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Biomedical subjects

C W Heath

Publications and source records attributed to C W Heath.

At least 73 records · Page 4Linked to original sources
PubMed1990

Mortality associated with the use of upper-body control holds by police.

A review of police records for the nine-year period from 1974 to 1982 identified 20 men who died following restraint by an upper-body control hold while in the custody of a large, urban police department. Using evidence from autopsy findings and police reports of events immediately preceding death, we concluded that control-hold use was associated with death in 19 of the 20 cases. This investigation points to three factors potentially associated with control hold-related death that deserve further investigation: Phencyclidine (PCP) use, sickle cell trait, and stress-related arrhythmias in the heart. PCP was detected in blood or other tissues from 6 of 17 decedents tested. Intravascular red blood cell sickling was found at autopsy in 4 of 14 black decedents (29%). Four decedents had some indication of cardiovascular abnormalities.

Adult↗
PubMed1989

Underreporting of AIDS cases in South Carolina, 1986 and 1987.

An evaluation of the completeness and accuracy of case reporting of the acquired immunodeficiency syndrome (AIDS) for the 18-month period from January 1, 1986, through June 30, 1987, was conducted for South Carolina. A total of 596,585 hospital discharge billing records were searched by computer for conditions defining AIDS. The resulting 1513 records were manually reviewed. Of these, 349 discharges for 163 individuals were classified as being definitely AIDS related, the clinical features of these cases meeting Centers for Disease Control criteria for AIDS diagnosis. Of these cases, 153 were reportable to the South Carolina AIDS registry at the time of their diagnosis. Comparison of this case list with registry records revealed that only 91 (59.5%) had been reported. Reporting was significantly poorer for cases among blacks (53.1%) than for cases among whites (71.6%). These findings may have important implications for the interpretation of AIDS surveillance data and for planning activities in which awareness of complete case counts may be critical.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Contact tracing to identify human immunodeficiency virus infection in a rural community.

This report describes a contact investigation conducted in rural South Carolina to identify, counsel, and educate persons infected with or exposed to the human immunodeficiency virus (HIV). Starting with one HIV antibody-positive man and his 19 sex contacts, we identified 83 sex contacts of HIV antibody-positive men. Of these, 64 were residents of the county and 63 (98%) agreed to be tested for evidence of HIV infection. Eight (13%) were HIV antibody positive. Thirty-six initially HIV antibody-negative men were reevaluated at a six-month follow-up visit, and three had seroconverted during this time. Of 25 men who reported practicing anal receptive intercourse, 13 (52%) were HIV antibody positive vs none of 43 men who reported strictly anal insertive intercourse. Comparing reported numbers of sexual contacts for the six-month periods before and after our initial investigation, the mean numbers of named sex contacts decreased by 82% for antibody-positive men and 54% for antibody-negative men. None of the men reported using condoms before entering the study; at the six-month follow-up visit, four (80%) of five of the antibody-positive men and 25 (69%) of 36 of the antibody-negative men reported using condoms at least some of the time.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Investigation of cancer case clusters: possibilities and limitations.

Discovery of meaningful biologic events through investigation of individual cancer case clusters is limited by the greater likelihood that any given cluster, otherwise unspecified, will be a random event and by restrictions arising from the necessarily retrospective nature of any studies undertaken. In the face of long and variable latencies, it is difficult to document potential oncogenic exposures and to estimate dosage. Since case numbers are usually small, statistical assessments may have only limited value. This, however, encourages greater attention to be given to case features and clinical details from which patterns of case associations within clusters can occasionally be seen. When similar epidemiologic case patterns are repeatedly encountered in different cluster situations (as was apparent with parish and school associations, reviewed here, in several communities in the United States), some biologic basis for such case clustering may be suspected. Similar suspicions are aroused when additional cases of rare cancer are observed in community settings to which case clustering has already drawn attention.

Demography↗
PubMed1985

Unexplained deaths in a children's hospital. An epidemiologic assessment.

During a nine-month period, July 1980 through March 1981, the mortality rate for patients on the cardiology ward of a children's hospital was 43.1 deaths per 10,000 patient-days, as compared with 11.0 deaths per 10,000 patient-days during the preceding 54 months. Twenty-five (76 per cent) of 33 infant deaths during this nine-month period occurred between midnight and 6:00 a.m., as compared with 1 of 10 infant deaths during a separate 27-month period (P less than 0.001). Although nearly all deaths occurred in patients with serious congenital heart disease, epidemic-period deaths were more likely to have an unexpected timing and a clinical pattern consistent with digoxin toxicity. In four patients, forensic and clinical digoxin measurements suggested that an intravenous overdose of digoxin had been administered shortly before death. Although a review of nursing schedules revealed a strong association (relative risk, 64.6) between infant deaths and the duty times of a particular nurse, the cause of the epidemic remains unclear. The study led to suggestions that the hospital strengthen central control over procedures for dispensing medicines and implement a system for monitoring the occurrence of deaths by time and place within the hospital.

Digoxin↗
PubMed1984

Polycythemia vera among participants of a nuclear weapons test.

Two cases of polycythemia vera and two cases of suspected polycythemia vera were found among 3,217 nuclear test participants present during the detonation of the nuclear device, "Smoky," on Aug 31, 1957, and traced through December 1981. The observed occurrence of four cases of polycythemia vera in a group this size significantly exceeds that expected. However, the small individual whole-body doses of radiation reported for these four participants makes the association with ionizing radiation tenuous, although this was the only known unusual risk factor.

Adult↗
PubMed1984

Cytogenetic findings in persons living near the Love Canal.

Cytogenetic analyses were performed on peripheral blood from 46 present or past residents of the area surrounding Love Canal, a former dump site for chemical wastes in Niagara Falls, NY. Participants included 17 persons in whom cytogenetic analyses had been performed in 1980 and 29 persons who had been living in 1978 in seven homes that directly adjoined the canal and in which environmental tests showed elevated levels of chemicals spreading from the canal. Frequencies of chromosomal aberrations and of sister chromatid exchange (SCE) did not differ significantly from control levels. For all participants, cigarette smoking was associated with an increase in sister chromatid exchange frequency.

Chromosome Aberrations↗
PubMed1983

Clinical epidemiology of toxic-oil syndrome. Manifestations of a New Illness.

An epidemic of a new illness involving multiple organ systems began in Spain in May 1981, with 19,828 cases and 315 deaths reported by June 1, 1982. An epidemiologic investigation has linked the occurrence of illness with ingestion of an unlabeled, illegally marketed cooking oil. To elucidate the natural history of this illness, we reviewed the medical records of 121 patients in one severely affected town 100 km northwest of Madrid. The findings during the first week after onset were those of a febrile, pneumonia-like illness. Gastrointestinal findings and striking eosinophilia became prominent later in the first month. Although the disease followed a self-limited course in many patients, severe neuromuscular manifestations (myalgia severe enough to restrict movement, motor deficits, atrophy of major muscle groups, and contractures of the jaw and extremities) occurred late in the course of the illness (an average of 96 days after onset) in 23 per cent of the patients. The onset of disease early in the epidemic and particularly severe initial systemic findings were associated with progression to neuromuscular illness.

Adolescent↗
PubMed1983

Love canal.

Explore the source record for details and available documents.

Chromosome Aberrations↗
PubMed1983

Mortality and cancer frequency among military nuclear test (Smoky) participants, 1957 through 1979.

Follow-up of health status has been completed through 1979 for 3,072 (95.5%) of 3,217 nuclear test participants on military maneuvers during the 1957 nuclear test "Smoky." In these participants, 112 cases of cancer were diagnosed, compared with 117.5 cases expected. During the same follow-up period (1957 through 1979), 64 persons died of cancer, compared with an expected 64.3. Statistically significantly increased frequency of occurrence and mortality was found only for leukemia. The amount of cumulative gamma radiation exposure for 1957 ranged from 0 to 10,397 mrem as measured by individual personnel film badges. Although uncertainty remains about the exact amount of radiation exposure, the lack of a significant increase after 22 years in either the incidence of or the mortality from any other cancer and the apparent lack of a dose effect by unit lead to the consideration that the leukemia findings may be attributable either to chance, to factors other than radiation, or to some combination of risk factors possibly including radiation.

Follow-Up Studies↗
PubMed1983

Field epidemiologic studies of populations exposed to waste dumps.

Epidemiologic studies are required for assessing health risks related to toxic waste exposure. Since the settings in which such studies must be performed are extremely diverse, epidemiologic approaches must be versatile. For any particular study, three fundamental requirements are to assess what toxic materials are present, understand how human exposure may occur, and objectively measure possible biologic effects. In assessing links between exposure and disease, epidemiologists must be particularly aware of: expected disease frequencies in relation to the size of populations studied, implications of long or varied disease latencies for study design and competing causes of disease and associated confounding variables. These concepts are illustrated by discussion of epidemiologic studies related to the Love Canal toxic waste dump site in Niagara Falls, NY.

Abortion, Spontaneous↗
PubMed1981

Review of four cases of childhood hepatic angiosarcoma--elevated environmental arsenic exposure in one case.

Four cases of childhood hepatic angiosarcoma (HAS), representing the malignant form of infantile hemangioendothelioma, are described. The morphologic appearance of childhood HAS differs from the adult form in the following features: the associated presence of benign infantile hemangioendothelioma; the presence of dysontogenetic features; and an altered appearance of the angiosarcoma itself. It is postulated for these cases that the benign infantile hemangioendothelioma progressed to the malignant angiosarcoma. One of the four cases had exposure to elevated levels of arsenic in the environment that may have contributed to this progression. This latter case adds to published reports associating arsenic exposure with increased risk for hepatic angiosarcoma.

Arsenic↗
PubMed1980

Leukemia among participants in military maneuvers at a nuclear bomb test. A preliminary report.

Preliminary studies indicate that nine cases of leukemia have occurred among 3,224 men who participated in military maneuvers during the 1957 nuclear test explosion "Smoky." This represents a significant increase over the expected incidence of 3.5 cases. They included four cases of acute myelocytic leukemia, three of chronic myelocytic leukemia, and one each of hairy cell and acute lymphocytic leukemia. At time of diagnosis, patient ages ranged from 21 to 60 years (mean, 41.8 years) and the interval from time of nuclear test to diagnosis from two to 19 years (mean, 14.2 years). Film-badge records, which are available for eight of the nine men, indicated gamma radiation exposure levels ranging from 0 to 2,977 mrem (mean, 1,033 mrem). Mean film-badge gamma dose for the entire Smoky cohort was 466.2 mrem.

Adult↗
PubMed1980

Cancer in children of parents exposed to hydrocarbon-related industries and occupations.

Recent animal and human studies suggest that prenatal exposure to carcinogens may increase the risk of childhood malignancy. The Texas Childhood Cancer Study (1976-1977) was designed to test the hypothesis that parental exposure to hydrocarbon-related occupations or industries increases this risk. The study subjects, parents of children with and without cancer, were questioned about their job histories. Parents of 296 children with cancer were not exposed to hydrocarbon-related occupations or industries more often than the uncles and aunts of these children, the parents of neighborhood children, or the parents of 283 children without cancer. During the year before birth, odds ratios for fathers of children seen at a hematology clinic with cancer relative to the uncles of these children (0.93), the fathers of neighborhood children (1.33), and the fathers of children seen at the clinic without cancer (0.50) were not statistically significantly different from 1.00 (p greater than 0.05). This lack of association persisted for the year after birth, the year before diagnosis, and the interval from the year before birth to the year of diagnosis; for different diagnoses; for different ages at diagnosis; and for the industries and occupations of female as well as male parents.

Adolescent↗