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Biomedical subjects

J A Harris

Publications and source records attributed to J A Harris.

At least 109 records · Page 6Linked to original sources
PubMed1990

Maternal water consumption during pregnancy and congenital cardiac anomalies.

This case-control study, conducted in a California county that had a local incident of water contamination in 1981, investigated the relation between a mother's reported consumption of tap water during pregnancy and congenital cardiac anomalies in their offspring born during 1981-1983. Data were obtained from telephone interviews with 145 mothers of children born with a severe cardiac anomaly and 176 mothers of children born without such an anomaly. A positive association between a mother's consumption of home tap water during the first trimester of pregnancy and cardiac anomalies in her infant was unrelated to the incident of water contamination, the mother's race, or her educational level. A negative relation was found between a mother's use of bottled water and cardiac anomalies among the infants. These findings corresponded primarily to births in 1981. These data could not fully distinguish between a potential causal agent in the water and differential reporting of exposure by study subjects.

California↗
PubMed1989

Congenital cardiac anomalies in relation to water contamination, Santa Clara County, California, 1981-1983.

In November 1981, a leak of solvents from an underground storage tank was detected at an electronics manufacturing plant in Santa Clara County, California. Solvents (predominantly 1,1,1-trichloroethene, or methyl chloroform) were found in a nearby well which supplied drinking water to the surrounding community. Residents were concerned about a possible relation between adverse reproductive outcomes and consumption of contaminated water. To address this concern, the California Department of Health Services conducted two epidemiologic studies: one of these, reported here, is a county-wide study of cardiac anomalies. This study, which looked at major cardiac anomalies among births throughout Santa Clara County in 1981-1983, found an increased prevalence in the service area of the water company which operated the contaminated well. During the potentially exposed time period (January 1981 through August 1982), 12 babies with major cardiac anomalies were born to residents of this area. This represents an excess of six cases over the number expected based on the prevalence in the remainder of the county (relative risk = 2.2, 95 per cent confidence interval 1.2-4.0). No excess was observed in the unexposed time period (September 1982 through December 1983). However, the temporal distribution of major cardiac cases born during the exposed time period suggests that the solvent leak is an unlikely explanation for this excess.

California↗
PubMed1989

Adverse pregnancy outcomes in relation to water contamination, Santa Clara County, California, 1980-1981.

An epidemiologic study was conducted to investigate a suspected cluster of adverse outcomes of pregnancies conceived in 1980-1981 among women who resided in a census tract in Santa Clara County, California that was thought to be exposed to drinking water from a well contaminated by an organic solvent, trichloroethane. A comparison census tract that received water from a different source was selected on the basis of demographic comparability. The cluster was confirmed; the odds ratio for spontaneous abortion was 2.3 (95% confidence interval (Cl) 1.3-4.2) after adjustment by multiple logistic regression for maternal risk factors, including maternal age, alcohol consumption, smoking, and prior fetal loss. The relative risk for congenital malformations was 3.1 (95% Cl 1.1-10.4). Because of the lack of precise information on the timing and extent of contamination, the pattern of spontaneous abortion rates throughout the study period cannot be used to either support or refute a causal inference.

Abnormalities, Drug-Induced↗
PubMed1988

Appearance and phenotypic characterization of circulating Leu 19+ cells in cancer patients receiving recombinant interleukin 2.

The effects of recombinant interleukin 2 (rIL-2) therapy on peripheral blood mononuclear cells expressing the Leu 19 surface marker were evaluated in 20 cancer patients. Leu 19 is a protein with a molecular weight of 220,000 expressed on 15% of normal peripheral blood mononuclear cells and is found on a majority of cells that mediate non-major histocompatibility complex-restricted cytotoxicity. Increased relative and absolute numbers of circulating Leu 19+ cells were observed in all patients receiving rIL-2. Increases in Leu 19+ cells were due in part to the development of a subpopulation of "bright" Leu 19+ cells (Leu 19b+) that possessed a higher density of membrane Leu 19 antigen than Leu 19+ cells assayed prior to therapy. Further characterization of rIL-2 induced Leu 19+ cells by dual immunofluorescence revealed considerable phenotypic heterogeneity within this population based on the coexpression of "dim" CD8 (CD8d+), CD16, and CD2 markers. The percentage of Leu 19+ CD8d+ cells was increased during rIL-2 therapy and comprised up to 60% of all circulating Leu 19+ cells. CD16+ and CD16- subsets of Leu 19+ cells were also increased by rIL-2. The density of CD16 antigen coexpression varied inversely with the density of Leu 19. Conversely, whereas the percentage of Leu 19 cells coexpressing CD2 was also increased by rIL-2 administration, the density of CD2 antigen expression was higher on the Leu 19b+ subset of cells. The development of circulating lymphokine-activated killer activity in three patients was temporally associated with the development of increased levels of circulating Leu 19+ cells. These studies demonstrate that rIL-2 administration induces preferential increases in cells expressing the natural killer and lymphokine-activated killer cell-associated marker Leu 19 and that these increases are associated with the development of circulating lymphokine-activated killer activity. Furthermore, Leu 19+ cells are comprised of phenotypically heterogeneous subsets which undergo characteristic changes during rIL-2 administration.

Antigens, Differentiation↗
PubMed1988

The effect of zeolite on the toxicity of lead to fungi.

In order to determine whether clinoptilolite, a naturally occurring zeolite, had any ameliorative effect on lead (Pb) toxicity to fungi, a series of growth experiments were performed. Three fungi, Aspergillus niger, Botrytis cinerea, and Fusarium culmorum, were grown on appropriately amended solid agar media, and their linear extension rates determined. B. cinerea was 25% inhibited, as compared to a control, at 100 mg dm(-3) Pb, and completely inhibited at 1000 mg dm(-3) Pb. F. culmorum was completely inhibited, and A. niger 97% inhibited at 1000 mg dm(-3) Pb. The addition of 3% clinoptilolite partially removed this inhibition in the case of A. niger and B. cinerea and almost completely removed it for F. culmorum. At a constant 500 mg dm(-3) Pb, increasing concentrations of clinoptilolite increased the linear extension rate of F. culmorum and B. cinerea, close to the rates achieved by the untreated controls. A. niger was not inhibited markedly at this Pb concentration. The evidence suggests that the Pb is adsorbed by the clinoptilolite which reduces the availability, and hence toxicity, of the metal to the fungi.

Journal Article↗
PubMed1988

Intracranial lesions shown by CT scans in 259 cases of first alcohol-related seizures.

We obtained CTs in 259 patients with a first alcohol-related convulsion. Each subject had generalized convulsions, recent abstinence from alcohol abuse, and no obvious etiology for seizures other than alcohol withdrawal. Patients with only focal seizures, major head injury, coma, or a severe toxic-metabolic disorder were excluded. We recorded history and signs of minor head injury, presence of headache, level of consciousness, neurologic signs, routine medical examination findings, and subsequent clinical course. Sixteen patients (6.2%) had intracranial lesions on CT. Eight had subdural hematomas or hygromas, two had vascular malformations, two had neurocysticercosis, and one each showed a Berry aneurysm, possible tumor, skull fracture with subarachnoid hemorrhage, and probable cerebral infarction. In ten cases (3.9%), clinical management was altered because of the CT result. History or signs of minor head trauma, headache, level of consciousness, or focal neurologic signs did not significantly correlate with CT abnormality.

Adult↗
PubMed1988

Epidemic giardiasis caused by a contaminated public water supply.

In the period November 1, 1985 to January 31, 1986, 703 cases of giardiasis were reported in Pittsfield, Massachusetts (population 50,265). The community obtained its water from two main reservoirs (A and B) and an auxiliary reservoir (C). Potable water was chlorinated but not filtered. The incidence of illness peaked approximately two weeks after the city began obtaining a major portion of its water from reservoir C, which had not been used for three years. The attack rate of giardiasis for residents of areas supplied by reservoir C was 14.3/1000, compared with 7.0/1000 in areas that received no water from reservoir C. A case-control study showed that persons with giardiasis were more likely to be older and to have drunk more municipal water than household controls. A community telephone survey indicated that over 3,800 people could have had diarrhea that might have been caused by Giardia, and 95 per cent of households were either using alternate sources of drinking water or boiling municipal water. Environmental studies identified Giardia cysts in the water of reservoir C. Cysts were also detected in the two other reservoirs supplying the city, but at lower concentrations. This investigation highlights the risk of giardiasis associated with unfiltered surface water systems.

Adult↗
PubMed1988

Assessing patterns of drug use in local jurisdictions.

Knowledge of drug use patterns is necessary for policy formulation and implementation, especially in terms of law enforcement strategies, treatment, and educational programs. Unfortunately it is usually impossible to accurately assess the overall extent of drug use and abuse. Instead, data are collected from a variety of sources to provide estimates used in policy planning. In this paper drug-related data from three sources are compared to determine similarities and differences in drug use among three population groups: those who come into contact with law enforcement agencies, high school students, and those enrolled in treatment programs. The uses of these data for policy and program planning are suggested.

Adolescent↗
PubMed1987

Effect on milk production of controlling muscid flies, and reducing fly-avoidance behaviour, by the use of Fenvalerate ear tags during the dry period.

Fenvalerate ear tags reduced fly loads on dry dairy cattle by 95% between July and September. Fly dislodging behaviour, such as ear flicks which correlated with numbers of Musca autumnalis on the face and stamps/kicks which correlated with numbers of Stomoxys calcitrans on the legs, was also significantly reduced. There was no significant difference between the tagged and untagged groups in the total time spent grazing each day. Milk yields were not statistically significantly different, but the tagged group showed a greater increase in milk yield between lactations, of 1.45 kg/cow daily in the first 12 weeks of the lactation.

Animals↗
PubMed1987

Exposure to aerial malathion application and the occurrence of congenital anomalies and low birthweight.

The association between exposure to low dose malathion, after its aerial application to 13,000 square miles in the San Francisco Bay area, and the occurrence of birth defects and low birthweight was examined using newborn hospital discharge data and vital records. No biologically plausible pattern of association was found. Limitations in the data and analysis are discussed.

Abnormalities, Drug-Induced↗
PubMed1987

Hospital diversification: bibliography on pharmaceutical services.

A pharmacy diversification bibliography is presented. The bibliography includes a selection of references to descriptive reports, research papers, editorials, letters, and commentaries on diversified pharmaceutical services. This bibliography represents important literature from the past 12 years on diversification strategies as well as specific diversified services. For additional information, references have also been included to articles that suggest opportunities for diversification, describe pharmacists' roles in specific services, discuss legal or reimbursement aspects of a service, or could be used to help justify the implementation of a service or "sell' a service to hospital administrators or consumers. The bibliography can be helpful to pharmacy managers and clinicians who are interested in becoming involved in diversification of pharmaceutical services.

Bibliographies as Topic↗
PubMed1984

Incidence of needlestick injuries in hospital personnel: implications for prevention.

A retrospective review of needlestick injuries was conducted for the period January 1979 through May 1981 at a major university teaching hospital. The objective of this review was to determine the needlestick injury rate among employees according to department, occupation, activity, shift, and full- or part-time status. Two hundred eighty-six incidents of needlestick injuries were recorded. Almost 90% of injuries occurred in nursing, housekeeping, and clinical laboratory personnel. Direct handling of needles primarily involved nursing and laboratory personnel. Housekeeping personnel were injured primarily as "innocent victims" hauling trash. Significantly elevated incidence rates were observed in part-time and night-shift personnel. Incidence rates in registered nurses significantly exceeded rates in licensed practical nurses. On the basis of these findings, it is suggested that prevention of such incidents should be focused on such high-risk groups.

Female↗
PubMed1984

Investigation of a cluster of anencephaly and spina bifida.

Environmental factors remain undefined as possible causes of spina bifida and anencephaly. The authors noted a fivefold increased incidence for 1979-1980 in the Antioch-Pittsburg , California area, prompting a case-control study. They studied nine case and 27 control mothers as well as eight case and 17 control fathers to evaluate factors including residence, occupation, drug use, illnesses, and pesticide or chemical exposure. Except for fathers' smoking (p less than 0.05), no exposure was associated with neural tube defects.

Adult↗
PubMed1984

Statistical association between cancer incidence and major-cause mortality, and estimated residential exposure to air emissions from petroleum and chemical plants.

An ecologic study design was used to investigate the relationship between exposure to air emissions produced by the petroleum and chemical industries, and average annual cancer incidence and major cause mortality rates among whites in Contra Costa County, California. Estimates for the exposure to major industrial sources of sulfur dioxide, hydrocarbons and oxides of nitrogen were used to subdivide the county by level of exposure to petroleum refinery and chemical plant emissions. Cancer incidence and major cause mortality rates were then calculated for whites in each of the exposure areas. In both males and females, residential exposure to petroleum and chemical air emissions was associated with an increased incidence of cancer of the buccal cavity and pharynx. In males, age-adjusted incidence rates for cancers of the stomach, lung, prostate and kidney and urinary organs were also associated with petroleum and chemical plant air emission exposures. In both sexes, we found a strong positive association between degree of residential exposure and death rates from cardiovascular disease and cancer, and a less strong positive association between exposure and death rates from cerebrovascular disease. There was also a positive association in men for deaths from cirrhosis of the liver. Although these observed associations occurred across areas of similar socioeconomic and broad occupational class, confounding variables and the "ecologic fallacy" must be considered as possible explanations. In particular, the stronger findings in men suggest an occupational explanation of the cancer incidence trends, and the effect observed in cirrhosis mortality suggests that lifestyle variables such as alcohol consumption were not adequately controlled for. While the public health implications of our findings remain unclear, the evidence presented is sufficient to warrant follow-up studies based on individual data in which possible biases can be more readily controlled.

Air Pollutants↗
PubMed1984

Consultant evaluation of a hospital medication system: analysis of the existing system.

A consultant team's evaluation of a system for distributing and controlling medications in a large teaching hospital is described. Through interviews with key personnel from administration, pharmacy, nursing, and the medical staff, an interdisciplinary research group identified problems in the reliability and response times of the hospital's existing medication system. After assessing staff expectations regarding acceptable standards for medication errors and response times and their attitudes toward proposed changes in the medication system, medication-error rates were determined using a pharmacist-observer method. Observations during 34 five-hour periods on four nursing units were conducted over a 17-day period. Medication-error rates were calculated as the frequency of medication errors during the observation period divided by the total opportunities for error (OE), which were defined as doses ordered plus unauthorized doses given. Response times for processing "now," "stat," and routine orders were also determined using work-sampling methods. The total medication-error rate for the nursing units studied was 9% excluding wrong-time errors; more than a third of doses were given more than 30 minutes before or after their scheduled administration times. Response times for "now" and "stat" orders averaged about 23 minutes, in conformance with the desired standard of 30 minutes. However, processing of routine orders required an average of two hours and seven minutes, much of which was attributed to delays in the messenger service. The basic design of the existing unit dose medication system contributed to problems in the reliability and efficiency of the system.

Attitude of Health Personnel↗
PubMed1984

Consultant evaluation of a hospital medication system: synthesis of a new system.

Recommendations of consultants for the implementation of a new medication system at a large teaching hospital are described. Based on a previous analysis of the hospital's existing drug distribution and control system that revealed problems in reliability and response time, an interdisciplinary consultant group offered 14 recommendations, which included implementation of a computerized unit dose delivery system and selected clinical pharmacy services. Functions identified for which computerization would produce the greatest benefits included maintenance of patient census data, medication order entry and retrieval, and preparation of a medication administration record for nursing. Recommendations for improving the unit dose system in the hospital consisted of increasing the number of medications packaged in true unit dose form, increasing the frequency of daily deliveries of scheduled medications, sending p.r.n. medications on an on-call basis, decreasing the lead time for preparation of i.v. solutions, and using a pharmacist-manned portable medication cart to reduce workload on the central pharmacy during peak workload periods. Clinical pharmacy services identified as having the greatest cost-benefit ratio were discharge consults, drug therapy monitoring, and drug-use review. Using information from published studies and cost data from the hospital, a net annual savings of over +152,000 was projected with implementation of these services. Improvements in the unit dose system and implementation of clinical pharmacy services were expected to result in substantial cost savings in the study hospital.

Computers↗