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Biomedical subjects

D Fish

Publications and source records attributed to D Fish.

At least 73 records · Page 4Linked to original sources

Timing of Ixodes scapularis (Acari: Ixodidae) oviposition and larval activity in southern New York.

Timing of oviposition and larval eclosion for fall- and spring-fed female blacklegged tick, Ixodes scapularis Say, and effect of temperature on those events in southern New York state, where Lyme disease is endemic, were determined in the field. We also examined seasonal pattern of larval host-seeking activity, as well as rate of survival for overwintering, unfed larvae. Totals of 9 and 8 replete female I. scapularis were released in fall 1988 and spring 1989, respectively. For the 10 females that oviposited, egg laying began in mid-to-late May, regardless of when ticks had fed. Likewise, larval eclosion was synchronized in July for all egg masses. Microhabitat temperatures experienced by females were not reliable indicators of female reproductive success, in terms of either presence or absence of eggs, or numbers of larvae recovered. However, average body size was significantly greater for females that oviposited successfully than for those that did not. The percentage of unfed larvae surviving the 8-mo overwintering period from late August to early May ranged from 1.9 to 31.4, with a mean survival rate of 10.4%. Concurrent drag sampling through the year indicated a bimodal pattern of larval abundance marked by a relatively small early peak of activity in late May that extended into early July. Because the first peak of larval activity occurred during the period of oviposition, 8 wk before onset of larval eclosion, it appears that bimodality represents activity of 2 consecutive cohorts, with the early peak composed of overwintering survivors. These data imply variation in timing of reproduction and larval activity from 1 geographic area to another. Efforts to devise a comprehensive scheme for the life cycle of I. scapularis must consider that population differences may exist.

Animals↗

Preoperative nutritional status and outcome of elective total hip replacement.

Preoperative malnutrition increases the morbidity rate and length of hospitalization for various types of surgical patients. However, among patients who undergo elective total hip replacement, it is unclear how preoperative nutritional data can be used to detect a high risk subgroup. The purpose of this study was to identify preoperative nutritional factors that could be used to define a subgroup of patients who have undergone elective total hip replacement who are at high risk for poor post-operative outcome. Preoperative nutritional factors were evaluated in 89 consecutive patients who underwent elective total hip replacement. An inverse relationship was found between serum albumin and length of stay. Patients with an albumin level less than 3.9 were twice as likely to require prolonged hospitalization ( > 15 days) when compared with those in whom the albumin level was 3.9 or greater. Complications were related to the preoperative orthopaedic diagnosis of avascular necrosis of the hip. A subgroup of the patients undergoing elective total hip replacement who are at risk for prolonged recovery can be identified preoperatively by using a serum albumin level of less than 3.9 g/dL. The traditional normal range for albumin may be inappropriate for these patients.

Adult↗

MRI-based surface area estimates in the normal adult human brain: evidence for structural organisation.

There are a number of quantitative relationships between geometric parameters describing the structure of the normal human cerebral cortex examined in vivo using volumetric magnetic resonance imaging. A voxel-counting method is used to estimate grey-white interface surface area. The effects of bias associated with the method are considered. In 33 normal controls, the cerebral hemispheres were symmetric in terms of total volume, irrespective of handedness, but not in terms of surface areas for right-handers. The surface area of the grey matter-white matter interface was directly proportional to the cortical grey matter volume, suggesting that growth of the neocortex is primarily tangential, with repetition of a basic structural element rather than gross alterations in the thickness of the cortex. The majority of the surface area of the grey-white interface lies within gyral white matter cores. The mean thickness of the cortex of the right cerebral hemisphere in vivo was 3.0 mm and that of the left 3.3 mm. There was a relationship between the cross-sectional area of the corpus callosum and grey-white interface surface area, suggesting that a fixed proportion and cortical neurons extend interhemispheric axons. These findings suggest that there are general architectural principles governing the organisation of the complex, but ordered, human cerebral cortex.

Adult↗

Logistic regression in case-control studies: the effect of using independent as dependent variables.

In case-control studies, cases are sampled separately from controls. In such studies the primary analysis concerns the estimation of the effect of covariables on being a case or a control. To explore causal pathways, further secondary analysis could concern the relationships among the covariables. In this paper the validity of such secondary analysis is addressed. In particular, the use of multiple logistic regression in case-control studies where the dependent variable is not the case/control indicator is explored. It is shown that only under very restrictive conditions will sample regression coefficients correctly estimate their true value. In many situations, it may be valid to regress one covariable on others in the control group, but not in the case group or the combined sample. This principle is illustrated by a study of sexually transmitted disease in Kenya.

Case-Control Studies↗

Environmental risk and prevention of Lyme disease.

An understanding of the environmental determinants of Lyme disease risk is essential to evaluate human disease potential and to recommend strategies for disease prevention. Tick vectors of Lyme disease require a vertebrate blood meal during each of three motile developmental stages (larva, nymph, and adult). Although the immature stages (larvae and nymphs) exhibit broad and overlapping host ranges, adult ticks are primarily dependent on deer for feeding and reproduction. Consequently, the distribution and abundance of these ticks often reflect those of deer. Several species of smaller mammals and some birds that host immature ticks are also competent reservoirs for Borrelia burgdorferi, which becomes established within the tick population during feeding. The relative abundance of these host species and their ability to infect ticks are key factors in determining the distribution of Lyme disease risk in the local environment. Available methods for reducing the risk of Lyme disease in the environment include the application of insecticides and use of deer fencing, which have been shown to be 83-97% effective in reducing risk. However, the adverse environmental impact of insecticides and high cost of deer fencing limit these methods to high-risk areas where human exposure is constant and unavoidable (i.e., residential or occupational). Personal protection in high-risk areas can lessen the likelihood of contact with ticks. Future prevention methods may include host-targeted insecticides, environmental alteration, and biologic control. Moreover, research is currently directed to identifying antigens for use in recombinant human vaccines.

Animals↗

Protection of dogs from Lyme disease with a vaccine containing outer surface protein (Osp) A, OspB, and the saponin adjuvant QS21.

A vaccine consisting of purified Escherichia coli-expressed recombinant full-length outer surface proteins A (OspA) and B (OspB) and the saponin adjuvant QS21 was evaluated for protection against Borrelia burgdorferi infection. Eleven beagles were vaccinated twice and then challenged with 10 field-collected adult female Ixodes scapularis. Xenodiagnosis revealed that all 11 nonvaccinated control dogs and 2 of 10 vaccinated dogs were infected with B. burgdorferi. Six of 11 control dogs also developed fever (0.75 +/- 0.38 degrees C) and were lethargic. One of the control dogs also developed a limp. Both of the infected vaccinated dogs were asymptomatic. Thus, the vaccine prevented tick-vectored infection and associated symptoms of Lyme disease.

Adjuvants, Immunologic↗

Effect of deer exclusion on the abundance of immature Ixodes scapularis (Acari: Ixodidae) parasitizing small and medium-sized mammals.

Effects of deer exclusion on abundance of immature Ixodes scapularis Say parasitizing small and medium-sized mammals, and the role mammals have in introducing ticks to exclosure areas, were examined at two sites in Westchester County, New York. In total, 686 mammal captures representing nine species were obtained, with white-footed mice, Peromyscus leucopus Rafinesque, composing > 80% of all captures, followed by raccoons, Procyon lotor (L.); opossums, Didelphis virginiana (Kerr); and striped skunks, Mephitis mephitis Schreber. At the Near Archives site, 14% of 81 individual mice, 46% of raccoons, and 33% of opossums captured were found to cross the exclosure fence, as did 12% of 50 mice and 38% of raccoons at the Hudson Pines site. Skunks apparently did not cross the fence at either site. Mice captured exclusively outside the Near Archives exclosure hosted significantly more larvae than mice captured inside only, with fence crossers hosting an intermediate number of larvae. At Hudson Pines, numbers of larvae on fence-crossing mice and those captured solely inside the exclosure were equivalent, with tick loads on mice captured outside the exclosure significantly greater. The number of larvae per raccoon did not differ significantly with capture location (inside, outside, or both sides of exclosure fence) at either site. Densities of host-seeking larvae and nymphs were significantly higher outside the exclosure than inside at Near Archives, though not at Hudson Pines. Differences in tick density inside and outside exclosures declined with each successive developmental stage so that adult density inside exclosures tended to converge with that outside at both sites. Although deer exclosures can have a significant impact on nymphal I. scapularis abundance, they may not reduce the risk of encountering infected adults. Mice, raccoons, and opossums have a role in introducing potentially infective ticks to areas where deer have been excluded, though the level of immigration of ticks into the area will likely depend on the density of ticks outside the exclosure.

Animals↗

Increase in abundance of immature Ixodes scapularis (Acari: Ixodidae) in an emergent Lyme disease endemic area.

Changes in the abundance of immature Ixodes scapularis Say, the primary vector of Lyme disease, were assessed over a 7-yr period in Westchester County, New York, where the disease is endemic. In total, 4,000 m2 were drag sampled at each of 6 study sites in June and July of 1984 and 1991. The abundance of nymphs collected from all sites was 2.6-fold greater in 1991 than in 1984. Four of the 6 sites had significantly more nymphs in 1991, with increases ranging from 1.1- to 46.5-fold. The abundance of larvae collected from all sites was 34.2-fold higher in 1991 than in 1984. Five of the sites sampled had significantly more larvae in 1991, with increases ranging from 2.7- to 681-fold. These data demonstrate that populations of immature I. scapularis in Westchester County have, overall, increased during the 7-yr period from 1984 to 1991. However, the magnitude of increase is not uniform from site to site.

Animals↗

Prostate-related symptoms in Canadian men 50 years of age and older: attitudes and consulting behaviors.

The objectives of this study were (1) to characterize the knowledge about the prostate gland, the attitudes towards the prostate problems, medications and physicians and the consulting behaviors of Canadian men 50 years of age or older; and, (2) to identify individual groupings based on these characteristics. A population-based, epidemiologic study of Canadian men 50 years of age or older, identified by a modified random digit dialing method, was undertaken via home telephone interviews. A total of 19 359 calls yielded a probability sample of 508 Canadian men 50 years of age or older who could participate in the study. A cluster analysis was conducted to determine whether respondents could be categorized based on their responses and attitudes. The results of the study indicate that many educational opportunities exist with regard to urinary complaints of men 50 years of age or older. Furthermore, it may be possible to identify individuals who will be more difficult than others to educate and treat.

Journal Article↗

Activity of repellents applied to skin for protection against Amblyomma americanum and Ixodes scapularis ticks (Acari: Ixodidae).

Twenty-nine repellents were tested on human skin for duration of activity as protectants against nymphal lone star ticks (Amblyomma americanum) and against black-legged or deer ticks (Ixodes scapularis Say). Eleven of these repellents, including deet, provided > 2 h of protection against the lone star tick. One repellent, 1-(3-cyclohexenyl-ylcarbonyl) piperidine, was effective > or = 4 h. Four repellents (2 pyridines and 2 piperidines with protection lasting 2.3-3 h) showed acaricidal activity to more than half of the ticks tested after 9-12 min of exposure. Seven repellents that were most effective against A. americanum, including deet, were tested against the black-legged tick. None was effective and no knock-down was observed. These results suggest that the black-legged tick is less sensitive to repellents than the lone star tick.

Animals↗

Competence of dogs as reservoirs for Lyme disease spirochetes (Borrelia burgdorferi).

Dogs become infected with Borrelia burgdorferi after being bitten by infected adult ticks. However, it is not known whether dogs are competent reservoirs of the organism, that is, it is not known whether infected dogs can subsequently transmit the bacterium to feeding immature ticks. To determine reservoir competence of dogs, 11 Beagles were experimentally infected by means of challenge exposure to infected adult deer ticks (Ixodes scapularis). Three weeks later, larval ticks were allowed to feed on the dogs. Engorged larvae were collected, allowed to molt to the nymph stage, and tested, by means of a direct fluorescent antibody assay, to detect the presence of B burgdorferi organisms. Overall, 78% of immature ticks tested were found to have become infected. We concluded that dogs might serve to increase human risk of exposure to B burgdorferi-infected ticks and, therefore, should be protected from exposure to infected ticks as well as immature ticks seeking a blood meal.

Animals↗

Cancer mortality in workers employed at a transformer manufacturing plant.

This study examined mortality to December 31, 1989 in a cohort of 2,222 males employed between 1947 and 1975 at a transformer manufacturing plant in Canada, where there had been extensive use of transformer fluid, some containing polychlorinated biphenyls (PCBs). A combined cohort list of 2,222 names was independently obtained from plant management and union officials. Mortality of 1,939 workers with known birthdates was ascertained by record linkage with the Canadian Mortality Data-base. Standardized mortality ratios (SMRs) for different criteria for acceptance of the death certificate link and for cohort membership (based on work history) ranged from .71-1.05. There was no significant increase in overall cancer deaths. The only significant site-specific increased mortality was pancreatic cancer (11 deaths), with SMRs ranging from 2.92-7.64 and higher mortality risk in those who entered the cohort prior to 1960. All but one of these deaths had a latency period of at least 10 years, and greatest SMRs were found in departments with the greatest exposure to transformer fluid. Several previous studies have found excess pancreatic cancers in association with oil exposures and electrical equipment manufacturing. The need to further investigate pancreatic cancer in transformer manufacturing and related exposures is evident.

Canada↗

'Prostate-related symptoms' in Canadian men 50 years of age or older: prevalence and relationships among symptoms.

OBJECTIVES: To determine the prevalence of symptoms associated with benign prostatic hyperplasia (BPH) in Canadian men, and to establish whether the traditional separation of these symptoms into obstructive and irritative categories is valid. SUBJECTS AND METHODS: A probability sample of 508 Canadian men 50 years of age or older was surveyed by telephone. The survey questions and scoring system used were devised to allow estimation of symptom prevalence and were based on the frequency and severity of the symptoms. Using the data from respondents who had moderate to severe symptoms, a cluster analysis was utilized to analyse relationships among symptoms. RESULTS: The most prevalent symptoms were nocturia (63%), weak stream (61%) and urinary frequency (46%). Urgency was reported by 18%, a sense of incomplete bladder emptying by 23%, intermittency by 18% and hesitancy by 13%. Using predefined cutoff scores, 23% of the respondents experienced moderate to severe symptoms associated with BPH; the prevalence of moderate to severe symptoms increased with age. The clusters were grouped on the basis of the symptoms driving them, with one cluster designated as 'moderates', two clusters designated as 'irritatives' and two designated as 'obstructives'. The moderates cluster was driven by respondents who had lower symptom scores evenly distributed across all symptoms. The irritatives and obstructives clusters were driven by respondents with higher scores for symptoms considered by convention to be irritative or obstructive in nature and, thus, were designated accordingly. Not all symptoms were discriminatory for irritative and obstructive symptom domains. CONCLUSIONS: A large percentage of Canadian men 50 years of age or older experience symptoms commonly associated with BPH. The theoretical concept of irritative and obstructive symptom domains was supported partially by the cluster analysis. A clear typology of men with BPH symptoms could prove useful if treatments were found to be more effective for certain types of BPH symptoms. Thus these observations warrant further investigation into the differential effects of management approaches for BPH symptoms according to symptom clusters.

Age Factors↗

Sleep problems in multiple sclerosis.

Twenty-eight consecutive patients with multiple sclerosis (MS) were clinically evaluated to determine the presence of sleep-related disorders. There were 12 males and 16 females aged between 22 and 67 with disability ranging between 1.5 and 8.5 on Kurtzke extended disability status score (EDSS). Fifteen patients (54%) reported sleep-related problems. These included difficulties initiating sleep and/or frequent awakenings due to spasms or discomfort in the legs (8 patients), difficulty in initiating or maintaining sleep (3), habitual snoring (4) and nocturia (1). All-night oximetry was performed and the tracings analysed for the number of dips in oxygen saturation (SaO2) or more than 4%. Three patients showed significant sleep-related oxygen desaturation (> 5 dips of > 4% SaO2/h). Subsequent polysomnography performed in 2 of the 3 patients with significant oxygen desaturation confirmed the presence of sleep apnoea. MRI analysis of brain stem regions showed abnormalities in 20/22 cases. The 3 patients showing nocturnal oxygen desaturation had MRI brain stem lesions, but their locations were variable and their general appearance not different from that seen in the 17 without sleep apnoea. Sleep disturbance in MS is common but poorly recognised. It is usually due to leg spasms, pain, immobility, nocturia or medication. It is much less commonly associated with nocturnal respiratory insufficiency.

Adult↗