YEAR BOOK INC PI ST LOUIS PA 11830 WESTLINE INDUSTRIAL DR, ST LOUIS, MO 63146-3318 SN 0002-9378 J9 AM J OBSTET GYNECOL JI Am. J. Obstet. Gynecol. PD JAN PY 1997 VL 176 IS 1 BP 108 EP 111 DI 10.1016/S0002-9378(97)80021-X PN 1 PG 4 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA WF178 UT WOS:A1997WF17800019 PM 9024099 ER PT J AU Hinman, AR AF Hinman, AR TI Quantitative policy analysis and public health policy: A macro and a micro view SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article; Proceedings Paper CT Workshop on the Impact of Quantitative Policy Analysis on Health Policy Formation, at the 1994 Meeting of the Society-for-Medical-Decision-Making CY OCT 16, 1994 CL CLEVELAND, OH SP Soc Med Decis Making DE cost analysis; health policy; Agency for Health Care Policy and Research; cost effectiveness; cost-benefit analysis ID VARICELLA VACCINATION PROGRAM; UNITED-STATES CHILDREN; COST-EFFECTIVENESS; PERTUSSIS-VACCINE; BENEFITS; RISKS; IMMUNIZATION; INFLUENZA; MEASLES AB This article considers three examples of the use of quantitative policy analysis in setting public health policy: (1) benefit:cost and cost-effectiveness studies of influenza immunization and their role in achieving Medicare reimbursement for influenza immunization; (2) the 1993 World Bank World Development Report, which compared the burden of various health problems in different regions of the world and the cost-effectiveness of interventions for these problems, recommending a core set of public health and primary care services as being the most cost-effective; and (3) the role of the Agency for Health Care Policy and Research and how it might change if health care reform legislation such as President Clinton's original proposal were to be enacted. Finally, I describe the use of quantitative policy analysis to guide policy in one government agency-the Centers for Disease Control and Prevention (CDC). Medical Subject Headings (MeSH): cost analysis, health policy, Agency for Health Care Policy and Research, cost effectiveness, cost-benefit analysis. RP Hinman, AR (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 34 TC 6 Z9 7 U1 0 U2 2 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JAN-FEB PY 1997 VL 13 IS 1 BP 6 EP 11 PG 6 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA WH260 UT WOS:A1997WH26000003 PM 9037336 ER PT J AU StLouis, ME Wasserheit, JN Gayle, HD AF StLouis, ME Wasserheit, JN Gayle, HD TI Janus considers the HIV pandemic - Harnessing recent advances to enhance AIDS prevention SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Editorial Material ID SEXUALLY-TRANSMITTED DISEASES; INFECTION RP StLouis, ME (reprint author), CTR DIS CONTROL & PREVENT, NATL CTR HIV STD & TB PREVENT, ATLANTA, GA 30333 USA. NR 29 TC 17 Z9 17 U1 0 U2 0 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JAN PY 1997 VL 87 IS 1 BP 10 EP 12 DI 10.2105/AJPH.87.1.10 PG 3 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WG315 UT WOS:A1997WG31500002 PM 9065212 ER PT J AU ElBassel, N Schilling, RF Irwin, KL Faruque, S Gilbert, L VonBargen, J Serrano, Y Edlin, BR AF ElBassel, N Schilling, RF Irwin, KL Faruque, S Gilbert, L VonBargen, J Serrano, Y Edlin, BR TI Sex trading and psychological distress among women recruited from the streets of Harlem SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; BRIEF SYMPTOM INVENTORY; HIV-INFECTION; RISK BEHAVIOR; CRACK COCAINE; YOUNG-ADULTS; USERS; POPULATION; ALCOHOL; DRUG AB Objectives. This study examines the relationship between sex trading and psychological distress and the implications of that relationship for prevention of human immunodeficiency virus among a sample of young women recruited from the streets of Harlem. Methods. Interviews were conducted with 346 predominantly drug-using women, aged 18 to 29 years, of whom 176 had exchanged sex for money or drugs in the previous 30 days and were categorized as ''sex traders.'' Psychological distress was measured by using the Brief Symptom Inventory. Results. Sex traders scored significantly higher than non-sex traders on the General Severity Index and on eight of the nine subscales of the Brief Symptom Inventory Multivariate analysis indicated that after adjustments were made for age; ethnicity; pregnancy; recent rape; perceived risk for acquired immunodeficiency syndrome; current, regular crack use; and current, regular alcohol use, sex traders scored 0.240 units higher on the General Severity Index than non-sex traders. Conclusions. Poor mental health and drug dependence may undermine the motivation and ability of these sex traders to adopt safer sex behavior. Therefore, interventions need to be integrated with mental health services and drug treatment to reduce risk behavior in this population. C1 CTR DIS CONTROL & PREVENT,DIV HIV AIDS PREVENT,ATLANTA,GA. ASSOC DRUG ABUSE PREVENT & TREATMENT,NEW YORK,NY. RP ElBassel, N (reprint author), COLUMBIA UNIV,SCH SOCIAL WORK,SOCIAL INETERVENT GRP,622 W 113TH ST,NEW YORK,NY 10025, USA. OI Edlin, Brian/0000-0001-8172-8797 FU PHS HHS [U64/CCU204582] NR 43 TC 107 Z9 108 U1 7 U2 13 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JAN PY 1997 VL 87 IS 1 BP 66 EP 70 DI 10.2105/AJPH.87.1.66 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WG315 UT WOS:A1997WG31500014 PM 9065229 ER PT J AU Gordon, RL Gerzoff, RB Richards, TB AF Gordon, RL Gerzoff, RB Richards, TB TI Determinants of US local health department expenditures, 1992 through 1993 SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article AB Objectives. This study examined local health department expenditures and their relationship to several departmental characteristics, including the size of the population in the department's jurisdiction. Methods. Local health department characteristics were obtained from a 1992/93 nationwide mail survey and modeled by means of multiple linear regression. Results. Great variability existed in the per capita expenditures of local health departments, and approximately 70% of the variability was accounted for by differences in jurisdiction population size. Additional characteristics of the health departments explained another 11%. The average unadjusted per capita expenditure by local health departments nationwide was $26. Conclusions. Local health department expenditures that support essential public health services average a dime a day per person. C1 CTR DIS CONTROL & PREVENT,PUBL HLTH PRACTICE PROGRAM OFF,ATLANTA,GA. EDS CORP,ATLANTA,GA. FU PHS HHS [U50/CCU302718] NR 25 TC 15 Z9 15 U1 0 U2 2 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 1015 FIFTEENTH ST NW, WASHINGTON, DC 20005 SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD JAN PY 1997 VL 87 IS 1 BP 91 EP 95 DI 10.2105/AJPH.87.1.91 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WG315 UT WOS:A1997WG31500018 PM 9065234 ER PT J AU Evans, CAW Gonzalez, AE Gilman, RH Verastegui, M Garcia, HH Chavera, A Pilcher, JB Tsang, VCW Alvarez, M Carcamo, C Castro, M Diaz, F Herrera, G Li, O Martinez, M Miranda, E Montenegro, T Naranjo, J Torres, P AF Evans, CAW Gonzalez, AE Gilman, RH Verastegui, M Garcia, HH Chavera, A Pilcher, JB Tsang, VCW Alvarez, M Carcamo, C Castro, M Diaz, F Herrera, G Li, O Martinez, M Miranda, E Montenegro, T Naranjo, J Torres, P TI Immunotherapy for porcine cysticercosis: Implications for prevention of human disease SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID TAENIA-SOLIUM; PERU; PIGS; ANTIGENS; ASSAY; NEUROCYSTICERCOSIS; DIAGNOSIS; FIELD; HOGS AB Taenia solium cysticercosis is an important cause of human disease in many developing countries. Porcine cysticercosis is a vital link in the transmission of this disease and impairs meat production. A treatment for porcine cysticercosis may be an effective way of preventing human disease that would also benefit pig farmers, facilitating control programs in disease-endemic regions. Previous research suggests that reinfection with cysticercosis or immunotherapy with cysticercal antigens may cause degeneration of cysticerci, potentially curing porcine cysticercosis. Therefore, a blinded, randomized, controlled study to assess the efficacy and safety of immunotherapy in 28 naturally parasitized pigs was performed. Four groups of pigs with similar weights were inoculated twice with membrane-enriched cysticercal antigens (MA), saline, aqueous-soluble crude cysticercal antigens (AA) in adjuvant (Freund's complete then incomplete), or adjuvant alone. Immunotherapy was well tolerated but had no consistent effect on the macroscopic appearance of cysticerci or eosinophil count. Histopathologic findings were variable, with both severe and minimal inflammatory reactions seen in adjacent cysticerci in all pigs. Nine (64%) of 14 pigs given immunotherapy developed new antibody bands on electroimmunotransfer blot compared with one (7%) of 14 control pigs (P < 0.01). Treatment with AA in adjuvant caused a significant increase in the proportion of cysticerci that failed to evaginate and were, therefore, not viable for infecting humans (34% for pigs given AA in adjuvant compared with 10% for adjuvant alone; P < 0.04). Although immunotherapy caused a statistically significant decrease in the viability of cysticerci, this immunologic reaction was not great enough to prevent human disease. C1 ADDENBROOKES HOSP,DEPT MED,CAMBRIDGE CB2 2QQ,ENGLAND. UNIV NACL MAYOR SAN MARCOS,LIMA 14,PERU. ASSOC BENEF PROYECTOS INFORMAT SALUD MED & AGR,LIMA,PERU. JOHNS HOPKINS UNIV,SCH HYG & PUBL HLTH,BALTIMORE,MD. UNIV PERUANA CAYETANO HEREDIA,LIMA,PERU. RP Evans, CAW (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. FU NIAID NIH HHS [U01 AI035894, 1-UO1-AI-35894-01]; Wellcome Trust [057434] NR 30 TC 15 Z9 17 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JAN PY 1997 VL 56 IS 1 BP 33 EP 37 PG 5 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WL889 UT WOS:A1997WL88900008 PM 9063358 ER PT J AU Collins, WE Sullivan, JS Morris, CL Galland, GG Richardson, BB Roberts, JM AF Collins, WE Sullivan, JS Morris, CL Galland, GG Richardson, BB Roberts, JM TI The Malayan IV strain of Plasmodium falciparum in Aotus monkeys SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article AB Forty-nine infections with the Malayan IV strain of Plasmodium falciparum were induced in different species of Aotus monkeys. The parasite was shown to be infective to four different species of Aotus monkeys via the inoculation of parasitized erythrocytes. Sporozoite transmission was obtained to A. lemurinus griseimembra, A. vociferans, and hybrid monkeys with A. azarae boliviensis x A. nancymai and A. lemurinus griseimembra x A. nancymai parentage. Anopheles freeborni and An. stephensi mosquitoes fed readily on animals and through membranes; both supported the development of infective sporozoites. Markedly increased levels of mosquito infection were routinely obtained by membrane feeding, indicating the presence of serum factors inhibitory to infection. The Malayan IV strain appears suitable for blood-stage and transmission-blocking vaccine trials. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ANIM RESOURCES BRANCH,ATLANTA,GA. CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,ATLANTA,GA. NR 9 TC 10 Z9 10 U1 0 U2 0 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JAN PY 1997 VL 56 IS 1 BP 49 EP 56 PG 8 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WL889 UT WOS:A1997WL88900011 PM 9063361 ER PT J AU Tsang, VCW Hillyer, GV Noh, J VivasGonzalez, BE Ahn, LH Pilcher, JB Hightower, AW Deseda, C DeMelecio, CF AF Tsang, VCW Hillyer, GV Noh, J VivasGonzalez, BE Ahn, LH Pilcher, JB Hightower, AW Deseda, C DeMelecio, CF TI Geographic clustering and seroprevalence of schistosomiasis in Puerto Rico (1995) SO AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE LA English DT Article ID ADULT MICROSOMAL ANTIGENS; SEROLOGIC REAGENT; FAST-ELISA; S-MANSONI; ANTIBODIES AB A systematic, island-wide survey for schistosomiasis in Puerto Rico has not been conducted for more than 40 years. In 1974, a thorough survey of Boqueron de Las Piedras, a small community, showed a prevalence of 40%. No additional information on prevalence in Puerto Rico has been obtained during the ensuing 21 years. Concern for the public health of residents and visitors prompted the formation of the Bilharzia Commission in 1994 and the systematic serosurvey reported herein. Two thousand nine hundred fifty-five plasma samples from healthy donors were obtained randomly from the Red Cross in March and April 1995. Sex, resident municipalities, and age of the donors were recorded. The donors were from all but three of 79 municipalities in Puerto Rico. No sample was available from the three out island municipalities of Mona, Vieques, and Culebra. Male donors (n = 2,027) outnumbered females (n = 928) by more than 2:1, ages ranged from nine to 76 years with most (85.3%) between 19 and 51 years of age. All samples were tested with the Falcon assay screening test:enzyme-linked immunosorbent assay (FAST(TM):ELISA) with microsomal antigens of Schistosoma mansoni. All FAST:ELISA+ samples were confirmed by enzyme-linked immunoelectrotransfer blot (EITB). Our data showed that 15.4% were FAST:ELISA+, and 10.6% were confirmed by EITB; 13.5% of the males and 4.1% of the females were EITB+. If we exclude those municipalities with fewer than five samples, the prevalence of EITB+ ranged from 0% to 38.5%, with the highest seroprevalence rates (21.1-38.5%) concentrated in 17 municipalities, which accounted for 48% of all seropositive samples. These 17 municipalities, however, contain only 18% of the total population of Puerto Rico. Two areas of high seroprevalence rates center around Jayuya (38.5%) and Naguabo (36.4%). The previously surveyed area of Boqueron is located in Las Piedras (35.3%), adjacent to Naguabo. In addition, we found 10% (21) of our total 215 donors less than 25 years of age to be EITB+ and all but two are residents of the high prevalence districts. These data strongly support the contention that schistosomiasis has been transmitted in a focal fashion during the past approximately 20 years. C1 UNIV PUERTO RICO,SCH MED,DEPT LAB MED & PATHOL,SAN JUAN,PR 00936. DEPT HLTH,OFF SECRETARY,SAN JUAN,PR 00936. RP Tsang, VCW (reprint author), CTR DIS CONTROL & PREVENT,DIV PARASIT DIS,NATL CTR INFECT DIS,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. NR 18 TC 14 Z9 15 U1 0 U2 1 PU AMER SOC TROP MED & HYGIENE PI MCLEAN PA 8000 WESTPARK DRIVE SUITE 130, MCLEAN, VA 22101 SN 0002-9637 J9 AM J TROP MED HYG JI Am. J. Trop. Med. Hyg. PD JAN PY 1997 VL 56 IS 1 BP 107 EP 112 PG 6 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA WL889 UT WOS:A1997WL88900021 PM 9063371 ER PT J AU Stevens, JA Powell, KE Smith, SM Wingo, PA Sattin, RW AF Stevens, JA Powell, KE Smith, SM Wingo, PA Sattin, RW TI Physical activity, functional limitations, and the risk of fall related fractures in community-dwelling elderly SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE elderly; falls; fractures; physical activity; exercise; activities of daily living ID WEIGHT-BEARING EXERCISE; HIP FRACTURE; POSTMENOPAUSAL WOMEN; OLDER WOMEN; MUSCLE STRENGTH; PROXIMAL FEMUR; CALCIUM INTAKE; HONG-KONG; BONE MASS; OSTEOPOROSIS AB This case-control study examines the association of vigorous and mild physical activity with fall-related fractures in a community-dwelling population age 65 and older in South Florida. Vigorous physical activity was defined as exercising doing heavy housecleaning, or other hard labor three or more times per week in the month prior to the index date; mild physical activity was defined as the number of hours per day subjects reported spending on their feet. A case was any subject who sustained a fall-related fracture (ICD-9CM-800 through ICD-9CM-829) over a 21-month Period (n = 471). Controls were a 10% random sample selected from the Health Care Financing Administration Medicare files (n = 712). The presence of any limitation in activities of daily living (ADL) significantly modified the effect of vigorous physical activity. Physically active subjects with no limitations (ADL = 0) were less likely to sustain a fall-related fracture than were inactive subjects, with an adjusted odds ratio (aOR) of 0.6, (0.5-0.8 95% CI), and active subjects with any limitation (ADL greater than or equal to 1) had an aOR of 3.2 (1.1-9.8 95% CI). Limiting this analysis to 159 hip fracture cases produced similar results. Mild physical activity was not associated with fracture. These results suggest that vigorous physical activity is associated with a lower fracture risk among elderly persons who have no limitations in ADL and with a higher risk among those with any limitations. (C) 1997 by Elsevier Science, Inc. C1 CTR DIS CONTROL & PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA. CTR DIS CONTROL & PREVENT,CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA. AMER CANC SOC,ATLANTA,GA 30329. NR 45 TC 47 Z9 48 U1 4 U2 10 PU ELSEVIER SCIENCE INC PI NEW YORK PA 655 AVENUE OF THE AMERICAS, NEW YORK, NY 10010 SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD JAN PY 1997 VL 7 IS 1 BP 54 EP 61 DI 10.1016/S1047-2797(96)00110-X PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WH069 UT WOS:A1997WH06900008 PM 9034407 ER PT J AU Brownson, RC Eriksen, MP Davis, RM Warner, KE AF Brownson, RC Eriksen, MP Davis, RM Warner, KE TI Environmental tobacco smoke: Health effects and policies to reduce exposure SO ANNUAL REVIEW OF PUBLIC HEALTH LA English DT Review DE attitudes; behavior; lung cancer; public policy; tobacco smoke pollution ID LUNG-CANCER RISK; PASSIVE SMOKING; NONSMOKING WOMEN; CIGARETTE CONSUMPTION; HEART-DISEASE; UNITED-STATES; INVOLUNTARY SMOKING; EMPLOYEE SMOKING; WORKPLACE; BAN AB The health hazards due to exposure to environmental tobacco smoke (ETS) are increasingly established. ETS contains thousands of chemicals including 43 known carcinogens. Known health effects of ETS exposure are lung cancer in nonsmokers, childhood disorders such as bronchitis, and perhaps, heart disease. Workplace exposure to ETS is widespread and is influenced strongly by the type of smoking policy in the workplace. To decrease ETS exposure, efforts to restrict public smoking have proliferated over the past decade. These restrictions have emanated from government as well as voluntary measures by various private industries. Bans on public smoking are effective in reducing nonsmokers' exposure to ETS. Workplace smoking bans also influence the intensity of smoking among employees and may increase quit smoking rates. In addition to the health benefits from smoke-free workplaces, there are likely cost savings to employers who implement such policies. C1 ST LOUIS UNIV, SCH PUBL HLTH, PREVENT RES CTR, ST LOUIS, MO 63108 USA. CTR DIS CONTROL & PREVENT, OFF SMOKING & HLTH, NATL CTR CHRON DIS PREVENT & HLTH PROMOT, ATLANTA, GA 30341 USA. HENRY FORD HLTH SYST, CTR HLTH PROMOT & DIS PREVENT, DETROIT, MI 48202 USA. UNIV MICHIGAN, SCH PUBL HLTH, DEPT HLTH POLICY & MANAGEMENT, ANN ARBOR, MI 48109 USA. RP Brownson, RC (reprint author), ST LOUIS UNIV, SCH PUBL HLTH, DEPT COMMUNITY HLTH, ST LOUIS, MO 63108 USA. NR 118 TC 82 Z9 82 U1 3 U2 7 PU ANNUAL REVIEWS PI PALO ALTO PA 4139 EL CAMINO WAY, PO BOX 10139, PALO ALTO, CA 94303-0139 USA SN 0163-7525 EI 1545-2093 J9 ANNU REV PUBL HEALTH JI Annu. Rev. Public Health PY 1997 VL 18 BP 163 EP 185 DI 10.1146/annurev.publhealth.18.1.163 PG 23 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA XA185 UT WOS:A1997XA18500007 PM 9143716 ER PT S AU Gaynes, R Monnet, D AF Gaynes, R Monnet, D BE Chadwick, DJ Goode, J TI The contribution of antibiotic use on the frequency of antibiotic resistance in hospitals SO ANTIBIOTIC RESISTANCE: ORIGINS, EVOLUTION, SELECTION AND SPREAD SE CIBA FOUNDATION SYMPOSIA LA English DT Article; Proceedings Paper CT Symposium on Antibiotic Resistance - Origins, Evolution, Selection and Spread CY JUL 16-18, 1996 CL CIBA FDN, LONDON, ENGLAND SP Ciba Fdn HO CIBA FDN ID GRAM-NEGATIVE BACILLI; UNITED-STATES; STAPHYLOCOCCUS-AUREUS; SURVEILLANCE; USAGE; SUSCEPTIBILITY; BACTEREMIA; ORGANISMS; PATTERNS; TRENDS AB Abundant evidence suggests a relationship between antibiotic resistance and use, including animal models, consistent associations between resistance and antibiotic use in hospitals, concomitant variation in resistance as antibiotic use varies, and a dose-response relationship for many pathogen/antibiotic combinations. Much of the evidence has come from studies performed in single hospitals. Most multicentre studies on resistance have not included data on antibiotic usage. Despite this substantial body of evidence, some studies have failed to demonstrate an association between antibiotic resistance and use, suggesting other contributing factors such as cross-transmission, inter-hospital transfer of resistance, a community contribution to resistance, or a complex relationship between resistance and the use of a variety of antibiotics. A multicentre study, project ICARE (Intensive Care Antimicrobial Resistance Epidemiology), implemented in 1994 by Centers for Disease Control and Prevention and Rollins School of Public Health, Emery University, has found dramatic differences in the patterns of antibiotic usage and resistance in US hospitals. The findings suggest that antibiotic usage is the major risk factor in development of antibiotic resistance in hospitals but the relationship can be complex with additional factors involved. Understanding the problem of antibiotic resistance in a hospital cannot be achieved without knowledge of the hospital's pattern of antibiotic use. C1 CTR HOSP LYON SUD,C CLIN,F-69495 PIERRE BENITE,FRANCE. RP Gaynes, R (reprint author), CTR DIS CONTROL & PREVENT,HOSP INFECT PROGRAM,MS E-55,1600 CLIFTON RD,ATLANTA,GA 30333, USA. NR 34 TC 35 Z9 36 U1 1 U2 28 PU JOHN WILEY & SONS LTD PI CHICHESTER PA BAFFINS LANE, CHICHESTER, WEST SUSSEX, ENGLAND PO19 1UD SN 0300-5208 BN 0-471-97105-7 J9 CIBA F SYMP PY 1997 VL 207 BP 47 EP 56 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA BH80X UT WOS:A1997BH80X00004 PM 9189634 ER PT S AU Cohen, ML AF Cohen, ML BE Chadwick, DJ Goode, J TI Epidemiological factors influencing the emergence of antimicrobial resistance SO ANTIBIOTIC RESISTANCE: ORIGINS, EVOLUTION, SELECTION AND SPREAD SE CIBA FOUNDATION SYMPOSIA LA English DT Article; Proceedings Paper CT Symposium on Antibiotic Resistance - Origins, Evolution, Selection and Spread CY JUL 16-18, 1996 CL CIBA FDN, LONDON, ENGLAND SP Ciba Fdn HO CIBA FDN ID UNITED-STATES; INFECTIONS; SALMONELLA AB Antimicrobial resistance is becoming an important public health problem for both hospital- and community-acquired infections. Ln the hospital, infections caused by drug-resistant Staphylococcus aureus, Mycobacterium tuberculosis, enterococci, and a variety of Gram-negative rods are resulting in increased morbidity, mortality and costs, in part because of prolonged hospitalization and the use of more expensive antimicrobial agents. Drug-resistant, community-acquired infections are also causing important problems in both the developed and the developing world. Although the relative importance of specific pathogens varies with the geographical area, community-acquired pathogens including Salmonella, Shigella, Neisseria gonorrhoeae, Haemophilus influenzae and Streptococcus pneumoniae are causing both sporadic cases and outbreaks of drug-resistant illness. The emergence of antimicrobial resistance is being attributed to a series of societal, technological, environmental and microbial changes. These include increasing populations of susceptible hosts, international travel and commerce, changes in technology and industry, microbial adaptation and change, and the breakdown of public health measures. Addressing emerging problems and antimicrobial resistance will require enhanced surveillance, prudent use of existing antimicrobial drugs, development of new antimicrobial agents, increased emphasis on infection control and hygienic practices, effective disease control programs, better use of existing vaccines, and development of more and better vaccines. RP Cohen, ML (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,1600 CLIFTON RD,C09,ATLANTA,GA 30333, USA. NR 26 TC 17 Z9 18 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA BAFFINS LANE, CHICHESTER, WEST SUSSEX, ENGLAND PO19 1UD SN 0300-5208 BN 0-471-97105-7 J9 CIBA F SYMP PY 1997 VL 207 BP 223 EP 231 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA BH80X UT WOS:A1997BH80X00014 PM 9189644 ER PT J AU Marley, SE Eberhard, ML Steurer, FJ Ellis, WL McGreevy, PB Ruebush, TK AF Marley, SE Eberhard, ML Steurer, FJ Ellis, WL McGreevy, PB Ruebush, TK TI Evaluation of selected antiprotozoal drugs in the Babesia microti-hamster model SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID INFECTION; AZITHROMYCIN; EFFICACY; DISEASE AB The presently used therapy for Babesia microti infections, a combination of quinine and clindamycin, does not always result in parasitologic cures, To identify possible alternative chemotherapeutic agents for such infections, we screened, in the hamster-B. microti system, 12 antiprotozoal drugs that have either recently been released for human use or were in experimental stages of development at the Waiter Reed Army Institute of Research for the treatment of malaria and leishmaniasis, Several well-recognized antimalarial drugs, such as mefloquine, halofantrine, artesunate, and artelenic acid, exhibited little or no effect on parasitemia, Two 8-aminoquinolines, WR006026 [8-(6-diethylaminohexylamino)-6-methoxy-4-methylquinoline dihydrochloride] and WR238605 [8-[(4-amino-1-methylbutyl)amino]-2,6-dimethoxy-4-methyl-5-(3-trifluoromethylphenoxy-7) quinoline succinate], produced clearance of patent parasitemia, Furthermore, blood from infected hamsters treated with WR238605 via an intramuscular injection failed to infect naive hamsters on subpassage, thus producing a parasitologic cure, These two compounds merit further screening in other systems and may prove useful in treating human babesiosis. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV PARASIT DIS,DEPT HLTH & HUMAN SERV,ATLANTA,GA 30341. UNIV GEORGIA,DEPT ZOOL,ATHENS,GA 30602. WALTER REED ARMY INST RES,DIV EXPT THERAPEUT,WASHINGTON,DC 20307. FU NIAID NIH HHS [5T32 AI07322] NR 22 TC 35 Z9 35 U1 1 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JAN PY 1997 VL 41 IS 1 BP 91 EP 94 PG 4 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA WA656 UT WOS:A1997WA65600017 PM 8980761 ER PT J AU Ashley, DL Prah, JD AF Ashley, DL Prah, JD TI Time dependence of blood concentrations during and after exposure to a mixture of volatile organic compounds SO ARCHIVES OF ENVIRONMENTAL HEALTH LA English DT Article ID PARTITION-COEFFICIENTS; OCCUPATIONAL EXPOSURE; BENZENE; TOLUENE; POPULATION; CHEMICALS; WORKERS; BREATH AB Volatile organic compounds constitute a group of important environmental pollutants that have been associated with the constellation of symptoms known as sick building syndrome. An understanding of the kinetics of uptake and elimination of volatile organic compounds is important for the proper interpretation of the internal dose concentrations of people exposed to these compounds. Blood concentrations measured before, during, and after exposure of five individuals to a mixture of volatile organic compounds in a controlled chamber are described. Blood concentrations were related directly to air exposure concentrations and appeared to he a function of the blood/air partition coefficient. The half-lives of the internal dose of the volatile organic compounds measured were less than 1/2 k, but the elimination time courses were multiexponential. The complexity of the elimination curve suggested the existence of multiple storage sites within the body. The presence of a long-term exponential in the blood elimination curve suggested that, with repeated exposure, bioaccumulation may occur in humans. C1 US EPA,HLTH EFFECTS RES LAB,HUMAN STUDIES DIV,RES TRIANGLE PK,NC 27711. RP Ashley, DL (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,MAILSTOP F-17,4770 BUFORD HIGHWAY NE,ATLANTA,GA 30341, USA. NR 19 TC 23 Z9 25 U1 0 U2 0 PU HELDREF PUBLICATIONS PI WASHINGTON PA 1319 EIGHTEENTH ST NW, WASHINGTON, DC 20036-1802 SN 0003-9896 J9 ARCH ENVIRON HEALTH JI Arch. Environ. Health PD JAN-FEB PY 1997 VL 52 IS 1 BP 26 EP 33 PG 8 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA WK841 UT WOS:A1997WK84100003 PM 9039854 ER PT J AU Jonas, BS Franks, P Ingram, DD AF Jonas, BS Franks, P Ingram, DD TI Are symptoms of anxiety and depression risk factors for hypertension? Longitudinal evidence from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study SO ARCHIVES OF FAMILY MEDICINE LA English DT Article ID BLOOD-PRESSURE REACTIVITY; BORDERLINE HYPERTENSION; STRESS; INFORMATION; PREDICTORS; HOSTILITY; MORTALITY; VALIDITY; TENSION; DISEASE AB Objective: To test the hypothesis that symptoms of anxiety and depression increase the risk of experiencing hypertension, using the National Health and Nutrition Examination I Epidemiologic Follow-up Study. Design: A cohort of men and women without evidence of hypertension at baseline were followed up for 7 to 16 years. The association between 2 outcome measures (hypertension and treated hypertension) and baseline anxiety and depression was analyzed using Cox proportional hazards regression adjusting for hypertension risk factors (age; sex; education; cigarette smoking; body mass index; alcohol use; history of diabetes, stroke, or coronary heart disease; and baseline systolic blood pressure). Analyses were stratified by race and age (white persons aged 25-44 years and 45-64 years and black persons aged 25-64 years). Setting: General community. Participants: A population-based sample of 2992 initially normotensive persons. Main Outcome Measures: Incident hypertension was defined as blood pressure of 160/95 mm Hg or more, or prescription of antihypertensive medications. Treated hypertension was defined as prescription of antihypertensive medications. Results: In the multivariate models for whites aged 45 to 64 years, high anxiety (relative risk [RR], 1.82; 95% confidence interval [CI], 1.30-2.53) and high depression (RR, 1.80; 95% CI, 1.16-2.78) remained independent predictors of incident hypertension. The risks associated with treated hypertension were also increased for high anxiety (RR, 2.36; 95% CI, 1.73-3.23) and high depression (RR, 1.89; 95% CI, 1.25-2.85). For blacks aged 25 to 64 years, high anxiety (RR, 2.74; 95% CI, 1.35-5.53) and high depression (RR, 2.99; 95% CI, 1.41-6.33) remained independent predictors of incident hypertension. The risks associated with treated hypertension were also increased for high anxiety (RR, 3.24; 95% CI, 1.59-6.61) and high depression (RR, 2.92; 95% CI, 1.37-6.22). For whites aged 25 to 44 years, intermediate anxiety (RR, 1.62; 95% CI, 1.18-2.22) and intermediate depression (RR, 1.60; 95% CI, 1.17-2.17) remained independent predictors of treated hypertension only. Conclusion: Anxiety and depression are predictive of later incidence of hypertension and prescription treatment for hypertension. C1 UNIV ROCHESTER,DEPT FAMILY MED,ROCHESTER,NY. HIGHLAND HOSP,PRIMARY CARE INST,ROCHESTER,NY. RP Jonas, BS (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR HLTH STAT,OFF ANAL EPIDEMIOL & HLTH PROMOT,6525 BELCREST RD,HYATTSVILLE,MD 20782, USA. NR 49 TC 284 Z9 315 U1 5 U2 28 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 1063-3987 J9 ARCH FAM MED JI Arch. Fam. Med. PD JAN-FEB PY 1997 VL 6 IS 1 BP 43 EP 49 DI 10.1001/archfami.6.1.43 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA WD610 UT WOS:A1997WD61000009 PM 9003169 ER PT J AU Ni, HY Sacks, JJ Curtis, L Cieslak, PR Hedberg, K AF Ni, HY Sacks, JJ Curtis, L Cieslak, PR Hedberg, K TI Evaluation of a statewide bicycle helmet law via multiple measures of helmet use SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID HEAD-INJURIES; CHILDREN; CAMPAIGN AB Objectives: To evaluate an Oregon law requiring bicyclists younger than 16 years to wear a helmet and to compare methods of measuring helmet use. Design: Four prelaw and postlaw statewide helmet use surveys: (1) statewide observations, (2) middle school observations, (3) classroom self-report surveys, and (4) a statewide adult telephone survey. Setting: Oregon. Subjects: Statewide observations, 3313 child bicyclists at 13 sites; middle school observations, 995 child bicyclists at 33 randomly selected middle schools; classroom self-report surveys, fourth, sixth, and eighth graders in 448 classrooms (ie, 8955 students) before the law was effected and 456 classrooms (ie, 9811 students) after the law was effected in 66 randomly selected schools; and statewide telephone survey, 1219 randomly called parents of 1437 children younger than 16 years. Main Outcome Measures: Prelaw and postlaw helmet use and ownership and knowledge and opinion about the law. Results: Observed helmet use among youth was 24.5% before the law was effected and 49.3% after the law was effected. School-observed use increased from 20.4% to 56.1%. Classroom survey self-reported ''always'' use of helmets increased from 14.7% to 39.4%; reported use on the day of the survey increased from 25.8% to 76.0%. Telephone survey-reported ''always'' helmet use increased from 36.8% to 65.7%. Younger children and girls were more likely to use helmets. Most students (ie, 87.8%) and parents (ie, 95.4%) knew about the law; however, only 42.6% of children thought, the law was a good idea. Conclusions: We conclude that (1) the law increased helmet use; (2) although use estimates differ, all helmet surveys showed similar degrees of prelaw and postlaw change; and (3) half of child bicyclists are still not wearing helmets, indicating a need for additional promotion of helmet wearing. Laws seem to be an effective way to increase helmet use. C1 CTR DIS CONTROL & PREVENT,DIV UNINTENT INJURY PREVENT,NATL CTR INJURY PREVENT & CONTROL,ATLANTA,GA. RP Ni, HY (reprint author), OREGON HLTH DIV,CTR DIS PREVENT & EPIDEMIOL,DEPT HUMAN RESOURCES,800 NE OREGON ST,SUITE 772,PORTLAND,OR 97232, USA. FU NHLBI NIH HHS [H34-CCHO 10476-01] NR 27 TC 42 Z9 42 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD JAN PY 1997 VL 151 IS 1 BP 59 EP 65 PG 7 WC Pediatrics SC Pediatrics GA WC696 UT WOS:A1997WC69600009 PM 9006530 ER PT J AU Escobedo, LG Reddy, M DuRant, RH AF Escobedo, LG Reddy, M DuRant, RH TI Relationship between cigarette smoking and health risk and problem behaviors among US adolescents SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Article ID HIGH-SCHOOL-STUDENTS; UNITED-STATES; DRUG-USE; DELINQUENCY; INITIATION; PREVENTION; MALES AB Objective: To examine whether sociodemographic factors and health risk and problem behaviors explain the prevalence of cigarette smoking among US adolescents. Design: Probability survey. Participants: A nationally representative sample of US adolescents. Main Outcome Measures: Weighted prevalence, adjusted odds ratio (OR), and 95% confidence intervals (CIs) for current smoking status by health risk and problem behaviors. Results: The prevalence of smoking was highest among adolescents who were white, older, and who had a high school education or lived in the Northeast. When we adjusted for sociodemographic factors and health risk and problem behaviors, smoking was associated with marijuana use (OR, 3.7; 95%CI, 2.7-5.1), binge drinking (OR, 2.1; 95% CI, 1.6-2.8), and fighting (OR, 1.4; 95% CI, 1.1-1.7) among white adolescent males. Similar associations between each of these 3 behaviors and cigarette smoking were found among white adolescent females and African American and Hispanic adolescent males and females. Cigarette smoking was also associated with using smokeless tobacco, having multiple sexual partners, and not using bicycle helmets among white adolescent males and females, having multiple sexual partners among Hispanic adolescent females, and carrying weapons among Hispanic adolescent males. Conclusions: Marijuana use, binge drinking, and fighting are correlates of cigarette smelting among US adolescents. These associations, which vary by sex and race or ethnicity, suggest clustering to form a risk behavior syndrome. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. HARVARD UNIV,CHILDRENS HOSP,SCH MED,BOSTON,MA 02115. NR 26 TC 89 Z9 89 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610 SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD JAN PY 1997 VL 151 IS 1 BP 66 EP 71 PG 6 WC Pediatrics SC Pediatrics GA WC696 UT WOS:A1997WC69600010 PM 9006531 ER PT J AU Rosenthal, S Chen, RT Hadler, S AF Rosenthal, S Chen, RT Hadler, S TI Reputed brain damage and 'serious' reactions from DTP vaccines - Reply SO ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE LA English DT Letter RP Rosenthal, S (reprint author), CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,MS E61,1600 CLIFTON RD NE,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 SN 1072-4710 J9 ARCH PEDIAT ADOL MED JI Arch. Pediatr. Adolesc. Med. PD JAN PY 1997 VL 151 IS 1 BP 108 EP 108 PG 1 WC Pediatrics SC Pediatrics GA WC696 UT WOS:A1997WC69600026 ER PT J AU Lindquester, GJ OBrian, JJ Anton, ED Greenamoyer, CA Pellett, PE Dambaugh, TR AF Lindquester, GJ OBrian, JJ Anton, ED Greenamoyer, CA Pellett, PE Dambaugh, TR TI Genetic content of a 20.9 kb segment of human herpesvirus 6B strain Z29 spanning the homologs of human herpesvirus 6A genes U40-57 and containing the origin of DNA replication SO ARCHIVES OF VIROLOGY LA English DT Article ID SIMPLEX VIRUS TYPE-1; EPSTEIN-BARR-VIRUS; IMMEDIATE-EARLY GENE; CYTOMEGALOVIRUS US22-GENE FAMILY; TELOMERIC REPEAT SEQUENCES; LONG UNIQUE REGION; BINDING PROTEIN; NUCLEOTIDE-SEQUENCE; HELICASE-PRIMASE; MONOCLONAL-ANTIBODIES AB A continuous 20.9 kb sequence from human herpesvirus 6 variant B (HHV-6B) strain 229 (GenBank accession number L16947) is genetically colinear with a discrete segment of the human cytomegalovirus (HCMV) UL region and with HHV-6 variant A (HHV-6A). Short nucleotide sequence determinations at multiple sites within an 8.5 kb region immediately 3' to the 20.9 kb contig revealed additional colinearity between HHV-6B, HCMV and HHV-6A. Homology studies with the predicted peptide sequences from 11 complete and 12 partial HHV-6B open reading frames (ORFs) revealed that most encode proteins conserved to varying degrees in all previously sequenced primate herpesviruses. HHV-6B homologs were identified for the HSV-1 ICP18.5, ICP8, UL52, UL24, UL25 and major capsid protein. Several HHV-6B proteins had limited amino acid similarity to their positional homologs in other herpesviruses. Each gene identified is highly homologous to its HHV-6A counterpart, including two unique HHV-6 genes predicted to encode membrane-associated glycoproteins. However, two regions of substantial divergence were noted, one spanning the origin of replication and the other encoding one of the putative HHV-6-specific glycoprotein genes. Substitutions in the latter region lead to predicted differences in reading frames and protein lengths among HHV-6 isolates. C1 CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA. DUPONT MERCK PHARMACEUT CO,EXPT STN,WILMINGTON,DE 19880. RP Lindquester, GJ (reprint author), RHODES COLL,DEPT BIOL,MEMPHIS,TN 38112, USA. FU NIAID NIH HHS [1 R15 AI3118901A1] NR 82 TC 11 Z9 11 U1 0 U2 0 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PY 1997 VL 142 IS 1 BP 103 EP 123 DI 10.1007/s007050050062 PG 21 WC Virology SC Virology GA WB845 UT WOS:A1997WB84500008 PM 9155876 ER PT J AU Lindquester, GJ Greenamoyer, CA Anton, ED OBrian, JJ Pellett, PE Dambaugh, TR AF Lindquester, GJ Greenamoyer, CA Anton, ED OBrian, JJ Pellett, PE Dambaugh, TR TI Comparison of a 20 kb region of human herpesvirus 6B with other human betaherpesviruses reveals conserved replication genes and adjacent divergent open reading frames SO ARCHIVES OF VIROLOGY LA English DT Article ID HUMAN CYTOMEGALO-VIRUS; ORIGIN-BINDING PROTEIN; CELL-RELATED SEQUENCES; DNA-SEQUENCE; UNIQUE REGION; US22-GENE FAMILY; GENOME; HOMOLOGS; IDENTIFICATION; PREVALENCE AB The sequence of a 20.15 kb region from human herpesvirus 6 variant B (HHV-6B) strain Z29 is described (GenBank accession number L14772). Determinations of protein homologies for seventeen predicted gene products revealed HHV-6B homologs of six proteins well-conserved both in genetic context and amino acid sequence throughout the alpha-, beta-, and gammaherpesvirus subfamilies. These include proteins involved in viral DNA replication, packaging and nucleotide metabolism, and conserved proteins of undefined function. The close evolutionary relationship of the human betaherpesviruses, HHV-6B, HHV-6A, HHV-7 and human cytomegalovirus (HCMV) was confirmed by identification of several protein sequences encoded only by these viruses, including homologs of the HCMV early phosphoprotein family and a series of HCMV open reading frames predicted to encode glycoprotein exons. Homologs of essential HSV-1 replication proteins, UL8 and UL9, were also identified. Downstream from the conserved replication locus, each betaherpesvirus contains a region of divergent, small open reading frames. The evolution of this region and its potential use in the development of a viral vector system are discussed. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. DUPONT MERCK PHARMACEUT CO,WILMINGTON,DE 19880. RP Lindquester, GJ (reprint author), RHODES COLL,DEPT BIOL,MEMPHIS,TN 38112, USA. FU NIAID NIH HHS [1R15 AI31189-01] NR 46 TC 7 Z9 9 U1 0 U2 0 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PY 1997 VL 142 IS 1 BP 193 EP 204 DI 10.1007/s007050050070 PG 12 WC Virology SC Virology GA WB845 UT WOS:A1997WB84500016 PM 9155884 ER PT J AU Roberts, BD Fang, G Butera, ST AF Roberts, BD Fang, G Butera, ST TI Influence of cell cycle on HIV-1 expression differs among various models of chronic infection SO ARCHIVES OF VIROLOGY LA English DT Article ID HUMAN-IMMUNODEFICIENCY-VIRUS; TUMOR-NECROSIS-FACTOR; LONG TERMINAL REPEAT; HL-60 CELLS; SUPPRESSOR PROTEIN; HUMAN-MONOCYTES; T-CELLS; S-PHASE; ACTIVATION; P53 AB Because of an inherent dependence on host cell second and third messenger signaling pathways for activation of HIV-1 expression, a potential exists for a relationship between the induction of latent HIV-1 and cell-cycle-related events. To investigate this potential relationship, cellular models of latent HIV-1 infection (OM-10.1 promyelocytes, ACH-2 T-lymphocytes, and U1 promonocytes) were chemically treated or gamma-irradiated to synchronize cultures at each cell cycle stage and then examined for constitutive and TNF-alpha-induced HIV-1 expression. Cell cycle synchronization alone had no effect on HIV-1 expression in OM-10.1 and U1 cultures; whereas enhanced constitutive HIV-1 expression was observed in AGH-2 cultures at G(2) + M. A 2 hour TNF-alpha treatment of all synchronized OM-10.1 cultures activated HIV-1 expression to a similar extent as unsynchronized cultures. In contrast, the extent of TNF-alpha-induced HIV-1 expression in AGH-2 S and G(2) + M cultures and in the Ul G(0)/G(1) culture was greater than that in unsynchronized control cultures. However, no delay in the initial response was observed. Thus, the influence of cell cycle on constitutive and induced HIV-1 expression varied in each cellular model and, therefore, may further relate to the different molecular mechanisms maintaining viral latency. RP Roberts, BD (reprint author), CTR DIS CONTROL & PREVENT,RETROVIRUS DIS BRANCH,DIV AIDS STD & TB LAB RES,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 49 TC 8 Z9 8 U1 0 U2 0 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PY 1997 VL 142 IS 6 BP 1087 EP 1099 DI 10.1007/s007050050144 PG 13 WC Virology SC Virology GA XE546 UT WOS:A1997XE54600002 PM 9229000 ER PT J AU Belliot, G Laveran, H Monroe, SS AF Belliot, G Laveran, H Monroe, SS TI Detection and genetic differentiation of human astroviruses: Phylogenetic grouping varies by coding region SO ARCHIVES OF VIROLOGY LA English DT Article ID POLYMERASE CHAIN-REACTION; ROUND-STRUCTURED VIRUSES; REVERSE TRANSCRIPTION; ACUTE GASTROENTERITIS; UNITED-KINGDOM; STOOL SAMPLES; RNA SEQUENCE; CELL-LINE; SEROTYPES; DIARRHEA AB Astroviruses are single-stranded, positive-sense RNA viruses that are associated with gastroenteritis in humans and animals. We describe a reverse transcription-polymerase chain reaction (RT-PCR) assay using primers targeted to a nonstructural protein coding region that allowed sensitive detection and genetic typing of representative strains of seven astrovirus serotypes. Phylogenetic analysis of the nucleotide sequences of PCR products from the reference strains and several wild isolates indicated two distinct genogroups of sequences in open reading frame la (ORF la). These genogroups correlated with serotype: genogroup A included strains of types 1 to 5, while genogroup B included strains of types 6 and 7. This phylogenetic arrangement differs from the nearly equidistant clustering of serotypes seen when comparing nucleotide sequences from either ORF Ib or ORF 2. It is possible that recombination was responsible for the observed difference in genetic relationships. C1 CTR DIS CONTROL & PREVENT,DIV VIRAL & RICKETTSIAL DIS,NATL CTR INFECT DIS,ATLANTA,GA 30333. FAC MED,SERV HYG HOSP,CLERMONT FERRAN,FRANCE. OI Monroe, Stephan/0000-0002-5424-716X NR 43 TC 111 Z9 120 U1 1 U2 2 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PY 1997 VL 142 IS 7 BP 1323 EP 1334 DI 10.1007/s007050050163 PG 12 WC Virology SC Virology GA XL126 UT WOS:A1997XL12600004 PM 9267446 ER PT J AU Schmid, DS Thieme, ML Gary, HE Reeves, WC AF Schmid, DS Thieme, ML Gary, HE Reeves, WC TI Characterization of T cell responses to herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) using a TNF-beta ELISpot cytokine assay SO ARCHIVES OF VIROLOGY LA English DT Article ID LYMPHOCYTES-T; VACCINATION; CD4+; KERATINOCYTES; RECOGNITION; EXPRESSION; ANTIBODIES; INFECTION; SUBSETS; INVITRO AB We examined the suitability of a TNF-beta cytokine ELISpot assay for assessing various aspects of the T cell response to herpes simplex viruses. The number of T cells responding to HSV-1 or HSV-2 was measured by TNF-beta ELISpot assay. The number of T cells producing TNF-beta in response to HSV-1 was hi,oh, ranging from 76 to 222 per 10(5). HSV-l-specific TNF-beta-secreting responder cell frequencies fluctuated over time in individual donors. Comparable fluctuations were not observed in the T cell frequencies to phytohemaglutinin (PHA). Responder cell frequencies to glycoproteins gB and go of HSV-2 accounted for a large number of the HSV-2-specific T cells as measured using the TNF-beta ELISpot assay. Type-specific and type-common components of the T cell response to HSV-1 and HSV-2 could be estimated with this assay. Type-common responder cells typically accounted for 25-30%. Finally, CD4(+) and CD8(+) TNF-beta-producing T cells were stimulated by HSV-1 at a CD4:CD8 ratio of 2:1, indicating that both major subsets of T lymphocytes are activated by HSV. C1 CTR DIS CONTROL & PREVENT,RESP & ENTER VIRUSES BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA. RP Schmid, DS (reprint author), CTR DIS CONTROL & PREVENT,VIRAL EXANTHEMS & HERPESVIRUS BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333, USA. NR 27 TC 7 Z9 7 U1 0 U2 1 PU SPRINGER-VERLAG WIEN PI VIENNA PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 VIENNA, AUSTRIA SN 0304-8608 J9 ARCH VIROL JI Arch. Virol. PY 1997 VL 142 IS 8 BP 1659 EP 1671 DI 10.1007/s007050050187 PG 13 WC Virology SC Virology GA XQ045 UT WOS:A1997XQ04500011 PM 9672626 ER PT J AU Adruino, MJ AF Adruino, MJ TI Untitled SO ARTIFICIAL ORGANS LA English DT Letter RP Adruino, MJ (reprint author), CTR DIS CONTROL & PREVENT,DIALYSIS & MED DEVICES SECT,HOSP INFECT PROGRAM C01,ATLANTA,GA 30333, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL SCIENCE INC PI MALDEN PA 350 MAIN ST, MALDEN, MA 02148 SN 0160-564X J9 ARTIF ORGANS JI Artif. Organs PD JAN PY 1997 VL 21 IS 1 BP 86 EP 86 PG 1 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA WB376 UT WOS:A1997WB37600025 ER PT J AU Tokars, JI Alter, MJ Miller, E Moyer, LA Favero, MS AF Tokars, JI Alter, MJ Miller, E Moyer, LA Favero, MS TI National surveillance of dialysis associated diseases in the United States - 1994 SO ASAIO JOURNAL LA English DT Editorial Material ID CHRONIC-HEMODIALYSIS; HEPATITIS-B; VIRUS; TRANSMISSION; HIV AB Dialysis centers in the United States were Surveyed in 1994 regarding a number of hemodialysis associated diseases and practices. A total of 2,449 centers, representing 206,884 patients and 50,314 staff members, responded. In 1994, 99% of centers used bicarbonate dialysate as the primary method of dialysis, 45% used high flux dialysis, and 75% reused dialyzers. Hepatitis B vaccine had been administered to 31% of patients and to 80% of staff members. Acute infection with hepatitis B virus occurred in 0.1% of patients and was more likely to be reported by centers with lower proportions of patients vaccinated against hepatitis B virus and those not using a separate room and dialysis machine to treat hepatitis B surface antigen positive patients. The prevalence of antibody to hepatitis C virus was 10.5% among patients and 1.9% among staff members and varied according to geographic region. Pyrogenic reactions in the absence of septicemia were reported by 22% of centers and were most highly associated with dialyzer reuse. Human immunodeficiency virus infection was reported to be present in 1.5% of patients; 37% of centers provided hemodialysis to one or more patients infected with human immunodeficiency virus. C1 CTR DIS CONTROL & PREVENT,INVEST & PREVENT BRANCH,HOSP INFECT PROGRAM,ATLANTA,GA 30333. RP Tokars, JI (reprint author), CTR DIS CONTROL & PREVENT,HOSP ENVIRONM LAB BRANCH,HOSP INFECT PROGRAM,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 31 TC 37 Z9 37 U1 0 U2 0 PU LIPPINCOTT-RAVEN PUBL PI PHILADELPHIA PA 227 EAST WASHINGTON SQ, PHILADELPHIA, PA 19106 SN 1058-2916 J9 ASAIO J JI Asaio J. PD JAN-FEB PY 1997 VL 43 IS 1 BP 108 EP 119 DI 10.1097/00002480-199701000-00019 PG 12 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA WF876 UT WOS:A1997WF87600019 PM 9116344 ER PT B AU Cooksey, RC AF Cooksey, RC BE Hastings, JW Kricka, LJ Stanley, PE TI Application of fluorescence, bioluminescence, and chemiluminescence technologies to antimycobacterial drug susceptibility testing SO BIOLUMINESCENCE AND CHEMILUMINESCENCE: MOLECULAR REPORTING WITH PHOTONS LA English DT Proceedings Paper CT 9th International Symposium on Bioluminescence and Chemiluminescence CY OCT, 1996 CL WOODS HOLE, MA SP USN Off Naval Res, BMG LabTechnol Inc, Durham, Boehringer Mannheim Biochem, Indianapolis, Clontech Labs Inc, Palo Alto, Dynex Technol Inc, Chantilly, EG & G Berthold, C/O Wallac Inc, Hamamatsu Photon Systs, Bridgewater, John Wiley & Sons Publ, Lab Syst Denley, Needham Heights, Lab Technol Inc, Roselle, Lumigen Inc, Southfield, MGM Instruments Inc, Hamden, Packard Instrument Co Inc, Meriden, PharMingen, San Diego, Photek Ltd, St Leonards Sea, Princeton Instruments Inc, Trenton, Promega, Madison, STRATEC Electron GmbH, Birkenfeld, Tropix Inc, Bedford, Turner Designs Inc, Sunnyvale, Universal Imaging Corp, W Chester, Wallac Inc, EG&G Co, Gaithersburg RP Cooksey, RC (reprint author), CTR DIS CONTROL & PREVENT,DIV AIDS STD & TB LAB RES,NATL CTR INFECT DIS,ATLANTA,GA 30333, USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA BAFFINS LANE, CHICHESTER, WEST SUSSEX, ENGLAND PO19 1UD BN 0-471-97502-8 PY 1997 BP 297 EP 302 PG 6 WC Biochemistry & Molecular Biology; Biophysics; Chemistry, Physical SC Biochemistry & Molecular Biology; Biophysics; Chemistry GA BK03Q UT WOS:A1997BK03Q00062 ER PT J AU Stauffer, JR Arnegard, ME Cetron, M Sullivan, JJ Chitsulo, LA Turner, GF Chiotha, S McKaye, KR AF Stauffer, JR Arnegard, ME Cetron, M Sullivan, JJ Chitsulo, LA Turner, GF Chiotha, S McKaye, KR TI Controlling vectors and hosts of parasitic diseases using fishes - A case history of schistosomiasis in Lake Malawi SO BIOSCIENCE LA English DT Article ID GASTROPODS C1 CTR DIS CONTROL & PREVENT, DIV PARASIT DIS, ATLANTA, GA 30333 USA. MINIST HLTH & POPULAT, AIDS CONTROL PROGRAMME, LILONGWE, MALAWI. UNIV SOUTHAMPTON, SOUTHAMPTON, HANTS, ENGLAND. UNIV MALAWI, ZOMBA, MALAWI. UNIV MARYLAND, APPALACHIAN ENVIRONM LAB, FROSTBURG, MD 21530 USA. RP Stauffer, JR (reprint author), PENN STATE UNIV, SCH FOREST RESOURCES, UNIVERSITY PK, PA 16802 USA. NR 58 TC 40 Z9 41 U1 2 U2 7 PU AMER INST BIOLOGICAL SCI PI WASHINGTON PA 1444 EYE ST, NW, STE 200, WASHINGTON, DC 20005 USA SN 0006-3568 EI 1525-3244 J9 BIOSCIENCE JI Bioscience PD JAN PY 1997 VL 47 IS 1 BP 41 EP 49 DI 10.2307/1313005 PG 9 WC Biology SC Life Sciences & Biomedicine - Other Topics GA VZ101 UT WOS:A1997VZ10100006 ER PT J AU Sham, RL Ou, CY Cappuccio, J Braggins, C Dunnigan, K Phatak, PD AF Sham, RL Ou, CY Cappuccio, J Braggins, C Dunnigan, K Phatak, PD TI Correlation between genotype and phenotype in hereditary hemochromatosis: Analysis of 61 cases SO BLOOD CELLS MOLECULES AND DISEASES LA English DT Article DE liver; iron; biopsy; transferrin saturation; HFE; HLA-H ID HEPATIC IRON INDEX; SCREENING-TESTS AB This report assesses the degree of iron overload in a cohort of patients in relationship to the presence or absence of the recently described 845 G-->A (C282Y) and 187 C-->G (H63D) mutations in the HFE (HLA-H) gene, Sixty-one patients with hereditary hemochromatosis diagnosed either with liver biopsy or on clinical grounds were included in this analysis, Forty-one patients were homozygous for C282Y, the genotype considered to be characteristic of hereditary hemochromatosis, At the time of this analysis, 37 of these 41 patients had achieved a state of iron depletion and mobilizable iron was calculated; 19 had less than 4 grams. Twenty-Five of these 41 patients had liver biopsies; 4 of these patients had a hepatic iron index less than 1.9, Of the 4 patients with a normal hepatic iron index, 3 had a quantitative hepatic iron of greater than 50 mu mol/g dry weight, and one had an inadequate biopsy sample. These findings support our suspicion that individuals may have hereditary hemochromatosis and homozygous C282Y despite relatively low body iron stores, Five patients were compound heterozygotes for C282Y and H63D. Four of these patients underwent liver biopsy; two had a hepatic iron index greater than 1.9. A third patient had a hepatic iron index of 1.3 but a quantitative hepatic iron of 90.6 mu mol/g dry weight. All patients were phlebotomized to a state of iron depletion and only one of these patients had a mobilizable iron greater than 4 grams, Three patients were homozygous for H63D; these patients had either a hepatic iron index >1.9 or greater than 4 grams of mobilizable iron. Patients with homozygous H63D and significant iron overload are not well described. Seven patients were heterozygous for either C282Y or H63D; 4 had significant iron overload but three did not. Five patients had no HFE mutations; one of these patients unequivocally has iron overload with a hepatic iron index of 4.4, We conclude that: (1) Identification of HFE mutations will be clinically useful in identifying patients with hereditary hemochromatosis, (2) Patient genotyping will help confirm a diagnosis of hereditary hemochromatosis in some patients with relatively low body iron stores, (3) Significant iron loading can occur in the absence of homozygous C282Y, adding to the evidence that genes other than HFE may be involved in iron loading, and (4) Homozygous H63D can be associated with significant iron overload. C1 MARY M GOOLEY HEMOPHILIA CTR INC,ROCHESTER,NY 14621. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30431. RP Sham, RL (reprint author), ROCHESTER GEN HOSP,DEPT MED,1425 PORTLAND AVE,ROCHESTER,NY 14621, USA. FU AHRQ HHS [R01 HS07616] NR 22 TC 59 Z9 59 U1 0 U2 1 PU BLOOD CELLS FOUNDATION PI LA JOLLA PA C/O ERNEST BEUTLER SCRIPPS RES INST, DEPT MOLECULAR EXP MEDICINE, LA JOLLA, CA 92037 SN 1079-9796 J9 BLOOD CELL MOL DIS JI Blood Cells Mol. Dis. PY 1997 VL 23 IS 16 BP 314 EP 320 DI 10.1006/bcmd.1997.0148 PG 7 WC Hematology SC Hematology GA XU779 UT WOS:A1997XU77900001 PM 9410475 ER PT J AU Martinez, AJ Visvesvara, GS AF Martinez, AJ Visvesvara, GS TI Free-living, amphizoic and opportunistic amebas SO BRAIN PATHOLOGY LA English DT Article ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; DISSEMINATED ACANTHAMOEBA INFECTION; BALAMUTHIA-MANDRILLARIS; LEPTOMYXID-AMEBA; POLYHEXAMETHYLENE BIGUANIDE; AIDS PATIENT; MENINGOENCEPHALITIS; KERATITIS; ENCEPHALITIS; NAEGLERIA AB Amebas belonging to the genera Naegleria, Acanthamoeba and Balamuthia are free-living, amphizoic and opportunistic protozoa that are ubiquitous in nature. These amebas are found in soil, water and air samples from all over the world. Human infection due to these amebas involving brain, skin, lung and eyes has increased significantly during the last 10 years. The epidemiology, immunology, protozoology, pathology, and clinical features of the infections produced by these protozoa differ strikingly. Infection by the pathogenic Naegleria fowleri is acquired by exposure to polluted water in ponds, swimming pools and man-made lakes. Raised temperatures during the hot summer months or warm water from power plants facilitate the growth of N. fowleri. IV. fowleri is a thermophilic ameba that grows well in tropical and subtropical climates. The CNS infection, called Primary Amebic Meningoencephalitis (PAM), produced by N. fowleri is characterized by an acute fulminant meningoencephalitis leading to death 3-7 days after exposure. Victims are healthy, young individuals with a history of recent water-related sport activities. The portal of entry is the olfactory neuroepithelium. The pathologic changes are an acute hemorrhagic necrotizing meningoencephalitis with modest purulent exudate, mainly at the base of the brain, brainstem and cerebellum. Trophozoites can be seen within the CNS lesions located mainly around blood vessels. Thus far 179 cases have been reported; 81 in the USA alone. Balamuthia mandrillaris and several species of Acanthamoeba are pathogenic ''opportunistic'' free-living amebas which cause Granulomatous Amebic Encephalitis (GAE) in humans and animals. GAE is an infection, usually seen in debilitated, malnourished individuals, in patients undergoing immunosuppressive therapy for organ transplants and in Acquired Immunodeficiency Syndrome (AIDS). The granulomatous component is negligible, particularly in immunocompromised individuals. Pathologically these amebas produce a patchy, chronic or subacute granulomatous encephalitis with the presence of trophozoites and cysts. The portal of entry is probably through the respiratory tract or an ulceration of the skin reaching the CNS by hematogenous spread. As of October 1, 1996, 166 cases (103 due to Acanthamoeba and 63 due to Balamuthia) of GAE have been reported from around the world. Of these 103 cases due to Acanthamoeba (72 have been reported in the USA alone, > 50 in AIDS), It is well known that several species of Acanthamoeba can also produce, chronic sight threatening ulceration of the cornea called Acanthamoeba keratitis (AK), mostly in contact lens wearers or in individuals with minor corneal abrasions. Hundreds of cases of AK have been documented world wide. C1 UNIV PITTSBURGH, SCH MED, PITTSBURGH, PA 15213 USA. PRESBYTERIAN UNIV HOSP, DEPT PATHOL NEUROPATHOL, PITTSBURGH, PA 15213 USA. CTR DIS CONTROL & PREVENT, DIV PARASIT DIS, NATL CTR INFECT DIS, ATLANTA, GA 30333 USA. NR 100 TC 338 Z9 348 U1 2 U2 34 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 1015-6305 EI 1750-3639 J9 BRAIN PATHOL JI Brain Pathol. PD JAN PY 1997 VL 7 IS 1 BP 583 EP 598 DI 10.1111/j.1750-3639.1997.tb01076.x PG 16 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA WD341 UT WOS:A1997WD34100006 PM 9034567 ER PT J AU Seidell, JC Flegal, KM AF Seidell, JC Flegal, KM TI Assessing obesity: Classification and epidemiology SO BRITISH MEDICAL BULLETIN LA English DT Article ID WAIST CIRCUMFERENCE; CARDIOVASCULAR RISK; UNITED-STATES; BODY-WEIGHT; PREVALENCE; SMOKING; OVERWEIGHT AB Obesity is generally defined as a body mass index (BMI) of 30 kg/m(2) and higher. Overweight is defined as a BMI between 25 and 30 kg/m(2). The prevalence varies considerably between countries, and between regions within countries. It is estimated that more than half of adults aged 35-65 living in Europe ore either overweight or obese. Overweight is more common among men than among women but obesity is more common among women. The prevalence of obesity in Europe is probably in the order of 10-20% in men and 15-25% in adult women. In most European countries who have reliable data on time-trends the prevalence of obesity seems to be increasing. In most European countries, obesity is usually inversely associated with socio-economic status, particularly among women. New classifications of overweight may be based on cut-off points For simple anthropometric measures which reflects both total adiposity as well as abdominal fatness. C1 CTR DIS CONTROL & PREVENT,NATL CTR HLTH STAT,HYATTSVILLE,MD 20782. RP Seidell, JC (reprint author), NATL INST PUBL HLTH & ENVIRONM,DEPT CHRON DIS & ENVIRONM EPIDEMIOL,POB 1,NL-3720 BA BILTHOVEN,NETHERLANDS. RI Flegal, Katherine/A-4608-2013; seidell, jacob/N-7427-2013 NR 27 TC 224 Z9 240 U1 0 U2 10 PU ROYAL SOC MEDICINE PRESS LTD PI LONDON PA 1 WIMPOLE STREET, LONDON, ENGLAND W1M 8AE SN 0007-1420 J9 BRIT MED BULL JI Br. Med. Bull. PY 1997 VL 53 IS 2 BP 238 EP 252 PG 15 WC Medicine, General & Internal SC General & Internal Medicine GA XJ956 UT WOS:A1997XJ95600002 PM 9246834 ER PT J AU deOnis, M Yip, R Mei, Z AF deOnis, M Yip, R Mei, Z TI The development of MUAC-for-age reference data recommended by a WHO Expert Committee SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID UPPER-ARM CIRCUMFERENCE; NUTRITIONAL-STATUS; MORTALITY; CHILDREN; RISK AB Low mid-upper-arm circumference (MUAC), determined on the basis of a fixed cut-off value, has commonly been used as a proxy for low weight-for-height (wasting). The use of a fixed cut-off value was based on the observation that MUAC showed small age- and sex-specific differences. However, in 1993, a WHO Expert Committee concluded that age independence is not reflected in the true pattern of mid-upper arm growth, recommended the use of MUAC-for-age, and presented age- and sex-specific MUAC reference data developed with observations obtained from a representative sample of children in the USA aged 6-59 months. In this article, we explain the methodology for the development of these data, present age- and sex-specific growth curves and tables and discuss the applications and limitations of MUAC as a nutritional indicator. To develop the reference data, estimates were first obtained for the mean and standard deviation of MUAC for each month of age using 7-month segmental regression equations, a 5th-degree and a 3rd-degree polynomial in age was then used to describe the mean and standard deviation, respectively, of MUAC-for age. These curves show important age-specific differences, and significant sex-specific differences for boys and girls <24 months of age. Correct interpretation of MUAC with regard to nutritional status requires the use of MUAC-for-age reference data such as those presented here. C1 UNICEF,JAKARTA,INDONESIA. CTR DIS CONTROL & PREVENT,DIV NUTR & PHYS ACT,MATERNAL & CHILD HLTH BRANCH,ATLANTA,GA. RP deOnis, M (reprint author), WHO,NUTR UNIT,CH-1211 GENEVA 27,SWITZERLAND. NR 17 TC 36 Z9 36 U1 1 U2 2 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 IS 1 BP 11 EP 18 PG 8 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WV440 UT WOS:A1997WV44000002 PM 9141745 ER PT J AU Perkins, BA Zucker, JR Otieno, J Jafari, HS Paxton, L Redd, SC Nahlen, BL Schwartz, B Oloo, AJ Olango, C Gove, S Campbell, CC AF Perkins, BA Zucker, JR Otieno, J Jafari, HS Paxton, L Redd, SC Nahlen, BL Schwartz, B Oloo, AJ Olango, C Gove, S Campbell, CC TI Evaluation of an algorithm for integrated management of childhood illness in an area of Kenya with high malaria transmission SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID PNEUMONIA; CHILDREN AB In 1993, the World Health Organization completed the development of a draft algorithm for the integrated management of childhood illness (IMCI), which deals with acute respiratory infections, diarrhoea, malaria, measles, ear infections, malnutrition, and immunization status.;The present study compares the performance of a minimally trained health worker to make a correct diagnosis using the draft IMCI algorithm with that of a fully trained paediatrician who had laboratory and radiological support. During the 14-month study period, 1795 children aged between 2 months and 5 years were enrolled from the outpatient paediatric clinic of Siaya District Hospital in western Kenya; 48% were female and the median age was 13 months. Fever, cough and diarrhoea were the most common chief complaints presented by 907 (51%), 395 (22%), and 199 (11%) of the children, respectively; 86% of the chief complaints were directly addressed by the IMCI algorithm. A total of 1210 children (67%) had Plasmodium falciparum infection and 1432 (80%) met the WHO definition for anaemia (haemoglobin <11 g/dl). The sensitivities and specificities for classification of illness by the health worker using the IMCI algorithm compared to diagnosis by the physician were: pneumonia (97% sensitivity, 49% specificity), dehydration in children with diarrhoea (51%, 98%); malaria (100%, 0%); ear problem (98%, 2%); nutritional status (96%, 66%); and need for referral (42%, 94%). Detection of fever by laying a hand on the forehead was both sensitive and specific (91%, 77%). There was substantial clinical overlap between pneumonia and malaria (n = 895), and between malaria and malnutrition (n = 811). Based on the initial analysis of these data, some changes were made in the IMCI algorithm. This study provides important technical validation of the IMCI algorithm, but the performance of health workers should be monitored during the early part of their IMCI training. C1 Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Atlanta, GA 30333 USA. Kenya Med Res Inst, Kisian, Kenya. Siaya Dist Hosp, Siaya, Kenya. WHO, Div Child Hlth & Dev, CH-1211 Geneva, Switzerland. RP Perkins, BA (reprint author), Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, 1600 Clifton Rd,Mailstop C-23, Atlanta, GA 30333 USA. NR 20 TC 78 Z9 81 U1 0 U2 2 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 SU 1 BP 33 EP 42 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 119NJ UT WOS:000075902300004 PM 9529716 ER PT J AU Birmingham, ME Lee, LA Ntakibirora, M Bizimana, F Deming, MS AF Birmingham, ME Lee, LA Ntakibirora, M Bizimana, F Deming, MS TI A household survey of dysentery in Burundi: Implications for the current pandemic in sub-Saharan Africa SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID SHIGELLOSIS; EPIDEMIC; TYPE-1; ACQUISITION; PREVENTION; ZAIRE AB To characterize the epidemiology of dysentery (defined as bloody diarrhoea) in Burundi, we reviewed national surveillance data and conducted a household cluster survey including two case-control studies: one at the household, the other at the individual level. We estimated that community incidences for dysentery (per 1000 residents) in Kibuye Sector were 15.3 and 27.3, and that dysentery accounted for 6% and 12% of all deaths, in 1991 and 1992, respectively. Factors associated (P less than or equal to 0.05) with contracting dysentery were being female, using a cloth rag after defecation, a history of recent weight loss, and not washing hands before preparing food. The attributable risk, at the household level, of not washing hands before preparing food was 30%. Secondary household transmission accounted for at most 11% of dysentery cases. This study suggests that Shigella dysenteriae type 1 may be one of the leading causes of preventable mortality in Burundi and other African countries where effective antimicrobial agents are no longer affordable. Since hands were the most important mode of transmission of S. dysenteriae in this study, community-based interventions aimed at increasing hand washing with soap and water, particularly after defecation and before food preparation, may be effective for controlling dysentery epidemics caused by S. dysenteriae type 1 in Africa. C1 CTR DIS CONTROL & PREVENT,INT HLTH PROGRAM OFF,ATLANTA,GA. MINIST PUBL HLTH,BUJUMBURA,BURUNDI. NR 33 TC 20 Z9 20 U1 0 U2 1 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 IS 1 BP 45 EP 53 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WV440 UT WOS:A1997WV44000007 PM 9141750 ER PT J AU Kalter, HD Schillinger, JA Hossain, M Burnham, G Saha, S de Wit, V Khan, NZ Schwartz, B Black, RE AF Kalter, HD Schillinger, JA Hossain, M Burnham, G Saha, S de Wit, V Khan, NZ Schwartz, B Black, RE TI Identifying sick children requiring referral to hospital in Bangladesh SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID RESPIRATORY-TRACT INFECTIONS; MORTALITY RISK; MALNUTRITION; PNEUMONIA; MANAGEMENT; DIAGNOSIS; CRITERIA AB The object of this study was to evaluate and improve the guidelines for the integrated Management of Childhood Illness (IMCI) with respect to identifying young infants and children requiring referral to hospital in an area of low malaria prevalence. A total of 234 young infants (aged 1 week to 2 months) and 668 children (aged 2 months to 5 years) were prospectively sampled from patients presenting at a children's hospital in Dhaka, Bangladesh. The study paediatricians obtained a standardized history and carried out a physical examination, including items in the IMCI guidelines developed by WHO and UNICEF, The paediatricians made a provisional diagnosis and judged whether each patient needed hospital admission. Using the paediatrician's assessment of a need for admission as the standard, the sensitivity and specificity of the current and modified IMCI guidelines for correctly referring patients to hospital were examined. The IMCI's sensitivity for a paediatrician's assessment in favour of hospital admission was 84% (95% confidence interval (CI): 75-90) for young infants and 86% (95% CI: 81-90) for children, and the specificity was, respectively, 54% (95% CI, 45-63) and 64% (95% CI: 59-69). One fourth or more in each group had a provisional diagnosis of pneumonia, and the IMCI's specificity was increased without lowering sensitivity by modifying the respiratory signs calling for referral. These results show that the IMCI has good sensitivity for correctly referring young infants and children requiring hospital admission in a developing country setting with a low prevalence of malaria, The guidelines' moderate specificity will result in considerable over-referral of patients not needing admission, thereby decreasing opportunities for successful treatment of patients at first-level health facilities. The impact of the IMCI guidelines on children's health and the health care system must be judged in the light of current treatment practices, health outcomes and referral patterns. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD 21205 USA. US Ctr Dis Control & Prevent, Div Bacterial Dis, Atlanta, GA USA. Dhaka Shishu Hosp, Bangladesh Inst Child Hlth, Dhaka, Bangladesh. RP Kalter, HD (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, 615 N Wolfe St,Suite E8132, Baltimore, MD 21205 USA. NR 27 TC 43 Z9 45 U1 0 U2 1 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 SU 1 BP 65 EP 75 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 119NJ UT WOS:000075902300007 PM 9529719 ER PT J AU Dietz, V Galazka, A vanLoon, F Cochi, S AF Dietz, V Galazka, A vanLoon, F Cochi, S TI Factors affecting the immunogenicity and potency of tetanus toxoid: Implications for the elimination of neonatal and non-neonatal tetanus as public health problems SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Review ID PLACENTAL-TRANSFER; IMMUNE-RESPONSE; VITAMIN-A; ANTIBODIES; MALARIA; IMMUNIZATION; PROTECTION; PREGNANCY; CHILDREN; IMMUNOCOMPETENCE AB An estimated 400 000 deaths occur annually from neonatal tetanus (NT). In 1989 WHO adopted the goal of eliminating NT as a public health problem worldwide. To achieve this, and to control non-neonatal tetanus (non-NT), WHO recommends that newborns be passively protected at birth by the antepartum administration of at least two doses of tetanus toroid (TT) to their mothers and that all children subsequently receive at least three doses of diphtheria-tetanus-pertussis (DTP) vaccine. For this strategy to be effective, the TT used must be immunogenic. Potential factors that may affect TT immunogenicity need to be evaluated if NT is to be eliminated and if non-NT is to be controlled. Although data are conflicting, concurrent malarial infection may decrease the immune response to TT; however, malarial chemoprophylaxis may enhance the immune response. Malnutrition does not appear to affect immunogenicity; nevertheless, one study suggests that vitamin A deficiency is associated with an impaired immune response. Although it has been postulated that placental transfer of tetanus antibody is impaired in African women, a survey of the published literature suggests that this is not the case. Freezing TT has been shown to decrease its potency, but its impact on immunogenicity needs more evaluation. C1 WHO,GLOBAL PROGRAMME VACCINES & IMMUNIZAT,EXPANDED PROGRAMME IMMUNIZAT,CH-1211 GENEVA,SWITZERLAND. CTR DIS CONTROL & PREVENT,NATL IMMUNIZATION PROGRAM,POLIO ERADICAT ACT,ATLANTA,GA 30333. NR 75 TC 29 Z9 29 U1 0 U2 3 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 IS 1 BP 81 EP 93 PG 13 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA WV440 UT WOS:A1997WV44000010 PM 9141753 ER PT J AU Bern, C Zucker, JR Perkins, BA Otieno, J Oloo, AJ Yip, R AF Bern, C Zucker, JR Perkins, BA Otieno, J Oloo, AJ Yip, R TI Assessment of potential indicators for protein-energy malnutrition in the algorithm for integrated management of childhood illness SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID NUTRITIONAL-STATUS; DEVELOPING-COUNTRIES; MORTALITY AB Potential indicators were assessed for the two classifications of protein-energy malnutrition in the guidelines for integrated management of childhood illness: severe malnutrition, which requires immediate referral to hospital, and very low weight, which calls for feeding assessment, nutritional counselling and follow-up. Children aged <2 years require feeding assessment and counselling as a preventive intervention. For severe malnutrition, we examined 1202 children admitted to a Kenyan hospital for any association of the indicators with mortality within one month. Bipedal oedema indicating kwashiorkor, and two marasmus indicators (visible severe wasting and weight-for-height (WFH) Z-score of <-3) were associated with a significantly increased mortality risk (odds ratios, 3.1-3.9). Very low weight-for-age (WFA) /Z-score of <-4.4) was not associated with an increased risk of mortality. Because first-level health facilities generally lack length-boards, bipedal oedema and visible severe wasting were chosen as indicators of severe malnutrition. To assess potential WFA thresholds for the very low weight classification, our primary source of data came from 1785 Kenyan outpatient children, but we also examined data from surveys in Nepal, Bolivia, and Togo. We examined the performance of WFA at various thresholds to identify children with low WFH and, for children aged less than or equal to 2 years, low height-for-age (HFA). Use of a WFA threshold Z-score of <-2 identified a considerable proportion of children (from 13% in Bolivia to 68% in Nepal) which, in most settings, would pose an enormous burden on the health facility. Among ill children in Kenya, a threshold WFA Z-score of <-3 had a sensitivity of 89-100% to detect children with WFH Z-scores of < -3, and with an identification rate of 9%, would avoid overburdening the clinics. Potential modifications include use of a more restrictive cut-off in countries with high rates of stunting, or the elimination of the WFA screen in order to concentrate efforts on intervention for all children below the 2-year age cut-off Key issues in every country include the capacity to provide counselling for many children and linkage to nutritional improvement programmes in the community. C1 Ctr Dis Control & Prevent, Div Nutr & Phys Act, Natl Ctr Chron Dis Prevent & Hlth Promot, Publ Hlth Serv,US Dept HHS, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Div Bacterial & Mycot Dis, Natl Ctr Infect Dis, Publ Hlth Serv,US Dept HHS, Atlanta, GA 30341 USA. Siaya Dist Hosp, Kenya Med Res Inst, Siaya, Kenya. RP Bern, C (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis F22, Natl Ctr Infect Dis, Atlanta, GA 30341 USA. NR 18 TC 22 Z9 23 U1 0 U2 2 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 SU 1 BP 87 EP 96 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 119NJ UT WOS:000075902300009 PM 9529721 ER PT J AU Zucker, JR Perkins, BA Jafari, H Otieno, J Obonyo, C Campbell, C AF Zucker, JR Perkins, BA Jafari, H Otieno, J Obonyo, C Campbell, C TI Clinical signs for the recognition of children with moderate or severe anaemia in western Kenya SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID AFRICAN CHILDREN; ANTIMALARIAL THERAPY; FALCIPARUM-MALARIA; ANEMIA; MORTALITY; ZAIRE; IRON AB Optimal treatment of Plasmodium falciparum-related paediatric anaemia can result in improved haematological recovery and survival. Clinical predictors are needed to identify children with anaemia in settings where laboratory measurements are not available. The use of conjunctival (eyelid), palmar, nailbed, and tongue pallor to detect children with moderate anaemia (haemoglobin, 5.0-7.9 g/dl) or severe anaemia (haemoglobin, <5.0 g/dl) was evaluated among children seen at an outpatient and inpatient setting in a hospital in western Kenya. Severe nailbed or severe palmar pallor had the highest sensitivity (62% and 60%, resp.), compared with severe conjunctival pallor (sensitivity = 31%), to detect children with severe anaemia in the outpatient setting. Children with moderate anaemia were best identified by the presence of nailbed or palmar pallor (sensitivity = 90% for both signs), compared with conjunctival pallor (sensitivity = 81%). Clinical signs of respiratory distress, in addition to the presence of severe pallor, did not increase the recognition of children requiring hospitalization for severe anaemia. Among inpatients, the sensitivity of severe nailbed pallor (59%) was highest for detecting children with severe anaemia, although the sensitivity of severe conjunctival parlor and severe palmar pallor was the same (53% for both signs). Presence of conjunctival pallor (sensitivity = 74%) was similar in sensitivity to both nailbed and palmar pallor (70% for both signs) among children with moderate anaemia. The sensitivity of tongue pallor was low among all children evaluated. Low haemoglobin levels were significantly associated with the likelihood of being smear-positive for P. falciparum. This study demonstrates that clinical criteria can be used to identify children with moderate and severe anaemia, thus enabling implementation of treatment algorithms. Children aged <36 months who live in an area with P, falciparum malaria should receive treatment with an effective antimalarial drug if they have pallor. C1 Ctr Dis Control & Prevent, Malaria Branch, Div Parasit Dis,Natl Ctr Infect Dis, Publ Hlth Serv,US Dept HHS, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Childhood & Resp Dis Branch, Div Bacterial & Mycot Dis, NCID,PHS,DHHS, Atlanta, GA 30341 USA. Siaya Dist Hosp, Siaya, Kenya. Kenya Med Res Inst, Clin Res Ctr, Nairobi, Kenya. RP Zucker, JR (reprint author), UNICEF, Hlth Sect, 3 UN Plaza,TA-24A, New York, NY 10017 USA. NR 21 TC 38 Z9 41 U1 0 U2 1 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 SU 1 BP 97 EP 102 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 119NJ UT WOS:000075902300010 PM 9529722 ER PT J AU Kalter, HD Burnham, G Kolstad, PR Hossain, M Schillinger, JA Khan, NZ Saha, S de Wit, V Kenya-Mugisha, N Schwartz, B Black, RE AF Kalter, HD Burnham, G Kolstad, PR Hossain, M Schillinger, JA Khan, NZ Saha, S de Wit, V Kenya-Mugisha, N Schwartz, B Black, RE TI Evaluation of clinical signs to diagnose anaemia in Uganda and Bangladesh, in areas with and without malaria SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID PSYCHOMOTOR DEVELOPMENT; IRON-DEFICIENCY; ANEMIA; CHILDREN; HEMOGLOBIN AB The object of this study was to assess the ability of pallor and other clinical signs, including those in the integrated Management of Childhood Illness (IMCI) guidelines developed by WHO and UNICEF, to identify severe anaemia and some anaemia in developing country settings with and without malaria. A total of 1226 and 668 children aged 2 months to 5 years were prospectively sampled from patients presenting at, respectively a district hospital in rural Uganda and a children's hospital in Dhaka, Bangladesh. The study physicians obtained a standardized history and carried out a physical examination that included pallor, signs of respiratory distress, and the remaining IMCI referral signs. The haematocrit or haemoglobin level was determined in all children with conjunctival or palmar pallor, and in a sample of the rest. Children with a blood level measurement and assessment of pallor at both sites were included in the anaemia analysis. Using the haematocrit or haemoglobin level as the reference standard, the correctness of assessments using severe and some pallor and other clinical signs in classifying severe and some anaemia was determined. While the full IMCI process would have referred most of the children in Uganda and nearly all the children in Bangladesh with severe anaemia to hospital. few would have received a diagnosis of severe anaemia. Severe palmar and conjunctival pallor, individually and together, had 10-50% sensitivity and 99% specificity for severe anaemia; the addition of grunting increased the sensitivity to 37-80% while maintaining a reasonable positive predictive value. Palmar pallor did not work as well as conjunctival pallor in Bangladesh for the detection for severe or some anaemia, Combining "conjunctival or palmar pallor" detected 71-87% of moderate anaemia and half or more of mild anaemia. About half the children with no anaemia were incorrectly classified as having "moderate or mild" anaemia. Anaemia was more easily diagnosed in Uganda in children with malaria. Our results show that simple clinical signs can correctly classify the anaemia status of most children. Grunting may serve as a useful adjunct to pallor in the diagnosis of severe anaemia. Conjunctival pallor should be added to the IMCI anaemia box, or the guidelines need to be adapted in regions where palmar pallor may not readily be detected. C1 Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, Baltimore, MD 21205 USA. Dhaka Shishu Hosp, Bangladesh Inst Child Hlth, Dhaka, Bangladesh. US Ctr Dis Control & Prevent, Div Bacterial Dis, Atlanta, GA USA. Minist Hlth, ARI CDD Programmes, Entebbe, Uganda. RP Kalter, HD (reprint author), Johns Hopkins Univ, Sch Hyg & Publ Hlth, Dept Int Hlth, 615 N Wolfe St,Suite E8132, Baltimore, MD 21205 USA. NR 22 TC 41 Z9 43 U1 0 U2 2 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 SU 1 BP 103 EP 111 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 119NJ UT WOS:000075902300011 PM 9529723 ER PT J AU Mei, Z GrummerStrawn, LM deOnis, M Yip, R AF Mei, Z GrummerStrawn, LM deOnis, M Yip, R TI The development of a MUAC-for-height reference, including a comparison to other nutritional status screening indicators SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID ARM CIRCUMFERENCE; MORTALITY; MALNUTRITION; CHILDREN; RISK AB Mid-upper-arm circumference (MUAC) based on a single cut-off value for all the children less than 5 years of age has been used for many years as an alternative nutritional status index for children during famines or refugee crises, and as an additional screening tool in nonemergencies. However, it has recently been questioned whether MUAC is age-and sex-independent. After reviewing the scientific evidence underlying the use and interpretation of MUAC, a WHO Expert Committee recommended a new MUAC-for-age reference far under-5-year-olds. In some settings, however, it is difficult to assess a child's age and in such circumstances MUAC-for-height may be a good alternative. The height-based QUAC stick is a simple means of adjusting MUAC cut-offs according to height, and the MUAC-for-height reference and the construction and use of the QUAC stick are described in this article. Described also is the use of the receiver operating characteristic (ROC) curve method to evaluate the performance of MUAC, MUAC-for-age, and MUAC-for-height in screening malnourished children. C1 WHO,NUTR UNIT,CH-1211 GENEVA 27,SWITZERLAND. UNICEF,JAKARTA,INDONESIA. RP Mei, Z (reprint author), CTR DIS CONTROL & PREVENT,DIV NUTR & PHYS ACT,MAILSTOP K-25,4770 BUFORD HIGHWAY,ATLANTA,GA 30341, USA. NR 29 TC 28 Z9 30 U1 1 U2 3 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 IS 4 BP 333 EP 341 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA XZ713 UT WOS:A1997XZ71300005 PM 9342892 ER PT J AU Yoon, SS Katz, J Brendel, K West, KP AF Yoon, SS Katz, J Brendel, K West, KP TI Efficiency of EPI cluster sampling for assessing diarrhoea and dysentery prevalence SO BULLETIN OF THE WORLD HEALTH ORGANIZATION LA English DT Article ID DEVELOPING-COUNTRIES; COMPUTER-SIMULATION; CHILDREN; VACCINATION; MORTALITY AB This study examines the efficiency of EPI cluster sampling in assessing the prevalence of diarrhoea and dysentery. A computer was used to simulate fieldwork carried out by a survey taker The bias and variance of prevalence estimates obtained using EPI cluster sampling were compared with those obtained using simple random sampling and cluster (stratified random) sampling. Efficiency ratios, calculated as the mean square error divided by total distance travelled, were used to compare EPI cluster sampling to simple random sampling and standard cluster sampling. EPI cluster sampling may be an appropriate low-cost tool for monitoring trends in the prevalence of diarrhoea and dysentery over time. However it should be used with caution when estimating the prevalence of diarrhoea at a single point in time because of the bias associated with this cluster sampling method. C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, CDC, Atlanta, GA 30341 USA. Johns Hopkins Univ, Sch Hyg & Publ Hlth, Baltimore, MD USA. RP Yoon, SS (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, CDC, Mail Stop F-47,4770 Buford Highway NE, Atlanta, GA 30341 USA. FU NCRR NIH HHS [RR04060] NR 22 TC 6 Z9 6 U1 1 U2 1 PU WORLD HEALTH ORGANIZATION PI GENEVA 27 PA DISTRIBUTION AND SALES, CH-1211 GENEVA 27, SWITZERLAND SN 0042-9686 J9 B WORLD HEALTH ORGAN JI Bull. World Health Organ. PY 1997 VL 75 IS 5 BP 417 EP 426 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA YM540 UT WOS:000071075000003 PM 9447775 ER PT J AU Steenland, K AF Steenland, K TI Laryngeal cancer incidence among workers exposed to acid mists (United States) SO CANCER CAUSES & CONTROL LA English DT Article DE acid mists; laryngeal cancer; men; steel workers; sulfuric acid; United States ID SULFURIC-ACID; HEALTH AB In 1992, the International Agency for Research on Cancer (IARC) determined that sufficient evidence existed to classify sulfuric acid mists as a human carcinogen, based primarily on six human studies. Possible mechanisms include irritation of epithelial cells in conjunction with cigarette smoking, or a direct genotoxic effect due to a modification of cellular pH. We have followed 1,031 men exposed to acid mists in the steel industry in the United States, via mailed questionnaire and telephone interview, extending by 10 years a prior follow-up of this cohort. These workers averaged 9.2 years of exposure, with an average first year of exposure of 1949. The primary exposure was to sulfuric acid mist, although part of the cohort was exposed to other acid mists. Fourteen laryngeal cancers were observed in the cohort compared with 5.6 expected based on US rates, with follow-up through 1994. A 14 percent upward adjustment in expected cancers due to differences in tobacco and alcohol consumption led to 6.4 laryngeal cancers expected, yielding a rate ratio of 2.2 (95 percent confidence interval = 1.2-3.7). Our findings are consistent with previous findings from this cohort and from most other studies, and tend to confirm IARC's classification of acid mists as a human carcinogen. The occupational exposures of this cohort were at least an order of magnitude higher than usual ambient exposures in urban air. RP Steenland, K (reprint author), NIOSH,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 23 TC 21 Z9 22 U1 1 U2 1 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0957-5243 J9 CANCER CAUSE CONTROL JI Cancer Causes Control PD JAN PY 1997 VL 8 IS 1 BP 34 EP 38 DI 10.1023/A:1018427003878 PG 5 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA WL126 UT WOS:A1997WL12600005 PM 9051320 ER PT J AU Wingo, PA Newsome, K Marks, JS Calle, EE Parker, SL AF Wingo, PA Newsome, K Marks, JS Calle, EE Parker, SL TI The risk of breast cancer following spontaneous or induced abortion SO CANCER CAUSES & CONTROL LA English DT Review DE abortion; breast cancer; pregnancy; women ID FULL-TERM PREGNANCY; ORAL-CONTRACEPTIVE USE; UNITED-STATES WOMEN; REPRODUCTIVE FACTORS; FAMILY HISTORY; YOUNG-WOMEN; PARITY; AGE; EPIDEMIOLOGY; POPULATION AB To evaluate the relationship between breast cancer risk and spontaneous and induced abortion, we conducted a detailed descriptive review of 32 epidemiologic studies that provided data by type of abortion and by various measures of exposure to abortion - number of abortions, timing of abortion in relation to first full-term pregnancy, length of gestation, and age at first abortion. Breast cancer risk did not appear to be associated with an increasing number of spontaneous or induced abortions. Our review also suggested that breast cancer risk probably was not related to the other measures of exposure to abortion, and probably did not differ by age or a family history of breast cancer. Finally, the data appeared to suggest a slightly increased risk among nulliparous women, but this tendency was based primarily on studies with a small number of nulliparous women who had had spontaneous or induced abortions. Definitive conclusions about an association between breast cancer risk and spontaneous or induced abortion are not possible at present because of inconsistent findings across studies. Future investigations should consider prospective designs, separate analyses of spontaneous and induced abortions, appropriate referent groups, and adequate adjustment for confounding and effect modification. Future investigations also should attempt to determine whether any increased risks reflect the transient increase in breast cancer risk hypothesized for full-term pregnancy or a causal relationship specific to spontaneous or induced abortion. C1 CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,ATLANTA,GA. CTR DIS CONTROL & PREVENT,NATL CTR CHRON DIS PREVENT & HLTH PROMOT,ATLANTA,GA. RP Wingo, PA (reprint author), AMER CANC SOC,EPIDEMIOL & SURVEILLANCE RES DEPT,1599 CLIFTON RD NE,ATLANTA,GA 30329, USA. NR 96 TC 43 Z9 43 U1 3 U2 4 PU RAPID SCIENCE PUBLISHERS PI LONDON PA 2-6 BOUNDARY ROW, LONDON, ENGLAND SE1 8NH SN 0957-5243 J9 CANCER CAUSE CONTROL JI Cancer Causes Control PD JAN PY 1997 VL 8 IS 1 BP 93 EP 108 DI 10.1023/A:1018443507512 PG 16 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA WL126 UT WOS:A1997WL12600013 PM 9051328 ER PT J AU Tomatis, L Huff, J HertzPicciotto, I Sandler, DP Bucher, J Boffetta, P Axelson, O Blair, A Taylor, J Stayner, L Barrett, JC AF Tomatis, L Huff, J HertzPicciotto, I Sandler, DP Bucher, J Boffetta, P Axelson, O Blair, A Taylor, J Stayner, L Barrett, JC TI Avoided and avoidable risks of cancer SO CARCINOGENESIS LA English DT Article ID AIR-POLLUTION; UNITED-STATES; LUNG-CANCER; RESPIRATORY CANCER; DOSE-RESPONSE; ARSENIC EXPOSURE; FOLLOW-UP; MORTALITY; WORKERS; CARCINOGENESIS AB Despite the considerable efforts and funds devoted to cancer research over several decades, cancer still remains a mainly lethal disease, Cancer incidence and mortality have not declined at the same rate as other major causes of death, indicating that primary prevention remains a most valuable approach to decrease mortality, There is general agreement that environmental exposures are variously involved in the causation of the majority of cancer cases and that at least half of all cancers could be avoided by applying existing etiologic knowledge. There is disagreement, however, regarding the proportion of cancer risks. attributable to specific etiological factors, including diet, occupation and pollution, Estimates of attributable risks are largely based today on unverified assumptions and the calculation of attributable risks involves taking very unequal evidence of various types of factors and treating them equally, Effective primary prevention resulting in a reduction of cancer risk can be obtained by: (i) a reduction in the number of carcinogens to which humans are exposed; or (ii) a reduction of the exposure levels to carcinogens, Exposure levels that could be seen as sufficiently low when based on single agents, may actually not be safe in the context of the many other concomitant carcinogenic and mutagenic exposures, The list of human carcinogens and of their target organs might be quite different if: (i) epidemiological data were available for a larger proportion of human exposures for which there is experimental evidence of carcinogenicity; (ii) more attention was paid to epidemiological evidence that is suggestive of an exposure-cancer association, but is less than sufficient, particularly in identifying target organs; and (iii) experimental evidence of carcinogenicity, supported by mechanistic considerations, were more fully accepted as predictions of human risk. C1 NIEHS, RES TRIANGLE PK, NC 27709 USA. UNIV N CAROLINA, SCH PUBL HLTH, DIV EPIDEMIOL, CHAPEL HILL, NC USA. INT AGCY RES CANC, F-69372 LYON 08, FRANCE. LINKOPING UNIV, DEPT OCCUPAT HLTH, S-58183 LINKOPING, SWEDEN. NCI, ENVIRONM EPIDEMIOL BRANCH, BETHESDA, MD 20892 USA. NIOSH, CINCINNATI, OH 45226 USA. OI taylor, jack/0000-0001-5303-6398; Sandler, Dale/0000-0002-6776-0018 NR 91 TC 85 Z9 86 U1 0 U2 5 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0143-3334 EI 1460-2180 J9 CARCINOGENESIS JI Carcinogenesis PD JAN PY 1997 VL 18 IS 1 BP 97 EP 105 DI 10.1093/carcin/18.1.97 PG 9 WC Oncology SC Oncology GA WJ978 UT WOS:A1997WJ97800014 PM 9054595 ER PT B AU Jackson, RJ AF Jackson, RJ BE Streissguth, A Kanter, J TI Public health implications of FAS SO CHALLENGE OF FETAL ALCOHOL SYNDROME: OVERCOMING SECONDARY DISABILITIES LA English DT Proceedings Paper CT Conference on the Challenge of Fetal Alcohol Syndrome - Overcoming Secondary Disabilities CY SEP, 1996 CL UNIV WASHINGTON, MED SCH, SEATTLE, WA HO UNIV WASHINGTON, MED SCH C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Atlanta, GA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU UNIV WASHINGTON PRESS PI SEATTLE PA SEATTLE, WA 98105 USA BN 0-295-97650-0 PY 1997 BP 198 EP 202 PG 5 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics; Psychiatry; Psychology SC Psychology; Public, Environmental & Occupational Health; Pediatrics; Psychiatry GA BK63C UT WOS:000072809300019 ER PT J AU Kahana, LM Kay, JM Yakrus, MA Waserman, S AF Kahana, LM Kay, JM Yakrus, MA Waserman, S TI Mycobacterium avium complex infection in an immunocompetent young adult related to hot tub exposure SO CHEST LA English DT Article DE drug susceptibility; Mycobacterium avium complex infection; restriction fragment length polymorphism ID ACQUIRED-IMMUNODEFICIENCY-SYNDROME; NONTUBERCULOUS MYCOBACTERIA; INTRACELLULARE; WATER; EPIDEMIOLOGY; AIDS AB An unusual case of Mycobacterium avium complex infection occurred in a young adult with no preexisting disease and no evidence of immunodeficiency. There was diffuse interstitial involvement of the lungs which suggested an active alveolitis. Diagnosis required open-lung biopsy. Restriction fragment length polymorphism analysis and multilocus enzyme electrophoresis indicated that the source of the infection was a hot tub. The infection proved to be exceptionally responsive to treatment, and there was complete resolution with a four-drug regimen. C1 ST JOSEPHS HOSP,DEPT MED,HAMILTON,ON,CANADA. ST JOSEPHS HOSP,DEPT PATHOL,HAMILTON,ON,CANADA. CHEDOKE MCMASTER HOSPS,DEPT MED,HAMILTON,ON,CANADA. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,ATLANTA,GA. NR 18 TC 72 Z9 75 U1 0 U2 2 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 SN 0012-3692 J9 CHEST JI Chest PD JAN PY 1997 VL 111 IS 1 BP 242 EP & DI 10.1378/chest.111.1.242 PG 4 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA WC114 UT WOS:A1997WC11400048 PM 8996025 ER PT B AU Fukuda, K AF Fukuda, K BE Yehuda, S Mostofsky, DI TI Development of the 1994 chronic fatigue syndrome case definition and clinical evaluation guidelines SO CHRONIC FATIGUE SYNDROME LA English DT Proceedings Paper CT 2nd Farber-Center International Conference on Chronic Fatigue Syndrome CY DEC 12-13, 1995 CL BAR-ILAN UNIV, GAMAT GAN, ISRAEL SP Farber Ctr Alzheimer Res, Ginsburg Chair Res Alzheimer Dis, Gold Fdn HO BAR-ILAN UNIV RP Fukuda, K (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,INFLUENZA BRANCH,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333, USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU PLENUM PRESS DIV PLENUM PUBLISHING CORP PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 BN 0-306-45587-0 PY 1997 BP 29 EP 50 PG 4 WC Immunology; Infectious Diseases; Psychiatry SC Immunology; Infectious Diseases; Psychiatry GA BH52Q UT WOS:A1997BH52Q00002 ER PT J AU Yang, MC Magee, DM Kaufman, L Zhu, YF Cox, RA AF Yang, MC Magee, DM Kaufman, L Zhu, YF Cox, RA TI Recombinant Coccidioides immitis complement-fixing antigen: Detection of an epitope shared by C-immitis, Histoplasma capsulatum, and Blastomyces dermatitidis SO CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY LA English DT Article ID FIXATION ANTIGEN; PROTEIN; PURIFICATION; THREAT AB We undertook an investigation to assess the utility of a recombinant Coccidioides immitis complement-fixing (CF) antigen for detecting CF antibody in sera from patients with coccidioidomycosis, Enzyme-linked immunosorbent assays established that recombinant CF antigen and, for comparison, a commercially available coccidioidin were reactive with 19 of 19 sera from patients with active coccidioidomycosis. The recombinant antigen was significantly more sensitive than coccidioidin. The median titer obtained when patients' sera were assayed against recombinant CF antigen was 1:51,200 compared to 1:25,600 with coccidioidin (P <0.027). The recombinant antigen was also more effective in distinguishing the antibody levels in sera from patients with pulmonary coccidioidomycosis than in sera from those with disseminated disease, Whereas patients with pulmonary disease showed a median antibody titer of 1:25,600, those with multifocal disease showed a median titer of 1:102,400 (P <0.028). The recombinant CF antigen was found, however, to express an epitope(s) that reacted with sera from 6 of 12 patients with histoplasmosis and 2 of 12 patients with blastomycosis. C1 TEXAS CTR INFECT DIS,DEPT CLIN INVEST,SAN ANTONIO,TX 78223. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. FU NIAID NIH HHS [AI12431] NR 22 TC 12 Z9 13 U1 0 U2 2 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 1071-412X J9 CLIN DIAGN LAB IMMUN JI Clin. Diagn. Lab. Immunol. PD JAN PY 1997 VL 4 IS 1 BP 19 EP 22 PG 4 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WB629 UT WOS:A1997WB62900005 PM 9008276 ER PT J AU Braden, CR Templeton, GL Stead, WW Bates, JH Cave, MD Valway, SE AF Braden, CR Templeton, GL Stead, WW Bates, JH Cave, MD Valway, SE TI Retrospective detection of laboratory cross-contamination of Mycobacterium tuberculosis cultures with use of DNA fingerprint analysis SO CLINICAL INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 35th Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) CY SEP 17-22, 1995 CL SAN FRANCISCO, CA SP Amer Soc Microbiol ID CLINICAL-FEATURES; POSITIVE CULTURES; STRAIN; EPIDEMIOLOGY; TRANSMISSION; INFECTION; OUTBREAK AB In 1992-1993, we investigated possible cross-contamination of Mycobacterium tuberculosis cultures as part of a study of tuberculosis in Arkansas by using DNA fingerprint analysis. Of patients whose isolates were matched, those for whom smears were negative and only one culture was positive were identified from laboratory records, Clinical, laboratory, DNA fingerprint, and epidemiological data were reviewed, Of 259 patients, nine (3.5%) were judged to be due to cross-contamination. None of these patients had a clinical course consistent with tuberculosis. All nine specimens were processed with another isolate with a matching DNA fingerprint, and epidemiological connections were not identified among any of the patients. To avoid erroneous diagnoses and unnecessary therapy and public health investigations, specimens from patients with tuberculosis whose smears are negative and only one culture is positive should be investigated for cross-contamination, An inconsistent clinical course and a DNA fingerprint that matches those of other culture-positive specimens processed concurrently, coupled with the lack of an epidemiological connection, suggest cross-contamination. C1 CTR DIS CONTROL & PREVENT,EPIDEM INTELLIGENCE SERV,EPIDEMIOL PROGRAM OFF,ATLANTA,GA 30333. UNIV ARKANSAS MED SCI HOSP,JOHN L MCCLELLAN MEM VET HOSP,LITTLE ROCK,AR 72205. ARKANSAS DEPT HLTH,LITTLE ROCK,AR 72205. RP Braden, CR (reprint author), CTR DIS CONTROL & PREVENT,DIV TB ELIMINAT,NATL CTR PREVENT SERV,MAILSTOP E-10,1600 CLIFTON RD,ATLANTA,GA 30333, USA. FU NIAID NIH HHS [AI01136] NR 21 TC 76 Z9 76 U1 0 U2 1 PU UNIV CHICAGO PRESS PI CHICAGO PA 5720 S WOODLAWN AVE, CHICAGO, IL 60637 SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JAN PY 1997 VL 24 IS 1 BP 35 EP 40 PG 6 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA WC117 UT WOS:A1997WC11700007 PM 8994753 ER PT J AU Black, CM AF Black, CM TI Current methods of laboratory diagnosis of Chlamydia trachomatis infections SO CLINICAL MICROBIOLOGY REVIEWS LA English DT Review ID POLYMERASE CHAIN-REACTION; DIRECT FLUORESCENT-ANTIBODY; GEN-PROBE PACE-2; MICROTRAK ENZYME-IMMUNOASSAY; LINKED-IMMUNOSORBENT-ASSAY; SEXUALLY-TRANSMITTED DISEASES; LOW-PREVALENCE POPULATION; FAMILY-PLANNING CLINICS; LEUKOCYTE ESTERASE TEST; FIRST-VOID URINE AB Infections caused by Chlamydia trachomatis are probably the most common sexually transmitted diseases in the United States. Commonly unrecognized and often inadequately treated, chlamydial infections can ascend the reproductive tract and cause pelvic inflammatory disease, which often results in the devastating consequences of infertility, ectopic pregnancy, or chronic pelvic pain. C. trachomatis infections are also known to increase the risk for human immunodeficiency virus infection. The obligate intracellular life cycle of C. trachomatis has traditionally required laboratory diagnostic tests that are technically demanding, labor-intensive, expensive, and difficult to access. In spite of these historical challenges, however; laboratory diagnosis of C. trachomatis has been a rapidly advancing area in which there is presently a wide array of commercial diagnostic technologies, costs, and manufacturers. This review describes and compares the diagnostic methods for C. trachomatis infection that are currently approved for use in the United States including the newest DNA amplification technologies which are yet to be licensed for commercial use. issues to consider in selecting a test for purposes of screening versus diagnosis based on prevalence performance, legal, social, and cost issues are also discussed. RP Black, CM (reprint author), CTR DIS CONTROL & PREVENT, NATL CTR INFECT DIS, DIV AIDS SEXUALLY TRANSMITTED DIS, BLDG 6-312, ATLANTA, GA 30333 USA. NR 243 TC 321 Z9 342 U1 0 U2 13 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1325 MASSACHUSETTS AVENUE, NW, WASHINGTON, DC 20005-4171 SN 0893-8512 J9 CLIN MICROBIOL REV JI Clin. Microbiol. Rev. PD JAN PY 1997 VL 10 IS 1 BP 160 EP + PG 0 WC Microbiology SC Microbiology GA WB408 UT WOS:A1997WB40800007 PM 8993862 ER PT J AU Chapman, DP AF Chapman, DP TI In the shadow of the epidemic: Being HIV-negative in the age of AIDS - Odets,W SO CONTEMPORARY PSYCHOLOGY LA English DT Book Review RP Chapman, DP (reprint author), CTR DIS CONTROL & PREVENT,DIV ADULT & COMMUN HLTH,ATLANTA,GA, USA. NR 1 TC 0 Z9 0 U1 0 U2 0 PU AMER PSYCHOLOGICAL ASSOC PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 SN 0010-7549 J9 CONTEMP PSYCHOL JI Comtemp. Psychol. PD JAN PY 1997 VL 42 IS 1 BP 57 EP 58 PG 2 WC Psychology, Multidisciplinary SC Psychology GA WD883 UT WOS:A1997WD88300037 ER PT J AU Pallansch, MA AF Pallansch, MA TI Coxsackievirus B epidemiology and public health concerns SO COXSACKIE B VIRUSES SE CURRENT TOPICS IN MICROBIOLOGY AND IMMUNOLOGY LA English DT Review ID POLYMERASE CHAIN-REACTION; DEPENDENT DIABETES-MELLITUS; IDIOPATHIC DILATED CARDIOMYOPATHY; ENTEROVIRUS-SPECIFIC IGM; MONOCLONAL-ANTIBODIES; VIRUS-INFECTIONS; UNITED-STATES; ASEPTIC-MENINGITIS; VIRAL PERSISTENCE; FATIGUE SYNDROME RP Pallansch, MA (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS,ATLANTA,GA 30333, USA. NR 97 TC 35 Z9 38 U1 0 U2 0 PU SPRINGER-VERLAG BERLIN PI BERLIN 33 PA HEIDELBERGER PLATZ 3, W-1000 BERLIN 33, GERMANY SN 0070-217X J9 CURR TOP MICROBIOL JI Curr.Top.Microbiol.Immunol. PY 1997 VL 223 BP 13 EP 30 PG 18 WC Immunology; Microbiology SC Immunology; Microbiology GA BJ47L UT WOS:A1997BJ47L00002 ER PT B AU Grummer-Strawn, LM AF Grummer-Strawn, LM BE Pebley, AR RoseroBixby, L TI The nutritional status of children in Central America SO DEMOGRAPHIC DIVERSITY AND CHANGE IN THE CENTRAL AMERICAN ISTHMUS LA English DT Proceedings Paper CT International Conference on the Population of the Central-American Isthmus CY 1996 CL UNIV COSTA RICA, SAN JOSE, COSTA RICA HO UNIV COSTA RICA AB Over the past several decades, the countries of Central America have been torn apart by revolution and civil strife, which have threatened the well-being of children in the region. In this analysis, I examine the nutritional status of children throughout the region, utilizing household based assessments of anthropometry. Data are analyzed from surveys conducted in El Salvador (1988 and 1993), Honduras (1987, 1991/92 and 1993/94), Nicaragua (1993/94) and Guatemala (1987). Geographic patterns of undernutrition are examined at the level of the health regions in each country. Focus here is on the entire distribution of anthropometry, not simply on those who fall below a specified cutoff, since it is observed that reductions in malnutrition usually result from a generalized shift in the distribution of heights and weights of all children in the population, rather than a change simply, among the shortest or thinnest children. In all four countries, rates of stunting are found to be high, with increased rates in rural areas, among children whose mothers have had little or no education, and among those at a lower socio-economic status. Rates of wasting are generally low throughout the region. In El Salvador, improvements in nutritional status are observed. C1 Ctr Dis Control & Prevent, Div Nutr, Maternal & Child Hlth Branch, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU RAND PI SANTA MONICA PA PUBLICATIONS DEPT, 1700 MAIN ST PO BOX 2138, SANTA MONICA, CA 90407-2138 USA BN 0-8330-2551-1 PY 1997 BP 191 EP 211 PG 21 WC Area Studies; Demography SC Area Studies; Demography GA BL06L UT WOS:000074146700010 ER PT B AU Danel, I Grummer-Strawn, L Caceres, JM Stupp, P AF Danel, I Grummer-Strawn, L Caceres, JM Stupp, P BE Pebley, AR RoseroBixby, L TI Maternal mortality and morbidity in El Salvador SO DEMOGRAPHIC DIVERSITY AND CHANGE IN THE CENTRAL AMERICAN ISTHMUS LA English DT Proceedings Paper CT International Conference on the Population of the Central-American Isthmus CY 1996 CL UNIV COSTA RICA, SAN JOSE, COSTA RICA HO UNIV COSTA RICA AB Maternal mortality, known as "the silent epidemic," is frequently underestimated in developing countries. Even less is known about maternal morbidity, and the limited information available comes from hospital studies. Since the majority of women in these countries give birth at home, hospital studies are not representative of all deliveries. A population-based household survey was carried out in EI Salvador between January and March 1993. A total of 6,207 women of reproductive age were interviewed. Maternal mortality was estimated based on the survival status of the respondent's sisters. Women who had been pregnant in the two years prior to the survey were asked about several problems during pregnancy, delivery and the post-partum period. Maternal morbidity is described using several demographic and reproductive variables. The national maternal mortality ratio was estimated at 158 per 100,000 live births for the period 1983-1993. This figure is more than three times larger than that reported by the Ministry of Health in 1988 (47 per 100,000 live births). In general, the use of prenatal services was 68%, the hospital delivery rate was 51% and the cesarean rate, based on the population, was 13.3%. However, there are large differences depending on factors such as the area of residence and the level of education. The percentage of women who reported maternal morbidity was high. The self-reported incidence of important causes of maternal morbidity during delivery include: hemorrhage (35%), fever (15%), prolonged labor (15%), loss of consciousness (11%), possible preeclampsia (8%), and convulsions (2%). The prevalence of self-reported prenatal morbidity was higher in women who received prenatal care. This finding generates questions about the interpretation of some self-reported morbidities. On the other hand, the self-reported prevalence of morbidity during delivery tvas higher in women who gave birth at home compared to women who gave birth in a hospital. Studies such as this one are a first step toward understanding and prevention of maternal morbidity and its sequelae. C1 Ctr Dis Control & Prevent, Div Reprod Hlth, Womens Hlth & Fertil Branch, Atlanta, GA 30341 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU RAND PI SANTA MONICA PA PUBLICATIONS DEPT, 1700 MAIN ST PO BOX 2138, SANTA MONICA, CA 90407-2138 USA BN 0-8330-2551-1 PY 1997 BP 213 EP 235 PG 23 WC Area Studies; Demography SC Area Studies; Demography GA BL06L UT WOS:000074146700011 ER PT S AU Conway, FT Smith, MJ LeGrande, D Cahill, J AF Conway, FT Smith, MJ LeGrande, D Cahill, J BE Salvendy, G Smith, MJ Koubek, RJ TI Psychological stress and musculoskeletal health SO DESIGN OF COMPUTING SYSTEMS: COGNITIVE CONSIDERATIONS SE ADVANCES IN HUMAN FACTORS / ERGONOMICS LA English DT Proceedings Paper CT 7th International Conference on Human-Computer Interaction (HCI International 97) CY AUG 24-29, 1997 CL SAN FRANCISCO, CA SP Chinese Acad Sci, EEC, European Strateg Programme Res & Dev Informat Technol, ESPRIT, Human Factors & Ergon Soc, IEEE Syst Man & Cybernet Soc, Japan Ergon Soc, Japan Management Assoc C1 NIOSH, Robert A Taft Labs, Cincinnati, OH 45226 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA SARA BURGERHARTSTRAAT 25, PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0921-2647 BN 0-444-82183-X J9 ADV HUM FACT ERGON PY 1997 VL 21 BP 493 EP 496 PN A PG 4 WC Computer Science, Cybernetics; Computer Science, Information Systems; Engineering, Industrial; Ergonomics; Information Science & Library Science SC Computer Science; Engineering; Information Science & Library Science GA BK42Z UT WOS:000072153000121 ER PT B AU Noji, EK AF Noji, EK GP WHO WHO TI The epidemiology of earthquakes: implications for vulnerability reduction, mitigation and relief SO EARTHQUAKES AND PEOPLE'S HEALTH: VULNERABILITY REDUCTION, PREPAREDNESS AND REHABILITATION LA English DT Proceedings Paper CT WHO Symposium on Earthquakes and Peoples Health - Vulnerability Reduction, Preparedness and Rehabilitation CY JAN 27-30, 1997 CL KOBE, JAPAN SP WHO, Ctr Hlth Dev C1 CDC, Int Emergency & Refugee Hlth Program, Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. RP Noji, EK (reprint author), CDC, Int Emergency & Refugee Hlth Program, Ctr Dis Control & Prevent, Atlanta, GA 30333 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WORLD HEALTH ORGANIZATION PI GENEVA PA DISTRIBUTION & SALES SERVICE, 1211 27 GENEVA, SWITZERLAND PY 1997 BP 11 EP 19 PG 9 WC Engineering, Geological; Public, Environmental & Occupational Health SC Engineering; Public, Environmental & Occupational Health GA BK21H UT WOS:000071542900001 ER PT J AU Knapp, JS Fox, KK Trees, DL Whittington, WL AF Knapp, JS Fox, KK Trees, DL Whittington, WL TI Fluorcquinolone resistance in Neisseria gonorrhoeae SO EMERGING INFECTIOUS DISEASES LA English DT Article ID IN-VITRO RESISTANCE; ANTIMICROBIAL SUSCEPTIBILITIES; CIPROFLOXACIN RESISTANCE; REDUCED UPTAKE; HONG-KONG; STRAINS; OFLOXACIN; NORFLOXACIN; MUTATIONS; JAPAN AB Fluoroquinolones and broad-spectrum cephalosporins are the most effective antimicrobial agents for the treatment of gonorrhea. However, clinically significant resistance to fluoroquinolones has emerged in Neisseria gonorrhoeae. fluoroquinolone-resistant strains account for approximately 10% of all gonococcal strains in Hong Kong and the Republic of the Philippines. As many as 50% of strains from some Far Eastern countries exhibit decreased susceptibility (intermediate resistance) to fluoroquinolones. Strains with intermediate resistance and clinically significant resistance are being isolated sporadically in North America, where resistant strains have been associated with an outbreak and with failure of infections to respond to treatment with doses of ciprofloxacin and ofloxacin recommended by the Centers for Disease Control and Prevention; strains exhibiting decreased susceptibility to these agents are endemic in at least one metropolitan area. Monitoring for fluoroquinolone resistance is now critical for ensuring adequate treatment of infections with resistant strains and for maximizing the time du ring which fluoroquinolones may be used to treat gonorrhea. C1 UNIV WASHINGTON,CTR AIDS & STD,SEATTLE,WA 98195. RP Knapp, JS (reprint author), CTR DIS CONTROL & PREVENT,1600 CLIFTON RD NE,MS G39,ATLANTA,GA 30333, USA. NR 44 TC 91 Z9 92 U1 1 U2 3 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN-MAR PY 1997 VL 3 IS 1 BP 33 EP 39 PG 7 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ421 UT WOS:A1997WQ42100004 PM 9126442 ER PT J AU GeorgesCourbot, MC Sanchez, A Lu, CY Baize, S Leroy, E LansoutSoukate, J TeviBenissan, C Georges, AJ Trappier, SG Zaki, SR Swanepoel, R Leman, PA Rollin, PE Peters, CJ Nichol, ST Ksiazek, TG AF GeorgesCourbot, MC Sanchez, A Lu, CY Baize, S Leroy, E LansoutSoukate, J TeviBenissan, C Georges, AJ Trappier, SG Zaki, SR Swanepoel, R Leman, PA Rollin, PE Peters, CJ Nichol, ST Ksiazek, TG TI Isolation and phylogenetic characterization of Ebola viruses causing different outbreaks in Gabon SO EMERGING INFECTIOUS DISEASES LA English DT Article ID STRAIN AB Three outbreaks of Ebola hemorrhagic fever have recently occurred in Gabon. Virus has been isolated from clinical materials from all three outbreaks, and nucleotide sequence analysis of the glycoprotein gene of the isolates and virus present in clinical samples has been carried out. These data indicate that each of the three outbreaks should be considered an independent emergence of a different Ebola virus of the Zaire subtype. As in earlier Ebola virus outbreaks, no genetic variability was detected between virus samples taken during an individual outbreak. C1 CTR DIS CONTROL & PREVENT,ATLANTA,GA. NATL INST VIROL,JOHANNESBURG,SOUTH AFRICA. RP GeorgesCourbot, MC (reprint author), CTR INT RECH MED FRANCEVILLE,BP 769,FRANCEVILLE,GABON. RI LEROY, Eric/I-4347-2016 OI LEROY, Eric/0000-0003-0022-0890 NR 15 TC 84 Z9 95 U1 0 U2 16 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN-MAR PY 1997 VL 3 IS 1 BP 59 EP 62 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ421 UT WOS:A1997WQ42100007 PM 9126445 ER PT J AU Izurieta, HS Strebel, PM Youngblood, T Hollis, DG Popovic, T AF Izurieta, HS Strebel, PM Youngblood, T Hollis, DG Popovic, T TI Exudative pharyngitis possibly due to Corynebacterium pseudodiphtheriticum, a new challenge in the differential diagnosis of diphtheria SO EMERGING INFECTIOUS DISEASES LA English DT Article ID RESPIRATORY-TRACT PATHOGEN; INFECTIVE ENDOCARDITIS; PULMONARY INFECTION; VALVE ENDOCARDITIS AB Corynebacterium pseudodiphtheriticum has rarely been reported to cause disease in humans, despite its common presence in the flora of the upper respiratory tract. We report here a case of exudative pharyngitis with pseudomembrane possibly caused by C. pseudodiphtheriticum in a 4-year-old girl. The case initially triggered clinical and laboratory suspicion of diphtheria. Because C. pseudodiphtheriticum can be easily confused with Corynebacterium diphtheriae in Gram stain, clarification of its role in the pathogenesis of exudative pharyngitis in otherwise healthy persons is of public health importance. Simple and rapid screening tests to differentiate C. pseudodiphtheriticum from C. diphtheriae should be performed to prevent unnecessary concern in the community and unnecessary outbreak control measures. C1 ROGERS PEDIAT CLIN,ROGERS,AR. RP Izurieta, HS (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 43 TC 15 Z9 17 U1 1 U2 2 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN-MAR PY 1997 VL 3 IS 1 BP 65 EP 68 PG 4 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ421 UT WOS:A1997WQ42100009 PM 9126447 ER PT J AU Rwaguma, EB Lutwama, JJ Sempala, SDK Kiwanuka, N Kamugisha, J Okware, S Bagambisa, G Lanciotti, R Roehrig, JT Gubler, DJ AF Rwaguma, EB Lutwama, JJ Sempala, SDK Kiwanuka, N Kamugisha, J Okware, S Bagambisa, G Lanciotti, R Roehrig, JT Gubler, DJ TI Emergence of epidemic O'nyong-nyong fever in southwestern Uganda, after an absence of 35 years SO EMERGING INFECTIOUS DISEASES LA English DT Letter C1 RAKAI PROJECT UGANDA VIRUS RES INST,RAKAI,UGANDA. MINIST HLTH,RAKAI,UGANDA. CTR DIS CONTROL & PREVENT,FT COLLINS,CO. RP Rwaguma, EB (reprint author), UGANDA VIRUS RES INST,ENTEBBE,UGANDA. NR 0 TC 24 Z9 24 U1 0 U2 1 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN-MAR PY 1997 VL 3 IS 1 BP 77 EP 77 PG 1 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ421 UT WOS:A1997WQ42100012 PM 9126450 ER PT J AU Dalton, CB Griffin, PM Slutsker, L AF Dalton, CB Griffin, PM Slutsker, L TI Electronic communication and the rapid dissemination of public health information SO EMERGING INFECTIOUS DISEASES LA English DT Letter ID SURVEILLANCE RP Dalton, CB (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 5 TC 2 Z9 2 U1 0 U2 0 PU CENTER DISEASE CONTROL PI ATLANTA PA ATLANTA, GA 30333 SN 1080-6040 J9 EMERG INFECT DIS JI Emerg. Infect. Dis PD JAN-MAR PY 1997 VL 3 IS 1 BP 80 EP 81 PG 2 WC Immunology; Infectious Diseases SC Immunology; Infectious Diseases GA WQ421 UT WOS:A1997WQ42100015 PM 9126453 ER PT J AU Sanderson, WT Talaska, G Zaebst, D DavisKing, K Calvert, G AF Sanderson, WT Talaska, G Zaebst, D DavisKing, K Calvert, G TI Pesticide prioritization for a brain cancer case-control study SO ENVIRONMENTAL RESEARCH LA English DT Article ID OCCUPATIONAL RISKS; EXPOSURE; FARMERS; TRENDS AB The incidence of brain cancer is rising in the United States while the causes remain largely unknown. Epidemiologic studies indicate that individuals working in agriculture have an increased risk of brain cancer. The National Institute for Occupational Safety and Health is conducting a case-control study of incident brain cancer cases in Iowa, Michigan, Minnesota, and Wisconsin to evaluate the risk associated with several environmental exposures, in particular agricultural pesticides. Hundreds of different pesticides are used in agriculture and it is not feasible to evaluate the association between brain cancer and exposure to each of these chemicals; therefore, a strategy was developed to identify which pesticides would be targeted in the study. First, lists of pesticides were created, documenting usage in each of the four states and the United States as a whole, by using data from reports prepared by the U.S. Department of Agriculture and Departments of Agriculture and land grant colleges within the four states. Then the following factors were considered in prioritizing pesticides for evaluation in the study: total volume of use prior to 1985, ranking of use in the four states and the United States as a whole by pesticide category, and toxicological evidence of carcinogenic, teratogenic, or mutagenic effects. Pesticide usage prior to 1985 was determined to allow for a minimum 10-year latency for the incident brain cancer cases diagnosed in 1995 or later. The selected pesticides include 56 herbicides, 49 insecticides, 12 fungicides, and 17 fumigants, accounting for over 99% of the total pounds of herbicides and insecticides and over 98% of the total pounds of fungicides and fumigants applied pre-1985. Prompt Lists of the pesticides are sent to study participants a few days before the study questionnaire is administered to allow them time to recall past use of pesticides; the lists include the common chemical names, trade names, the crops that the pesticides are most commonly used on, and the years that the pesticides have been marketed. The methods used to select this subset of 134 pesticides document historical pesticide usage and may be useful in prioritizing pesticides for other research studies. (C) 1997 Academic Press. C1 UNIV CINCINNATI,DEPT ENVIRONM HLTH,KETTERING LAB,CINCINNATI,OH 45221. RP Sanderson, WT (reprint author), NIOSH,MAILSTOP R-14,4676 COLUMBIA PKWY,CINCINNATI,OH 45226, USA. NR 28 TC 12 Z9 15 U1 1 U2 1 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0013-9351 J9 ENVIRON RES JI Environ. Res. PY 1997 VL 74 IS 2 BP 133 EP 144 DI 10.1006/enrs.1997.3759 PG 12 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA YC686 UT WOS:A1997YC68600006 PM 9339226 ER PT J AU Johnson, BL AF Johnson, BL TI The triennial international symposium on neurobehavioral methods: The history and hope SO ENVIRONMENTAL RESEARCH LA English DT Article; Proceedings Paper CT 5th International Symposium on Neurobehavioral Methods and Effects in Occupational and Environmental Health CY DEC 03-07, 1994 CL CAIRO, EGYPT AB In 1982 in Milan, Italy, a series of triennial international symposia on neurobehavioral methods and their application commenced. Five of these symposia have been conducted. This paper reviews the origin of this neurobehavioral symposium and recounts the key findings and observations produced during each. In particular, the commitment of the symposium's organizers to meeting the needs of developing countries is discussed. An examination of the five symposia found that more than 250 papers have been published as proceedings. Furthermore, the symposia have maintained the original intent to assist developing countries. The symposium continues to emphasize the need to relate basic mechanisms of neurotoxicity to various neurobehavioral test batteries and method. (C) 1997 Academic Press. RP Johnson, BL (reprint author), AGCY TOX SUBST & DIS REGISTRY,ATLANTA,GA 30333, USA. NR 17 TC 1 Z9 1 U1 0 U2 0 PU ACADEMIC PRESS INC JNL-COMP SUBSCRIPTIONS PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 SN 0013-9351 J9 ENVIRON RES JI Environ. Res. PY 1997 VL 73 IS 1-2 BP 2 EP 8 DI 10.1006/enrs.1997.3723 PG 7 WC Environmental Sciences; Public, Environmental & Occupational Health SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health GA XY135 UT WOS:A1997XY13500002 PM 9311526 ER PT J AU Yang, QH Khoury, MJ AF Yang, QH Khoury, MJ TI Evolving methods in genetic epidemiology .3. Gene-environment interaction in epidemiologic research SO EPIDEMIOLOGIC REVIEWS LA English DT Article ID DEPENDENT DIABETES-MELLITUS; CANCER SUSCEPTIBILITY GENE; HAPLOTYPE-RELATIVE-RISK; CASE-PARENTAL CONTROL; COMPLEX TRAITS; BREAST-CANCER; LINKAGE DISEQUILIBRIUM; QUANTITATIVE TRAIT; NUCLEAR FAMILIES; OVARIAN-CANCER C1 CTR DIS CONTROL & PREVENT,OFF GENET & DIS PREVENT,ATLANTA,GA. RP Yang, QH (reprint author), CTR DIS CONTROL & PREVENT,BIRTH DEFECTS & GENET DIS BRANCH,NATL CTR ENVIRONM HLTH,MS F-45,ATLANTA,GA 30341, USA. NR 98 TC 125 Z9 130 U1 1 U2 4 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0193-936X J9 EPIDEMIOL REV JI Epidemiol. Rev. PY 1997 VL 19 IS 1 BP 33 EP 43 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA YE667 UT WOS:A1997YE66700005 PM 9360900 ER PT J AU Steinberg, KK Sanderlin, KC Ou, CY Hannon, WH McQuillan, GM Sampson, EJ AF Steinberg, KK Sanderlin, KC Ou, CY Hannon, WH McQuillan, GM Sampson, EJ TI DNA banking in epidemiologic studies SO EPIDEMIOLOGIC REVIEWS LA English DT Article ID EPSTEIN-BARR-VIRUS; LYMPHOBLASTOID CELL-LINES; DRIED BLOOD SPECIMENS; FILTER-PAPER BLOTTERS; GENOMIC DNA; CRYOPRESERVED LYMPHOCYTES; GENETIC-ANALYSIS; CYSTIC-FIBROSIS; NUCLEATED CELLS; STORAGE TIME C1 NATL CTR HLTH STAT,HYATTSVILLE,MD 20782. RP Steinberg, KK (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR ENVIRONM HLTH,MS-F24,4770 BUFORD HIGHWAY,CHAMBLEE,GA 30341, USA. NR 60 TC 34 Z9 35 U1 0 U2 1 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 SN 0193-936X J9 EPIDEMIOL REV JI Epidemiol. Rev. PY 1997 VL 19 IS 1 BP 156 EP 162 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA YE667 UT WOS:A1997YE66700017 PM 9360912 ER PT J AU Khoury, MJ AF Khoury, MJ TI Genetic epidemiology and the future of disease prevention and public health SO EPIDEMIOLOGIC REVIEWS LA English DT Article ID HUMAN GENOME PROJECT; ENVIRONMENT INTERACTION; HEMOCHROMATOSIS; ETHICS RP Khoury, MJ (reprint author), CTR DIS CONTROL & PREVENT, TASK FORCE GENET DIS PREVENT, MAILSTOP F45, 4770 BUFORD HIGHWAY, ATLANTA, GA 30341 USA. NR 40 TC 44 Z9 44 U1 0 U2 5 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0193-936X EI 1478-6729 J9 EPIDEMIOL REV JI Epidemiol. Rev. PY 1997 VL 19 IS 1 BP 175 EP 180 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA YE667 UT WOS:A1997YE66700019 PM 9360914 ER PT J AU Boss, LP AF Boss, LP TI Epidemic hysteria: A review of the published literature SO EPIDEMIOLOGIC REVIEWS LA English DT Review ID MASS PSYCHOGENIC ILLNESS; PARENTALLY REPORTED EPIDEMIC; REPETITION STRAIN INJURY; ELEMENTARY-SCHOOL; ARJENYATTAH EPIDEMIC; SOCIOGENIC ILLNESS; OUTBREAK; SCHOOLCHILDREN; MANAGEMENT; CAMELFORD C1 Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hazards & Hlth Effects, Atlanta, GA 30341 USA. RP Boss, LP (reprint author), Ctr Dis Control & Prevent, Natl Ctr Environm Hlth, Div Environm Hazards & Hlth Effects, MS F-39,4770 Buford Highway NE, Atlanta, GA 30341 USA. NR 112 TC 62 Z9 65 U1 4 U2 11 PU JOHNS HOPKINS UNIV SCHOOL HYGIENE PUB HEALTH PI BALTIMORE PA 111 MARKET PLACE, STE 840, BALTIMORE, MD 21202-6709 USA SN 0193-936X J9 EPIDEMIOL REV JI Epidemiol. Rev. PY 1997 VL 19 IS 2 BP 233 EP 243 PG 11 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA YX478 UT WOS:000072044000004 PM 9494785 ER PT B AU Gubler, DJ AF Gubler, DJ BE Saluzzo, JF Dodet, B TI The emergence of dengue/dengue hemorrhagic fever as a global public health problem SO FACTORS IN THE EMERGENCE OF ARBOVIRUS DISEASES: EMERGING DISEASES LA English DT Proceedings Paper CT Conference on Factors in the Emergence of Arbovirus Diseases CY DEC 08-10, 1996 CL ANNECY, FRANCE SP Marcel Merieux Fdn DE dengue; Aedes aegypti; emerging diseases AB Dengue/dengue hemorrhagic fever is one of the most important resurgent tropical diseases worldwide. A global pandemic that began during World War II has intensified in the past 16 years, with expanding geographic distribution of both the viruses and the mosquito vectors, increased frequency of epidemics, the development of hyperendemicity (co-circulation of multiple virus serotypes) and the emergence of dengue hemorrhagic fever in new areas. This paper briefly reviews the changing epidemiology of dengue in each major tropical region and discusses some of the factors responsible for the resurgence of this old disease. RP Gubler, DJ (reprint author), CTR DIS CONTROL & PREVENT,DIV VECTOR BORNE INFECT DIS,NATL CTR INFECT DIS,PUBL HLTH SERV,FT COLLINS,CO 80522, USA. NR 0 TC 13 Z9 14 U1 2 U2 5 PU EDITIONS SCIENTIFIQUE & MEDICALES ELSEVIER PI PARIS PA 141, RUE DE JAVEL, PARIS, FRANCE BN 2-84299-005-6 PY 1997 BP 83 EP 92 PG 4 WC Public, Environmental & Occupational Health; Infectious Diseases; Virology SC Public, Environmental & Occupational Health; Infectious Diseases; Virology GA BJ25P UT WOS:A1997BJ25P00007 ER PT B AU Peters, CJ AF Peters, CJ BE Saluzzo, JF Dodet, B TI Emergence of Rift Valley fever SO FACTORS IN THE EMERGENCE OF ARBOVIRUS DISEASES: EMERGING DISEASES LA English DT Proceedings Paper CT Conference on Factors in the Emergence of Arbovirus Diseases CY DEC 08-10, 1996 CL ANNECY, FRANCE SP Marcel Merieux Fdn DE Rift Valley fever; emerging viruses; hemorrhagic fever; arthropod-borne viruses; Madagascar; vaccines AB Rift Valley fever is a mosquito-borne epidemic disease of sub-Saharan Africa that threatens invasion of any part of the globe with cattle and sheeps herds and high populations of mosquitoes. Should an introduction of the virus occur in a receptive area, the only effective way to deal with an epidemic is through a live-attenuated veterinary vaccine to block livestock transmission and thus protect humans from febrile disease, hemorrhagic fever, encephalitis, and retinopathy. The endemic circulation of the virus in sub-Saharan Africa is at least partially dependent on transovarial transmission in flood-water Aedes mosquitoes; additional research on the vertical and horizontal transmission is urgently needed to understand the regulation of the endemic and epidemic transmission of the virus. The epidemic transmission of Rift Valley fever virus in Africa today can be understood in terms of ecologic factors such as introduced livestock species, irrigation projects, and major ecologic changes exemplified in the island of Madagascar. RP Peters, CJ (reprint author), CTR DIS CONTROL & PREVENT,1600 CLIFTON RD,MS G-14,ATLANTA,GA 30333, USA. NR 0 TC 25 Z9 27 U1 0 U2 4 PU EDITIONS SCIENTIFIQUE & MEDICALES ELSEVIER PI PARIS PA 141, RUE DE JAVEL, PARIS, FRANCE BN 2-84299-005-6 PY 1997 BP 253 EP 264 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases; Virology SC Public, Environmental & Occupational Health; Infectious Diseases; Virology GA BJ25P UT WOS:A1997BJ25P00024 ER PT J AU Ibrahim, A Liesack, W Steigerwalt, AG Brenner, DJ Stackebrandt, E RobinsBrowne, RM AF Ibrahim, A Liesack, W Steigerwalt, AG Brenner, DJ Stackebrandt, E RobinsBrowne, RM TI A cluster of atypical Yersinia strains with a distinctive 16S rRNA signature SO FEMS MICROBIOLOGY LETTERS LA English DT Article DE Yersinia; 16S ribosomal RNA; bacterial classification; nucleotide sequence; DNA hybridization; Yersinia frederiksenii ID HEAT-STABLE ENTEROTOXIN; RIBOSOMAL-RNA SEQUENCES; NUCLEOTIDE-SEQUENCE; ENTEROCOLITICA; IDENTIFICATION; GENE; DNA AB Thirty-eight bacterial isolates from raw milk samples in Queensland, Australia were identified as members of the genus Yersinia on the basis of biochemical profile, ability to hybridize with a genus-specific DNA probe, comparative 16S rDNA sequence analysis, and the presence of characteristic 16S rDNA signature nucleotides which occur in all Yersinia spp. Twenty-five of these isolates reacted with typing sera (O:22 or O:58) of Y. enterocolitica; the remainder were non-typable. None of the isolates displayed any of the phenotypic or genetic virulence-associated characteristics of Y. enterocolitica. Comparative 16S rDNA sequence analysis revealed that members of this group appear to represent a new sub-line within the genus Yersinia, most closely related to Y. frederiksenii hybridization group 2 (unnamed genomospecies 2). This finding was confirmed by DNA hybridization studies which indicated that the strains belonged to the unnamed genomospecies, Yersinia frederiksenii genomospecies 2, which is biochemically indistinguishable from Y. frederiksenii (Y. frederiksenii genomospecies 1). A 23-nucleotide 16S rDNA signature stretch which characterised these strains was identified. C1 ROYAL CHILDRENS HOSP,DEPT MICROBIOL & INFECT DIS,PARKVILLE,VIC 3052,AUSTRALIA. UNIV MELBOURNE,DEPT MICROBIOL,PARKVILLE,VIC 3052,AUSTRALIA. UNIV QUEENSLAND,CTR BACTERIA DIVERS & IDENTIFICAT,DEPT MICROBIOL,BRISBANE,QLD 4072,AUSTRALIA. STATENS SERUM INST,DEPT CLIN MICROBIOL,DK-2300 COPENHAGEN,DENMARK. MAX PLANCK INST TERR MIKROBIOL,D-35043 MARBURG,GERMANY. CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333. DSMZ,BRAUNSCHWEIG,GERMANY. OI Robins-Browne, Roy/0000-0001-9179-7884 NR 21 TC 15 Z9 15 U1 0 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0378-1097 J9 FEMS MICROBIOL LETT JI FEMS Microbiol. Lett. PD JAN 1 PY 1997 VL 146 IS 1 BP 73 EP 78 DI 10.1016/S0378-1097(96)00456-9 PG 6 WC Microbiology SC Microbiology GA WC416 UT WOS:A1997WC41600011 PM 8997709 ER PT B AU Barrett, TJ AF Barrett, TJ BE Tortorello, ML Gendel, SM TI Molecular fingerprinting of foodborne pathogenic bacteria: An introduction to methods, uses, and problems SO FOOD MICROBIOLOGICAL ANALYSIS: NEW TECHNOLOGIES SE IFT BASIC SYMPOSIUM SERIES LA English DT Proceedings Paper CT 1996 Basic Symposium on Food Microbiological Analysis - New Technologies CY JUN 21-22, 1996 CL NEW ORLEANS, LA SP Inst Food Technologists RP Barrett, TJ (reprint author), CTR DIS CONTROL & PREVENT,NATL CTR INFECT DIS,DIV BACTERIAL & MYCOT DIS,ATLANTA,GA 30333, USA. NR 0 TC 6 Z9 6 U1 0 U2 0 PU MARCEL DEKKER PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 BN 0-8247-0087-2 J9 IFT BAS SYM PY 1997 VL 12 BP 249 EP 264 PG 16 WC Biotechnology & Applied Microbiology; Chemistry, Analytical; Food Science & Technology SC Biotechnology & Applied Microbiology; Chemistry; Food Science & Technology GA BJ42W UT WOS:A1997BJ42W00012 ER PT J AU Selik, RM Chu, SY Ward, JW AF Selik, RM Chu, SY Ward, JW TI Trends in infectious diseases and cancers among persons dying of HIV infection in the United States from 1987 to 1992 (Reprinted from Annals of Internal Medicine, vol 123, pg 933-936, 1995) SO FORMULARY LA English DT Reprint ID HUMAN-IMMUNODEFICIENCY-VIRUS; PNEUMOCYSTIS-CARINII PNEUMONIA; AIDS PATIENTS; PROPHYLAXIS; SURVIVAL; THERAPY; MEN AB Objective. To determine trends in the relative frequency of infectious diseases and cancers among U.S. residents dying of human immunodeficiency virus (HIV) infection. Data source. National multiple-cause mortality data for 1987 to 1992 compiled from death certificates. Subjects. Deaths reported with HIV infection as the underlying cause and with nonunderlying causes that could be secondary to HIV infection. Data analysis. Trends in the annual percentage of deaths associated with each infectious disease or cancer that accounted for at least 1.0% of all HIV-related deaths. Results. From 1987 to 1992, the percentage of HIV-related deaths associated with the following diseases decreased: pneumocystosis, from 32.5% to 13.8%; cryptococcosis, from 7.7% to 5.0%; and candidiasis, from 2.3% to 1.7%. The percentage of deaths associated with the following diseases increased: nontuberculous mycobacteriosis, from 6.7% to 12.2%; cytomegalovirus disease, from 5.2% to 9.9%; bacterial septicemia, from 9.0% to 11.5%; non-Hodgkin lymphoma, from 3.9% to 5.7%; tuberculosis, from 2.9% to 4.1%; progressive multifocal leukoencephalopathy, from 0.8% to 1.9%; bacterial pneumonia, from 1.2% to 2.1%; and cryptosporidiosis or isosporiasis, from 0.7% to 1.2%. The percentages of deaths associated with toxoplasmosis, Kaposi sarcoma, and pneumonia caused by unspecified organisms had no significant linear trends (ranges from 4.9% to 5.5%, 10.4% to 12.1%, and 17.6% to 18.6%, respectively). Conclusions. The percentage of HIV-related deaths associated with pneumocystosis has decreased dramatically, probably because of chemoprophylaxis and improved treatment. Pneumonia caused by unspecified organisms has now become the leading secondary cause of death among persons dying of HIV infection. Decreases in the percentages of HIV-related deaths associated with cryptococcosis and candidiasis may reflect the use of new antifungal agents such as fluconazole. RP Selik, RM (reprint author), CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333, USA. NR 21 TC 0 Z9 0 U1 2 U2 3 PU ADVANSTAR COMMUNICATIONS PI DULUTH PA 131 W FIRST ST, DULUTH, MN 55802 SN 1082-801X J9 FORMULARY JI Formulary PD JAN PY 1997 VL 32 SU 1 BP S43 EP S47 PG 5 GA WC573 UT WOS:A1997WC57300005 ER PT J AU Pasha, TM Leighton, JA Smilack, JD Heppell, J Colby, TV Kaufman, L AF Pasha, TM Leighton, JA Smilack, JD Heppell, J Colby, TV Kaufman, L TI Basidiobolomycosis: An unusual fungal infection mimicking inflammatory bowel disease SO GASTROENTEROLOGY LA English DT Article ID ZYGOMYCOSIS AB Basidiobolus ranarum is a fungus belonging to the Entomophthoraceae family and is mainly associated with subcutaneous soft tissue infection. The disease is usually characterized by an insidious onset of massive induration of the subcutaneous tissue involving the limbs, trunk, or buttocks, Most cases of basidiobolomycosis have been reported from Africa, South America, and tropical Asia, Visceral involvement is extremely rare, Only 4 cases with involvement of the gastrointestinal tract, including 1 fatal case originating in the United States, have been well documented in the English-language literature. This case report describes the first successfully treated patient residing in the United States who had B. ranarum infection involving the gastrointestinal tract. C1 MAYO CLIN SCOTTSDALE,DIV GASTROENTEROL,SCOTTSDALE,AZ 85250. MAYO CLIN SCOTTSDALE,DIV INFECT DIS,SCOTTSDALE,AZ 85250. MAYO CLIN SCOTTSDALE,DIV GEN SURG,SCOTTSDALE,AZ 85250. MAYO CLIN SCOTTSDALE,DIV PATHOL,SCOTTSDALE,AZ 85250. MAYO CLIN & MAYO FDN,DIV GASTROENTEROL,ROCHESTER,MN 55905. CTR DIS CONTROL & PREVENT,ATLANTA,GA. NR 20 TC 30 Z9 30 U1 0 U2 0 PU W B SAUNDERS CO PI PHILADELPHIA PA INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD JAN PY 1997 VL 112 IS 1 BP 250 EP 254 DI 10.1016/S0016-5085(97)70242-7 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA WA905 UT WOS:A1997WA90500034 PM 8978366 ER PT J AU Yang, QH Khoury, MJ Mannino, D AF Yang, QH Khoury, MJ Mannino, D TI Trends and patterns of mortality associated with birth defects and genetic diseases in the United States, 1979-1992: An analysis of multiple-cause mortality data SO GENETIC EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT 46th Annual Meeting of the American-Society-of-Human-Genetics CY OCT 29-NOV 02, 1996 CL SAN FRANCISCO, CA SP Amer Soc Human Genet DE birth defect; genetic disease; mortality; genetic epidemiology ID INTENSIVE-CARE UNIT; CONGENITAL-MALFORMATIONS; DEATH; DISORDERS; POPULATION; PREVENTION; ANOMALIES AB Contemporary information on the trends and patterns of mortality associated with birth defects and genetic diseases is lacking in the United States. To study these trends and patterns, we used the Multiple-Cause Mortality Files of the National Center for Health Statistics. From 1979 through 1992, 320,208 deaths in the United States were associated with birth defects and genetic diseases. The age-adjusted mortality rates for people with birth defects declined from about 8.2/100,000 in 1979 to about 6.7/100,000 in 1992, and the mortality rates for people with genetic diseases increased from 2.2/100,000 in 1979 to 2.5/100,000 in 1992. The mortality rate was higher among men than among women and higher among blacks than among whites or other races for both birth defect-and genetic disease-associated deaths. The rate among infants with birth defects was more than 25 times higher than that among other age groups. About half of the children whose deaths were associated with birth defects had cardiovascular system defects, 15% had central nervous system defects, and 12% had chromosomal defects. For deaths associated with genetic diseases, hereditary neurologic or storage disorders were the most common genetic diseases (38%), followed by metabolic disorders (21%), sickle cell and thalassemia (12%). The decline in the rate of mortality from birth defects in the United States probably reflects improvements in medical and surgical care and other factors. Most of the mortality associated with birth defects remains in the pediatric age group (less than 15 years old). The upward trend we detected for the deaths with genetic diseases was most likely related to improved recognition and reporting of some genetic diseases rather than to the increased prevalence. (C) 1997 Wiley-Liss, Inc.(dagger) C1 CTR DIS CONTROL & PREVENT,DIV BIRTH DEFECTS & DEV DISABIL,NATL CTR ENVIRONM HLTH,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,TASK FORCE GENET DIS PREVENT,ATLANTA,GA 30341. CTR DIS CONTROL & PREVENT,AIR POLLUT & RESP HLTH BRANCH,DIV ENVIRONM HAZARDS & HLTH EFFECTS,ATLANTA,GA 30341. RP Yang, QH (reprint author), CTR DIS CONTROL & PREVENT,BIRTH DEFECTS & GENET DIS BRANCH,BDDD,EPIDEMIOL INTELLIGENCE SERV,ATLANTA,GA 30341, USA. OI Mannino, David/0000-0003-3646-7828 NR 37 TC 34 Z9 34 U1 1 U2 4 PU WILEY-LISS PI NEW YORK PA DIV JOHN WILEY & SONS INC, 605 THIRD AVE, NEW YORK, NY 10158-0012 SN 0741-0395 J9 GENET EPIDEMIOL JI Genet. Epidemiol. PY 1997 VL 14 IS 5 BP 493 EP 505 DI 10.1002/(SICI)1098-2272(1997)14:5<493::AID-GEPI4>3.0.CO;2-2 PG 13 WC Genetics & Heredity; Mathematical & Computational Biology SC Genetics & Heredity; Mathematical & Computational Biology GA YD500 UT WOS:A1997YD50000004 PM 9358267 ER PT J AU Savage, A Sun, FZ Crawford, DC Ashley, AE Yang, QH Sherman, SL AF Savage, A Sun, FZ Crawford, DC Ashley, AE Yang, QH Sherman, SL TI Sequential sib-pair and association studies to detect genes in quantitative traits SO GENETIC EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT Genetic Analysis Workshop 10 (GAW10) CY OCT 26-29, 1996 CL WATSONVILLE, CALIFORNIA DE association; sequential approach; sib pair analysis; TDT ID LINKAGE DISEQUILIBRIUM AB We applied sib-pair and association methods to a GAW data set of nuclear families with quantitative traits. Our approaches included 1) preliminary statistical studies including correlations and linear regressions, 2) sib-pair methods, and 3) association studies. We used a single data set to screen for linkage and association and, subsequently, additional data sets to confirm the preliminary results. Using this sequential approach, sib-pair analysis provided evidence for the genes influencing Q1, Q2, and Q4. We correctly predicted MG1 for Q1, MG2 for Q2, and MG4 for Q4. We did not find any false positives using this approach. Association studies identified chromosomes 8 and 9 to be associated with Q4; however these are assumed to be false positives as no associations were modeled into the data. (C) 1997 Wiley-Liss, Inc. C1 Emory Univ, Sch Med, Dept Genet & Mol Med, Atlanta, GA 30322 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA USA. Ctr Dis Control & Prevent, Div Birth Defects & Dev Disabil, Natl Ctr Environm Hlth, Atlanta, GA USA. RP Sherman, SL (reprint author), Emory Univ, Sch Med, Dept Genet & Mol Med, 1462 Clifton Rd,Room 440C, Atlanta, GA 30322 USA. RI Sun, Fengzhu /G-4373-2010; Crawford, Dana/C-1054-2012; OI Ashley-Koch, Allison/0000-0001-5409-9155 NR 5 TC 1 Z9 1 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 0741-0395 J9 GENET EPIDEMIOL JI Genet. Epidemiol. PY 1997 VL 14 IS 6 BP 885 EP 890 DI 10.1002/(SICI)1098-2272(1997)14:6<885::AID-GEPI54>3.0.CO;2-I PG 6 WC Genetics & Heredity; Mathematical & Computational Biology SC Genetics & Heredity; Mathematical & Computational Biology GA YM987 UT WOS:000071121800055 PM 9433595 ER PT J AU Yang, QH Atkinson, M Sun, FZ Sherman, S Khoury, MJ AF Yang, QH Atkinson, M Sun, FZ Sherman, S Khoury, MJ TI The method of sib-pair linkage analysis in context of case-control design SO GENETIC EPIDEMIOLOGY LA English DT Article; Proceedings Paper CT Genetic Analysis Workshop 10 (GAW10) CY OCT 26-29, 1996 CL WATSONVILLE, CALIFORNIA DE case-control design; gene-environment interaction; sib-pair linkage analysis AB We used sib-pair linkage analysis as part of an epidemiologic approach to solving Problem 2 of the GAW10 data set of nuclear families. We recoded the quantitative trait Q1 into a dichotomous trait using Q1 greater than or equal to 40 as the cut-point. In a case-control design of sib-pair analysis, the affected siblings of the proband were the case subjects and the unaffected siblings were the control subjects. Case and control subjects were compared with respect to the number of alleles at one or more loci (0,1,2) that were identical-by-descent (IBD) with those of the proband. Odds ratios (ORs) and 95% confidence intervals (95% CI) were then computed with subjects sharing no alleles (share-0) serving as the reference group. Significantly high ORs were taken as indication of linkage between a marker locus and a suspected disease-susceptibility locus. The case-control sib-pair analysis identified marker D5G15 as associated with disease susceptibility (OR of sharing two alleles [share-2] = 7.7 [95% CI 2.5-23.9]). Our results were consistent with the results from Kruglyak and Lander's method of complete multipoint sib-pair analysis for linkage. For the marker (D5G15) identified through sib-pair analysis, we examined the effects of other covariates and evaluated gene-environment interaction using conditional logistic regression. (C) 1997 Wiley-Liss, Inc. C1 Ctr Dis Control & Prevent, Birth Defects & Genet Dis Branch, Div Birth Defects & Dev Disabil, Natl Ctr Environm Hlth, Atlanta, GA 30341 USA. Ctr Dis Control & Prevent, Epidem Intelligence Serv, Epidemiol Program Off, Atlanta, GA 30341 USA. Emory Univ, Dept Genet & Mol Med, Atlanta, GA 30322 USA. RP Yang, QH (reprint author), Ctr Dis Control & Prevent, Birth Defects & Genet Dis Branch, Div Birth Defects & Dev Disabil, Natl Ctr Environm Hlth, 4770 Buford Hwy,MS F-45, Atlanta, GA 30341 USA. RI Sun, Fengzhu /G-4373-2010 NR 8 TC 2 Z9 2 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 0741-0395 J9 GENET EPIDEMIOL JI Genet. Epidemiol. PY 1997 VL 14 IS 6 BP 939 EP 944 PG 6 WC Genetics & Heredity; Mathematical & Computational Biology SC Genetics & Heredity; Mathematical & Computational Biology GA YM987 UT WOS:000071121800064 PM 9433604 ER PT J AU Ke, ZX Benedict, MQ Cornel, AJ Besansky, NJ Collins, FH AF Ke, ZX Benedict, MQ Cornel, AJ Besansky, NJ Collins, FH TI The Anopheles albimanus white gene: molecular characterization of the gene and a spontaneous white gene mutation SO GENETICA LA English DT Article DE Anopheles albimanus; malaria vector; transformation; white gene ID CERATITIS-CAPITATA; X-CHROMOSOME; GAMBIAE; SEQUENCE; BINDING; EYE AB We have cloned and characterized the white gene of Anopheles albimanus. Comparison of the deduced amino acid sequence of this white gene with its homologs from six species of Diptera show that the An, albimanus gene is most similar to the white gene of An. gambiae (92% identity). A spontaneous white-eyed mutant An. albimanus was caused by an approximately 10 kb insertion into a CT dinucleotide repeat region of intron 2 of the white locus. The flanks of this insertion are long (at least 400 bp), nearly perfect inverted terminal repeat sequences. This cloned white gene should be useful as a marker for germ line transformation of An. albimanus. C1 Ctr Dis Control & Prevent, Div Parasit Dis, Entomol Branch, Atlanta, GA 30341 USA. Emory Univ, Dept Biol, Atlanta, GA 30322 USA. Univ Notre Dame, Dept Biol Sci, Notre Dame, IN 46556 USA. Univ Calif, Kearney Agr Expt Field Stn, Mosquito Control Res Labs, Parlier, CA 93648 USA. RP Collins, FH (reprint author), Ctr Dis Control & Prevent, Div Parasit Dis, Entomol Branch, Mailstop F22, Atlanta, GA 30341 USA. NR 27 TC 6 Z9 7 U1 0 U2 0 PU KLUWER ACADEMIC PUBL PI DORDRECHT PA SPUIBOULEVARD 50, PO BOX 17, 3300 AA DORDRECHT, NETHERLANDS SN 0016-6707 J9 GENETICA JI Genetica PY 1997 VL 101 IS 2 BP 87 EP 96 DI 10.1023/A:1018376525897 PG 10 WC Genetics & Heredity SC Genetics & Heredity GA YU738 UT WOS:000071749300002 PM 9465401 ER PT J AU Rimal, RN Ratzan, SC Arntson, P AF Rimal, RN Ratzan, SC Arntson, P TI Reconceptualizing the ''patient'': Health care promotion as increasing citizens' decision-making competencies SO HEALTH COMMUNICATION LA English DT Article ID FAMILY COMMUNICATION; POLITICAL-SOCIALIZATION; MASS MEDIA; PERSPECTIVE; TELEVISION; EDUCATION; BEHAVIOR; PATTERNS; CHILD AB Moving away from source-oriented models of communication, this article proposes that we reframe our understanding of the ''patient'' as an active citizen involved in individual and collective decision making. Citizens' health-related decisions in their physical, social, and mediated environments are examined. The role of the health communication researcher in each of these environments is to increase citizens' decision-making competencies, a task that requires adopting (a) a multilevel conceptualization of health and (b) a definition of communication that involves the exchange of shared meaning. C1 TUFTS UNIV,SCH MED,EMERSON COLL,EMERSON TUFTS PROGRAM HLTH COMMUN,MEDFORD,MA 02155. NORTHWESTERN UNIV,DEPT COMMUN STUDIES,EVANSTON,IL 60208. CTR DIS CONTROL & PREVENT,ATLANTA,GA 30333. RP Rimal, RN (reprint author), TEXAS A&M UNIV,DEPT SPEECH COMMUN,COLLEGE STN,TX 77843, USA. NR 67 TC 15 Z9 15 U1 0 U2 3 PU LAWRENCE ERLBAUM ASSOC INC PI MAHWAH PA 10 INDUSTRIAL AVE, MAHWAH, NJ 07430-2262 SN 1041-0236 J9 HEALTH COMMUN JI Health Commun. PY 1997 VL 9 IS 1 BP 61 EP 74 DI 10.1207/s15327027hc0901_5 PG 14 WC Communication; Health Policy & Services SC Communication; Health Care Sciences & Services GA VY338 UT WOS:A1997VY33800005 ER PT J AU Nair, SK Miller, CW Thiessen, KM Garger, EK Hoffman, FO AF Nair, SK Miller, CW Thiessen, KM Garger, EK Hoffman, FO TI Modeling the resuspension of radionuclides in Ukrainian regions impacted by Chernobyl fallout SO HEALTH PHYSICS LA English DT Article DE soil; air sampling; calibration; Chernobyl AB Following the 1986 Chernobyl event, large amounts of radioactive materials were deposited in nearby areas. Concentrations of various radionuclides were measured in air and surface soil. To study the resuspension of radioactive particulate, three different exposure situations were developed on the basis of the collected data under the auspices of the international BIOMOVS II (BIOspheric MOdel Validation Study) project, Modelers were asked to predict seasonal air concentrations and resuspension factors at several locations at different distances from Chernobyl for six successive years following the accident. Measurements of radionuclide deposition on topsoil were provided for each site along with information on soil, vegetation, land use, surface roughness, meteorology, and climate, In this paper, the three exposure situations are described, along with the initial data set provided to the modelers; two modeling approaches used to make the endpoint predictions are also presented. After the model predictions were submitted, the measured air concentrations and resuspension factors were released to the modelers. Generally, the predictions were well within an order of magnitude of the measured values. Time dependent trends in predictions and measurements were in good agreement with one of the models, which (a) explicitly accounted for loss processes in soil and (b) used calibration to improve its predictive capabilities. Reasons for variations between predictions and measurements, suggestions for the improvement of models, and conclusions from the model validation study are presented. C1 SENES OAK RIDGE INC, OAK RIDGE, TN 37830 USA. CTR DIS CONTROL & PREVENT, ATLANTA, GA 30341 USA. UKRAINIAN ACAD AGR SCI, INST RADIOECOL, UA-33 KIEV, UKRAINE. FU PHS HHS [R23/CCR409756-02] NR 12 TC 6 Z9 6 U1 1 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0017-9078 EI 1538-5159 J9 HEALTH PHYS JI Health Phys. PD JAN PY 1997 VL 72 IS 1 BP 77 EP 85 DI 10.1097/00004032-199701000-00010 PG 9 WC Environmental Sciences; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging SC Environmental Sciences & Ecology; Public, Environmental & Occupational Health; Nuclear Science & Technology; Radiology, Nuclear Medicine & Medical Imaging GA VY758 UT WOS:A1997VY75800012 PM 8972830 ER PT B AU Diaz, HF Pulwarty, RS AF Diaz, HF Pulwarty, RS BE Diaz, HF Pulwarty, RS TI Decadal climate variability, Atlantic hurricanes, and societal impacts: An overview SO HURRICANES: CLIMATE AND SOCIOECONOMIC IMPACTS LA English DT Proceedings Paper CT Workshop on Atlantic Hurricane Variability on Decadal Time Scales - Nature, Causes and Socioeconomic Impacts CY FEB 09-10, 1995 CL NATL HURRICANE CTR, MIAMI, FL HO NATL HURRICANE CTR AB The level of societal risk to hurricane impact is a function of the frequency, strength, and duration of landfalling hurricanes, and of the degree of preparedness and types of mitigation strategies available to and employed by different segments of society. The goals of this book are twofold. First, we hope to bring together into one volume the state-of-the-art knowledge regarding hurricane variability on different time scales (from seasonal to decadal), the status of the current hurricane prediction capability (principally in the United States and Europe), and to consider some of the science-based implications of future climatic variability as it might influence the frequency and intensity of these great storms. A second objective is to explore a wide range of socioeconomic issues related to historical and recent impacts of hurricane activity in the Atlantic, to assess how these vulnerabilities may arise in different parts of the affected region (the Caribbean, Gulf of Mexico and U.S. East Coast), and to highlight the possible role of insurance in mitigation strategies. It is possible to increase societal vulnerability to a given event with and without changes in hurricane frequency. We hope to raise awareness of the potential impacts that global climate change may have on the climatology of tropical storm systems and to identify what those changes may mean in the context of socioeconomic trends and planning in the region. RP Diaz, HF (reprint author), NOAA,ERL,CDC,325 BROADWAY,BOULDER,CO 80303, USA. NR 0 TC 1 Z9 1 U1 0 U2 1 PU SPRINGER-VERLAG BERLIN PI BERLIN 33 PA HEIDELBERGER PLATZ 3, W-1000 BERLIN 33, GERMANY BN 3-540-62078-8 PY 1997 BP 3 EP 14 PG 12 WC Meteorology & Atmospheric Sciences SC Meteorology & Atmospheric Sciences GA BH80Q UT WOS:A1997BH80Q00001 ER PT B AU Kiefer, M Moss, CE AF Kiefer, M Moss, CE GP LASER INST AMER TI Laser generated air contaminants released during laser cutting of fabrics and polymers SO ILSC'97 - PROCEEDINGS OF THE INTERNATIONAL LASER SAFETY CONFERENCE, VOL 3 LA English DT Proceedings Paper CT 1997 International Laser Safety Conference (ILSC 97) CY MAR 17-20, 1997 CL ORLANDO, FL SP Laser Inst Amer DE laser generated air contaminants (LGACs); laser safety; ventilation AB Environmental monitoring was conducted at an industrial facility to qualitatively identify the major contaminants generated while cutting fabrics and polymers with a 25 W CO2 continuous beam laser. Carbon monoxide, hydrogen cyanide, and particulates were also assessed, and a bulk sample of residue from the laser exhaust duct was analyzed for inorganic acids, pH, and volatile organic compounds. Samples were collected while cutting vinyl, acrylic, woven fabrics, felt, Formica(R), and Plexiglass(R). The laser parameters were standardized to allow for meaningful comparison of results for each target material. The volatile organic compound samples were collected in multibed sorbent tubes with subsequent analysis via thermal desorption and gas chromatography/mass spectroscopy. Depending on the material being cut, a wide variety of compounds were detected. The highest relative concentrations of volatile compounds were found during laser cutting of felt fabrics. The lowest concentrations and fewest number of compounds were from woven fabrics. The compounds detected included hydrochloric acid, aldehydes, benzene, vinyl chloride, various acrylates, acrylonitrile, acetonitrile, styrene, furans, phenol, and butyl cellosolve. Methyl methacrylate was a significant peak detected during the laser cutting of acrylic ester polymers, Plexiglass, and polyvinyl chloride with adhesive backing. Carbon monoxide was not detected above background (2 ppm) during any of the laser cutting trials. Hydrogen cyanide was detected during the laser cutting of felt (15 ppm) and Formica(R) (8-10 ppm). Particles greater than or equal to 0.03 mu m in diameter (mu md) generated during the laser cutting exceeded background particle levels by a factor of ten or more. Most compounds detected in the thermal desorption air samples were also detected in bulk sample, and the residue was acidic (pH = 3). Area samples collected outside the laser enclosure suggested the local exhaust ventilation system sufficiently contained the air contaminants. RP Kiefer, M (reprint author), NIOSH,CTR DIS CONTROL & PREVENT,CINCINNATI,OH 45226, USA. NR 0 TC 0 Z9 0 U1 0 U2 2 PU LASER INST AMERICA PI ORLANDO PA 12424 RESEARCH PKWY, STE 130, ORLANDO, FL 32826 BN 0-912035-13-7 PY 1997 BP 262 EP 268 PG 7 WC Public, Environmental & Occupational Health; Optics SC Public, Environmental & Occupational Health; Optics GA BJ29K UT WOS:A1997BJ29K00032 ER PT J AU Tsang, VCW Wilkins, PP AF Tsang, VCW Wilkins, PP TI Immunodiagnosis of schistosomiasis SO IMMUNOLOGICAL INVESTIGATIONS LA English DT Article; Proceedings Paper CT Proceedings of the 13th International Convocation on Immunology - Immunological and Molecular Diagnosis of Infectious Disease CY JUN 01-05, 1996 CL BUFFALO, NY SP SUNY, Ernest Witebsky Ctr Immunol ID LINKED IMMUNOSORBENT-ASSAY; ADULT MICROSOMAL ANTIGENS; CIRCULATING ANODIC ANTIGEN; S-MANSONI; SEROLOGIC REAGENT; TAENIA-SOLIUM; SINGLE-TUBE; FAST-ELISA; ANTIBODIES; BLOT AB The most efficacious and practical means of diagnosing human schistosomiasis is based on the detection of infection-specific antibodies. Because of their high sensitivity and specificity, antibody assays remain the most practical assays for epidemiologic studies and patient management. Antibody assays are particularly useful in the diagnosis of schistosomiasis in visitors from developed countries to endemic areas. These patients are often Lightly infected, and tests that depend on detection of ova or circulating antigens are not reliable for these type of light and acute infections. Initial screening may be performed in the field or laboratory with the FAST-ELISA, using adult microsomal antigens. Species-specific confirmation is obtained by immunoblots with the same antigens. RP Tsang, VCW (reprint author), CTR DIS CONTROL & PREVENT,US PUBL HLTH SERV,NATL CTR INFECT DIS,DIV PARASIT DIS,IMMUNOL BRANCH,ATLANTA,GA 30341, USA. NR 27 TC 46 Z9 50 U1 0 U2 5 PU MARCEL DEKKER INC PI NEW YORK PA 270 MADISON AVE, NEW YORK, NY 10016 SN 0882-0139 J9 IMMUNOL INVEST JI Immunol. Invest. PY 1997 VL 26 IS 1-2 BP 175 EP 188 DI 10.3109/08820139709048925 PG 14 WC Immunology SC Immunology GA WG293 UT WOS:A1997WG29300017 PM 9037622 ER EF