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Biomedical subjects

K C Klontz

Publications and source records attributed to K C Klontz.

At least 19 recordsLinked to original sources
PubMed2000

A nationwide outbreak of alopecia associated with the use of a hair-relaxing formulation.

OBJECTIVE: To study the long-term outcome of adverse effects reported by persons who used a commercial hair-straightening product known as the Rio Hair Naturalizer System (World Rio Corporation). DESIGN: Survey of individuals who contacted the Food and Drug Administration in 1994 and 1995 to report adverse effects linked to using the product. SETTING: Persons residing in the United States. PATIENTS: A total of 464 (59% of 790 eligible) patients who returned a completed questionnaire. MAIN OUTCOME MEASURES: Adverse effects associated with using the Rio Hair Naturalizer System products (neutral or color enhancer). RESULTS: Ninety percent of respondents were African American women between the ages of 15 and 55 years. The most common complaints associated with the use of the products were hair breakage and/or hair loss, reported by 95% of respondents. Three quarters of those experiencing hair loss reported losing 40% or more of their original hair. The median time between the loss of original hair and the growth of new hair was 8 months; however, 40 (9%) respondents reported having no new growth at the time of completing the survey, some 2 years after using the product. When mixed according to package instructions, the mean pH of a sample of 20 neutral product kits tested was 1.39 (range, 1.1-3.15). For the 21 color-enhancer products tested, the mean pH was 2.82 (range, 2. 29-3.08). CONCLUSIONS: A nationwide outbreak of alopecia and scalp injuries involving tens of thousands of women (and some men) occurred following the marketing of a chemical hair-relaxing product. Most of those affected reported substantial hair loss, with a majority indicating growth of new hair that was abnormal in both quantity and quality.

Adolescent↗
PubMed2000

Recalls of foods and cosmetics due to microbial contamination reported to the U.S. Food and Drug Administration.

In the U.S., food product recalls serve as an important intervention in stemming the consumption of food products contaminated with infectious disease agents. We summarize the number and nature of foods and cosmetics recalled as a result of microbial contamination reported to the U.S. Food and Drug Administration (FDA) for the period 1 October 1993 through 30 September 1998. During this period, microbial contamination of food and cosmetic products was the leading cause for recalls, accounting for a total of 1,370 recalls (36% of all products recalled). Listeria monocytogenes accounted for the greatest number of food products recalled because of microbial contamination, whereas Pseudomonas aeruginosa was the most common microbe associated with recalls of cosmetic products. Dairy products, followed by seafood and pastry items, were the types of products most often associated with recalls due to microbial contamination. The FDA was the entity most often responsible for detecting microbial contamination of foods and cosmetics (33% of all such recalls), followed by state regulatory agencies (24%), and manufacturers/retailers (21%). Nineteen percent of recalls were associated with at least one reported case of illness. Salmonella was the pathogen most often implicated in reports of illness associated with these recalled products.

Animals↗
PubMed1998

Raw shellfish consumption among renal disease patients. A risk factor for severe Vibrio vulnificus infection.

BACKGROUND: Raw shellfish-associated Vibrio vulnificus septicemia, with a case-fatality rate of nearly 50%, occurs most commonly in immunocompromised patients or those with liver disease. METHODS: Sixty patients with renal disease treated with hemodialysis at The George Washington University and awaiting renal transplantation completed an initial survey that assessed their raw shellfish eating habits and knowledge regarding the pathogen V. vulnificus. Patients were then given educational materials describing the risks of eating raw shellfish and, one month later, completed a second survey that assessed their knowledge retention and intent to eat or not eat raw shellfish in the future. RESULTS: Sixty of 68 (88%) eligible patients completed the survey. Forty-eight percent of patients reported having eaten raw shellfish after being diagnosed with kidney disease, with the highest rates reported among subjects < or = 49 years old and subjects with more than a high school education. Prior to receiving the educational materials, no patient had heard of the pathogen V. vulnificus. Three quarters of patients reported never having been advised by a physician to avoid eating raw shellfish. One month after reading the educational materials, 75% of patients said they would refrain from eating raw shellfish in the future. CONCLUSIONS: In view of their immunocompromised status, patients with end-stage renal disease should be counseled to abstain from eating raw shellfish.

Adolescent↗
PubMed1998

The epidemiology of raw milk-associated foodborne disease outbreaks reported in the United States, 1973 through 1992.

OBJECTIVES: This study describes the epidemiology of raw milk-associated outbreaks reported to the Centers for Disease Control and Prevention from 1973 through 1992. METHODS: Surveillance data for each reported raw milk-associated outbreak were reviewed. A national survey was conducted to determine the legal status of intrastate raw milk sales for the period 1973 through 1995. RESULTS: Forty-six raw milk-associated outbreaks were reported during the study period; 40 outbreaks (87%) occurred in states where the intrastate sale of raw milk was legal. CONCLUSIONS: Consumption of raw milk remains a preventable cause of foodborne disease outbreaks.

Animals↗
PubMed1997

Age-dependent resistance factors in the pathogenesis of foodborne infectious disease.

With increasing age there is an increase in both the incidence as well as the mortality due to many infectious illnesses, and foodborne infectious disease is no exception. A review of the pertinent literature identified studies concerning foodborne disease caused by infectious agents in the elderly, as well as those factors that could account for the increase in morbidity and mortality seen in the elderly due to foodborne infections. The published information suggested that the basis for the increased incidence, severity and risk of death of many foodborne infectious diseases in elderly persons is related to factors such as reduced gastric acidity, a higher prevalence of underlying medical disorders (co-morbidity factors), and immune system changes that result in a less effective host defense against infectious agents. The greater risk of foodborne disease experienced by elderly persons results from the contribution of non-immune and immune mediated factors. Due to the growing number of persons over the age of 65 years in the United States, foodborne disease in this age group will continue to be an important source of illness and death in the population.

Aged↗
PubMed1997

Systemic allergic reaction following ingestion of undeclared peanut flour in a peanut-sensitive woman.

BACKGROUND: Although peanuts and peanut butter are well recognized as food allergens, few reports describe allergic reactions associated with eating peanut flour. OBJECTIVE: To describe an allergic reaction that occurred in a peanut-sensitive woman who ate undeclared peanut flour that was part of a flavor ingredient contained in a dry soup mixture, and to estimate the amount of peanut protein the patient ingested. METHODS: The patient was interviewed, medical records from her emergency room visit were reviewed, and the manufacturer of the soup mix was investigated to ascertain the proportion of the soup mix constituted by the undeclared peanut flour. RESULTS: Minutes after ingesting the soup, a 33-year-old woman experienced a systemic allergic reaction. She was treated successfully in the emergency room with intravenous fluids, corticosteroids, and diphenhydramine. Investigation of the soup manufacturer revealed that undeclared peanut flour was a component of a flavoring ingredient in the soup. Based on the concentration of peanut flour in the flavoring, we estimated the patient ate approximately 45 mg of peanut protein. CONCLUSIONS: Inadvertent ingestion of peanut flour by peanut-sensitive individuals may lead to systemic allergic reactions.

Adult↗
PubMed1997

Frequency of infected aneurysms among patients in Department of Veterans Affairs hospitals, 1986-1990: the role of Salmonella.

Patients with infected aneurysms discharged from Department of Veterans Affairs hospitals during fiscal years 1986 to 1990 were identified using International Classification of Diseases codes to determine the proportion of patients infected with Salmonella. Twenty-three patients with infected aneurysms were identified. All patients were males; the median age was 63 years. A Gram-positive organism was recovered from 16 patients (70%), a Gram-negative organism from 6 patients (26%), and a fungus from 1 patient. Three patients, all with aneurysms of the abdominal aorta, were infected with Salmonella. Overall, the vessels most often involved included arteries of the extremities (10 patients) and the abdominal or thoracic aorta (9 patients). An increased incidence of nontyphoidal salmonellosis in the United States during the last few decades, along with an aging of the U.S. population, suggests that Salmonella can be expected to maintain a niche in the bacteriology of infected aneurysms.

Aneurysm, Infected↗
PubMed1996

The epidemiology of Vibrio infections in Florida, 1981-1993.

The epidemiology of 690 Vibrio infections reported in Florida during 1981-1993 is described. Most infections resulted in one of three clinical syndromes: gastroenteritis (51%), wound infections (24%), or primary septicemia (17%). Case-fatality rates were 1% for gastroenteritis, 5% for wound infections, and 44% for primary septicemia. While gastroenteritis had little seasonal variation, 91% of primary septicemias and 86% of wound infections occurred from April through October, mostly due to the seasonality of Vibrio vulnificus and Vibrio parahaemolyticus infections. Infected wounds were largely a result of occupational activities around seawater. Some 68% of gastroenteritis cases and 83% of the primary septicemias were associated with raw oyster consumption. Preexisting liver disease was present in 48% of patients with primary septicemia and was associated with a fatal outcome in both wound infections (relative risk [RR], 28.3; 95% confidence interval [CI], 6.3-127.5; P < .0001) and primary septicemia (RR, 1.9; 95% CI, 1.2-3.1; P < .01).

Adolescent↗
PubMed1995

Associations between diet and health behavior: results from the 1992 Rhode Island Behavioral Risk Factor Survey.

The 1992 Rhode Island Behavioral Risk Factor Surveillance System was used to assess self-reported health behaviors of consumers of finfish and raw shellfish. We hypothesized that consumers of finfish, foods considered to be healthy, were more likely than nonconsumers of finfish to partake in health-promoting behaviors. Similarly, we postulated that consumers of raw molluscan shellfish, foods linked to an elevated risk of acquiring various illnesses, were more likely than nonconsumers of raw-shellfish to partake in risk-taking behaviors. Finfish eaters were significantly more likely than abstainers to report recent exercise, efforts to lose weight, periodic monitoring of serum cholesterol, and not currently being smokers. Raw shellfish eaters were significantly more likely than abstainers to report recent acute and chronic alcohol consumption. The results suggest that inquiry into dietary patterns may be an avenue for exploring other health behaviors.

Adolescent↗
PubMed1993

Eating as a hazard to health: preventing, treating dental injuries caused by foreign objects in food.

The Food and Drug Administration maintains a passive surveillance system for reporting and follow-up of complaints related to food items. The most commonly reported complaint is the discovery of foreign objects in food. The most common injuries are abrasions to the throat and buccal mucosa. Although dentists are qualified to treat oral injury resulting from foreign object ingestion, more physicians than dental professionals treat soft tissue trauma.

Digestive System↗
PubMed1992

The protective effect of alcohol on the occurrence of epidemic oyster-borne hepatitis A.

Limited data indicate that drinking alcoholic beverages along with eating food contaminated with Shigella or Salmonella decreases the risk and/or the severity of illness. No such study has been reported following exposure to a viral pathogen. During an oyster-borne outbreak of hepatitis A, we studied the effect of ingestion of alcoholic beverages concomitant with consumption of contaminated oysters. The analysis was restricted to 51 cases and 33 controls who had consumed the implicated raw oysters. After controlling for potential confounders, we found a protective effect for beverages that have an alcohol concentration of greater than or equal to 10% (odds ratio = 0.1, 95% confidence interval = 0.02-0.9), but not for beverages with an alcohol concentration of less than 10% (odds ratio = 0.7, 95% confidence interval = 0.2-2.9).

Adult↗
PubMed1991

The risk of Vibrio illness in the Florida raw oyster eating population, 1981-1988.

In the period 1981-1988, 333 cases of bacteriologically confirmed Vibrio illness were reported in Florida adult residents. A total of 197 patients (59.2%) had consumed raw oysters the week prior to becoming ill, and among those 197, 38 (19.3%) had a liver disease, 13 (6.6%) had past gastric surgery, and 15 (7.6%) were diabetic. To calculate a population-based incidence rate, the authors obtained prevalence estimates of annual raw oyster consumption, liver disease, previous gastric surgery, and diabetes through a random telephone survey of Florida adult residents and applied them to the January 1985 Florida population. The estimated age-standardized annual incidence of Vibrio illness per million was 95.4 for raw oyster eaters with liver disease, 9.2 for raw oyster eaters without liver disease, and 2.2 for non-raw oyster eaters. Those with prior gastric surgery had a moderately increased risk of Vibrio illness. The annual incidence for Vibrio septicemia was 82.8 for raw oyster eaters with liver disease, 2.0 for raw oyster eaters without liver disease, and 0.4 for non-raw oyster eaters. While estimates on which these data are based are subject to a number of potential biases, this is the first study to provide estimates of the risk of Vibrio illness in raw oyster eaters, and it supports the recommendation that raw oyster consumption should be avoided by persons with liver disease.

Adolescent↗
PubMed1991

Needlestick injuries and hepatitis B immunization in Florida paramedics: a statewide survey.

STUDY OBJECTIVES: To determine the incidence of needlestick injury among paramedics working in Florida during 1987, to describe the circumstances surrounding such injuries, and to assess the hepatitis B vaccination status of this group. DESIGN: Survey of a systematic random sample of paramedics using a self-administered questionnaire. SETTING: Florida. TYPE OF PARTICIPANTS: Paramedics. MAIN RESULTS: A completed questionnaire was returned by 300 of 500 paramedics (60%) who received the mailed questionnaire. Sixty-nine paramedics (23%) reported a total of 110 needlestick injuries. More than one third of injuries occurred in conjunction with recapping needles. Almost 62% of reported injuries could have been prevented had proper needle disposal technique been used. Sixty-two percent of paramedics reported having had at least one dose of the hepatitis B vaccine. Sixty-five percent of the unvaccinated paramedics said they would take the hepatitis B vaccine if it was offered free. CONCLUSION: The majority of needlestick injuries among paramedics in Florida could be prevented with proper needle disposal. Offering the hepatitis B vaccine at no charge to paramedics in Florida could increase the vaccination rate substantially.

Adult↗
PubMed1991

The raw oyster consumer--a risk taker? Use of the Behavioral Risk Factor Surveillance System.

We used the 1988 Behavioral Risk Factor Surveillance System in Florida to determine the prevalence of consumption of raw oysters, a vehicle implicated in the transmission of several pathogens. One-third of survey respondents reported ever eating raw oysters. The prevalence was higher for persons 18-49 years old and for males, and, when controlled for age and sex, for persons who reported being cigarette smokers or acute or chronic alcohol drinkers, and driving while intoxicated.

Adolescent↗
PubMed1991

A multistate outbreak of hepatitis A caused by the consumption of raw oysters.

BACKGROUND: In August 1988 we investigated a multistate outbreak of hepatitis A caused by Panama City, Florida, raw oysters. METHODS: Cases of hepatitis A (HA) with onset in July-August 1988 were identified among persons who ate seafoods harvested in the coastal waters of Panama City, Florida. We conducted a case-control study, using eating companions of case-patients, and calculated attack rate (AR) per 1000 dozen raw oysters served. Enzyme immunoassay (EIA) and a polymerase chain reaction (PCR) technique were performed on samples of raw shellfish obtained from Panama City coastal waters. RESULTS: Sixty-one case-patients were identified in five states: Alabama (23), Georgia (18), Florida (18), Tennessee (1), and Hawaii (1). We found an increased risk of HA for raw oyster eaters (odds ratio = 24.0; 95% confidence interval = 5.4-215.0; P less than .001). The AR of HA in seafood establishments was 1.9/1000 dozen raw oysters served. The EIA and PCR revealed HA virus antigen and nucleic acid in oysters from both unapproved and approved oyster beds, in confiscated illegally harvested oysters, and in scallops from an approved area. CONCLUSIONS: The monitoring of coastal waters and the enforcement of shellfish harvesting regulations were not adequate to protect raw oyster consumers. More emphasis should be placed on increasing public awareness of health hazards associated with eating raw shellfish.

Adolescent↗