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Biomedical subjects

J Biddle

Publications and source records attributed to J Biddle.

At least 19 recordsLinked to original sources

Why most workers with occupational repetitive trauma do not file for workers' compensation.

Despite the availability of no fault insurance for wage replacement and medical care costs, the majority of workers diagnosed with an occupational disease do not apply for workers' compensation. The objective of the study was to determine the reasons why workers diagnosed with work-related musculoskeletal disease did not apply for workers' compensation benefits. A cross-sectional study of 1598 individuals diagnosed with neck, upper extremity, and low back work-related musculoskeletal disease from April to June 1996 was performed. All individuals were interviewed over the telephone using a standardized questionnaire. The questionnaire included questions about the precipitating event; demographics; health limitations; mood; pain level; and attitudes toward their health care provider, fellow workers, management, work environment, and filing for workers' compensation. Whenever possible, standardized questions from previous surveys were used. The interviewed individuals with work-related musculoskeletal disease were reported by health care practitioners as required by the state of Michigan's occupational disease reporting law. Workers reported during 12 weeks in the spring of 1996 by a Michigan health care professional as having a neck, back, or upper extremity musculoskeletal disorder were eligible to participate. Among the 2703 reports received, 490 individuals could not be reached, 22 did not speak English, 12 had died or were too incapacitated by other medical conditions, and 581 refused. We interviewed 59% of all eligible workers and 73% of all workers who were reachable and capable of responding in English. Only 25% of workers diagnosed with musculoskeletal disease filed a workers' compensation claim. The factors significantly associated with filing a claim were (1) increased length of employment (> 21 years: odds ratio [OR], 3.01, 95% confidence interval [CI], 1.31 to 6.90); 11 to 20 years: OR, 2.34, 95% CI, 1.01 to 5.47; 6 to 10 years: OR, 1.76, 95% CI, 0.73 to 4.25; 1 to 5 years: OR, 2.36, 95% CI, 1.03 to 5.42; < 1 year: OR, 1.00; (2) lower annual income (< $40,000: OR, 1.75, 95% CI, 1.06 to 2.88 vs > or = $80,000: OR, 1.00); (3) workers' dissatisfaction with coworkers (OR, 1.76, 95% CI, 1.01 to 3.06); (4) physician restrictions on activity (OR, 2.16, 95% CI, 1.55 to 3.00); (5) type of physician providing treatment (specialist, including surgeon or orthopedist: OR, 3.63, 95% CI, 2.37 to 5.55); physical and occupational therapist: OR, 2.15, 95% CI, 1.35 to 3.43); family practitioner: OR, 1.33, 95% CI = 0.89 to 2.01; company physician: OR = 1.00); (6) off work > or = 7 days (OR, 14.85, 95% CI, 10.57 to 20.85); (7) decreased current health status (OR, 0.82, 95% CI, 0.70 to 0.96); and (8) increased severity of illness (OR, 1.24, 95% CI, 1.06 to 20.88). This study showed that only 25% of workers with a work-related musculoskeletal condition filed for workers' compensation and refutes the common perception that an individual with a work-related problem is likely to file a workers' compensation claim. The strongest predictors of who would file were those factors associated with the severity of the condition. Other factors were increasing length of employment, lower annual income, and worker dissatisfaction with coworkers. Our study population consisted mainly of unionized autoworkers, and our findings may not be generalizable to the total workforce.

Adolescent↗

What percentage of workers with work-related illnesses receive workers' compensation benefits?

This study estimates the rate at which workers suffering from occupational illnesses file for workers' compensation lost wage benefits and identifies some of the factors that affect the probability that a worker with an occupational illness will file. A database of reports of known or suspected cases of occupational illness is matched with workers' compensation claims data. Overall, between 9% and 45% of reported workers file for benefits. Data limitations prevent a more precise estimate of this rate, but a large proportion of workers with occupational illnesses clearly does not utilize the worker's compensation system. Logit analysis of a choice-based sample shows that women and employees of small firms are more likely than others to file for worker's compensation and that filing rates vary considerably across industries and diagnostic categories. Acute conditions related to the current job are no more likely to lead to claims than chronic conditions with long latency periods between exposure and development of disease.

Adult↗

Comparison of traditional and molecular methods of typing isolates of Staphylococcus aureus.

Fifty-nine Staphylococcus aureus isolates and 1 isolate of Staphylococcus intermedius were typed by investigators at eight institutions by using either antibiograms, bacteriophage typing, biotyping, immunoblotting, insertion sequence typing with IS257/431, multilocus enzyme electrophoresis, restriction analysis of plasmid DNA, pulsed-field or field inversion gel electrophoresis, restriction analysis of PCR-amplified coagulase gene sequences, restriction fragment length polymorphism typing by using four staphylococcal genes as probes, or ribotyping. Isolates from four well-characterized outbreaks (n = 29) and a collection of organisms from two nursing homes were mixed with epidemiologically unrelated stock strains from the Centers for Disease Control and Prevention. Several isolates were included multiple times either within or between the sets of isolates to analyze the reproducibilities of the typing systems. Overall, the DNA-based techniques and immunoblotting were most effective in grouping outbreak-related strains, recognizing 27 to 29 of the 29 outbreak-related strains; however, they also tended to include 3 to 8 epidemiologically unrelated isolates in the same strain type. Restriction fragment length polymorphism methods with mec gene-associated loci were less useful than other techniques for typing oxacillin-susceptible isolates. Phage typing, plasmid DNA restriction analysis, and antibiogram analysis, the techniques most readily available to clinical laboratories, identified 23 to 26 of 29 outbreak-related isolates and assigned 0 to 6 unrelated isolates to outbreak strain types. No single technique was clearly superior to the others; however, biotyping, because it produced so many subtypes, did not effectively group outbreak-related strains of S. aureus.

Bacterial Typing Techniques↗

Outbreak of penicillinase-producing Neisseria gonorrhoeae with an African connection.

Previous outbreaks of penicillinase-producing gonococcal infection in the United States have generally been attributed to importation of Southeast Asian strains. During July 1982 through July 1983, 110 cases of gonorrhea caused by penicillinase-producing strains were reported in metropolitan Atlanta, Georgia. Among the 53 infected women, 14 (26%) had pelvic inflammatory disease (PID). Compared to other infected women, those with PID experienced a greater delay from the time of last sexual exposure (19.1 vs 8.1 days) to receipt of appropriate antibiotic therapy (P less than .01). At least 22 prostitutes were involved in the outbreak. Sixteen (76%) of 21 isolates tested were serogroup 1A; 15 required arginine and proline for growth; and 17 (81%) possessed a 3.2 megadalton plasmid. Our data suggest that this outbreak was associated with both African and Southeast Asian strains.

Adult↗

Treating gonococcal infections resistant to penicillin in Bangkok: comparison of cefuroxime and spectinomycin.

Gonococcal organisms have become resistant to antimicrobials throughout the world. Such resistance is common in Thailand, where 40% of gonococci produce penicillinase (PPNG strains) and over half the remainder have MICs of penicillin greater than or equal to 1 mg/l. To evaluate the effectiveness of cefuroxime against such resistant organisms, a controlled clinical trial comparing spectinomycin and cefuroxime was conducted at Bangrak Hospital, Bangkok, in 1982-3. Of 472 patients who were randomly assigned to treatment, 365 (77%) yielded positive cultures before treatment and returned for follow up evaluation three to 13 days after treatment. Of the 365 patients, 359 (98%) were cured, and no difference between the two treatment regimens was found either by the sex of the patient or by the presence of PPNG strains. The MIC of cefuroxime against all organisms was less than or equal to 1 mg/l. In vitro susceptibilities of gonococci in Bangkok have not changed appreciably during the past two years. Regimens of cefuroxime and spectinomycin are highly effective even for the relatively resistant gonococci in Bangkok. The pharmacokinetics, in vitro susceptibilities, and effectiveness of cefuroxime encourage evaluation of lower doses of the drug.

Adolescent↗

Common beta-lactamase-specifying plasmid in Haemophilus ducreyi and Neisseria gonorrhoeae.

Eighty-nine strains of Haemophilus ducreyi from a chancroid epidemic in Orange County, California, were examined for plasmid content. Seventy-eight (88%) of these isolates were found to contain a plasmid of 3.2 megadaltons which conferred beta-lactamase production. Restriction endonuclease digests indicated that this was the same plasmid that was found in some strains of beta-lactamase-producing Neisseria gonorrhoeae.

DNA, Bacterial↗

Plasmid profile, serogrouping, and auxotyping of Neisseria gonorrhoeae isolates from Africa.

The plasmid patterns of 90 isolates of Neisseria gonorrhoeae (including 39 penicillinase-producing strains) originating from various countries in Africa were determined. Serogrouping by coagglutination and auxotyping were used to characterise the isolates. The 4.4-megadalton plasmid was present in seven isolates out of 39 penicillinase-producing strains, two of which occurred with a conjugative 24.5-megadalton plasmid. The African strains were predominantly serogroup WI and wild type. Arginine-dependent isolates were as common as proline-dependent types.

Africa↗

Epidemiological characterisation of Neisseria gonorrhoeae isolates from the Far East.

One hundred strains of Neisseria gonorrhoeae (including 30 penicillinase producing (PPNG) strains) originating from Korea were characterised by plasmid analysis, auxotyping, and serogrouping. Eighty per cent of the isolates possessed the conjugative 24.5 megadalton (Mdal) plasmid. A novel 7.8 Mdal plasmid was present in four isolates (one PPNG and three non-PPNG strains). Seventy five per cent of all the strains tested were wild type and belonged to serogroup WII, while 20% were proline requiring and belonged to serogroup WII. Two of the remaining strains were tyrosine auxotrophs, while another strain was arginine requiring; these three strains carried the conjugative plasmid and belonged to serogroup WII.

Gonorrhea↗

Antimicrobial resistance of Neisseria gonorrhoea in Bangkok: is single-drug treatment passé.

201 gonococcal isolates obtained from patients attending clinics in Bangkok were tested for in-vitro antimicrobial susceptibility. 42% of these isolates were penicillinase-producing Neisseria gonorrhoeae (PPNG); of the 116 isolates of non-PPNG 53% had a penicillin minimum inhibitory concentration (MIC) greater than or equal to 1 microgram/ml and the remainder had MIC greater than or equal to 0.06 microgram penicillin/ml. Similarly high in-vitro resistance was found for six of eight other antimicrobial agents tested. These high antimicrobial MICs reflect the difficulties encountered in selecting therapeutic agents for the control of gonorrhoea in Thailand. Single-drug treatment for gonorrhoea may no longer be effective in some settings. There is an urgent need to evaluate combination therapies appropriate to such settings.

Anti-Bacterial Agents↗

Antimicrobial susceptibility of gonococci isolated in the Central African Republic.

Using agar dilution techniques, we determined the minimum inhibitory concentrations (MIC) of 11 antimicrobials for 70 isolates of Neisseria gonorrhoeae obtained in Bangui, Central African Republic. These gonococci were found to be fairly susceptible to commonly used antibiotics: only 3 isolates (4%) had a penicillin MIC >/= 1.0 mug/ml and 6 (9%) had a tetracycline MIC >/= 2.0 mug/ml. With regard to other antibiotics, 54 isolates (77%) had an erythromycin MIC >/= 0.25 mug/ml, all had a spectinomycin MIC </= 16 mug/ml, and 32 (46%) had a sulfamethoxazole/trimethoprim MIC >/= 9.5/0.5 mug/ml. None of these isolates produced penicillinase.This study has helped to provide a rational basis for establishing national gonorrhoea treatment recommendations in the Central African Republic.

Anti-Bacterial Agents↗

Evidence for two distinct types of penicillinase-producing Neisseria gonorrhoeae.

Since their recognition early in 1976, penicillinase (beta-lactamase)-producing Neisseria gonorrhoeae (P.P.N.G.) have been isolated in more than 15 countries. Most strains isolated in or epidemiologically linked with the Far East are relatively resistant to tetracycline in vitro, are phenotypically wild-type or proline-dependent auxotypes, and carry a plasmid with a molecular weight of 5800 000 (5-8 X 10(6)) daltons coding for beta-lactamase production. In contrast, P.P.N.G. epidemiologically linked with West Africa are more susceptible to tetracycline, require arginine for growth, and their gene coding for beta-lactamase synthesis is contained in a smaller 3-2 X 10(6) dalton plasmid. Moreover, 43% of the Far Eastern strains, but none of those from West Africa, have an additional 24-5 X 10(6) dalton conjugative plasmid which transfers the beta-lactamase R factor(s) to other gonococci. The presence of this conjugative plasmid may explain the relatively high prevalence of P.P.N.G. in certain areas of the Far East.

Africa, Western↗

Single-dose treatment of uncomplicated acute gonococcal urethritis in Ethiopian men: comparison of rosoxacin, spectinomycin, penicillin, and ampicillin.

A total of 140 Ethiopian men with gonococcal urethritis were randomly assigned to treatment with aqueous procaine penicillin G (4.8 X 10(6) units intramuscularly [im] plus 1.0 g of oral probenicid); oral ampicillin (3.5 g plus 1.0 g of oral probenicid); spectinomycin (2.0 g im); or oral rosoxacin (Acrosoxacin; 300 mg). Failure rates were 24%, 19%, zero, and 3%, respectively. Forty-four (31.4%) patients were infected with penicillinase-producing Neisseria gonorrhoeae (PPNG) and were evenly distributed in the treatment groups. All 39 PPNG strains analyzed for plasmid content possessed a 2.6-Mdalton plasmid; 28 (71.8%) had a 3.2-Mdalton beta-lactamase-encoding plasmid, ten (25.6%) had a 4.4-Mdalton plasmid (three with and seven without a 24.5-Mdalton plasmid), and one had only a 24.5-Mdalton plasmid. Two patients were infected with N. gonorrhoeae-possessing plasmids apparently capable of encoding but not producing beta-lactamase. Both spectinomycin and rosoxacin are excellent single-dose treatment regimens for gonococcal urethritis in men. All people receiving these drugs in Ethiopia should be tested serologically for syphilis, however, as eight (11.8%) of 68 men in this study also had active latent syphilis.

4-Quinolones↗