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Biomedical subjects

M C Mahoney

Publications and source records attributed to M C Mahoney.

67 records · Page 4Linked to original sources

Neofissure after right upper lobectomy: radiographic evaluation.

Following lobectomy of the right upper lobe of the lung, a single fissure, the neofissure, separates the right middle and lower lobes. In 25 patients in whom chest radiographs and computed tomographic (CT) scans were obtained after right upper lobectomy, the neofissure was identifiable to some extent on the radiographs in seven (28%) and on CT scans in 24 (96%). Among those patients in whom the neofissure was seen in its entirety, in 12 of 20 (60%) it was oriented predominantly in the coronal plane, paralleling the course of the original major fissure but displaced anteriorly and superiorly. In seven of 20 patients (35%) the superior aspect was coronal, rotated clockwise toward the sagittal plane inferiorly. In one of 20 patients (5%) the neofissure was oriented predominantly in the sagittal plane. The right middle lobe lies anterior and medial to the neofissure; the right lower lobe lies posterior and lateral.

Humans↗

Right middle lobe collapse following right upper lobectomy.

Radiographic and computed tomographic (CT) examinations of the chest in four patients with collapse of the right middle lobe of the lung after lobectomy of the right upper lobe were reviewed. The diagnosis of collapse was made on the basis of findings of increased density in the right middle lobe and volume loss evidenced by displacement of the neofissure seen at CT. Plain radiographic findings included opacity in the right hilar and paramediastinal areas in all four patients, with smooth margination simulating mediastinal widening in three.

Female↗

Prevalence and laboratory identification of methicillin-resistant Staphylococcus aureus in community hospitals.

The prevalence of methicillin-resistant Staphylococcus aureus infections in community hospitals in northern Minnesota, Wisconsin, and Michigan was found to be one case in 82,565 patients. The percentage of S. aureus isolates resistant to methicillin was less than 0.2% (5 of 2,835). In this study, conducted from 1 June 1982 to 31 May 1983, a laboratory-controlled methodology was used.

Cross Infection↗

Mortality patterns among persons with antecedent syphilis infection.

BACKGROUND AND OBJECTIVES: Few studies have examined the patterns of death among persons with a history of syphilis infection. GOALS OF THIS STUDY: This analysis examines the cause-specific mortality patterns among a cohort of persons diagnosed with syphilis. STUDY DESIGN: Individuals diagnosed with serologically confirmed syphilis in New York State (excluding New York City) between 1972 and 1987 were matched to the New York State mortality files to identify the deaths among members of the cohort. RESULTS: The overall observed mortality between 1973 and 1987 was generally comparable to the expected number among both men (SMR = 0.94; 95% CI = 0.87-1.02) and women (SMR = 0.88; 0.78-0.99). An excess of deaths due to all causes was observed among men between the ages of 25 and 54 (SMR = 1.74; 1.53-1.97), with the largest excess observed in the 25- to 34-year-old age group (SMR = 2.32; 1.87-2.85). Among men, excesses were noted for deaths due to AIDS-related causes. Among both genders, excess deaths were observed for possible alcohol-related causes. CONCLUSION: The unique mortality patterns of this cohort suggest the need for increased identification of and interventions directed toward high-risk behavior of individuals diagnosed with syphilis.

Adult↗

Smallpox: clinical highlights and considerations for vaccination.

Smallpox virus has gained considerable attention as a potential bioterrorism agent. Recommendations for smallpox (vaccinia) vaccination presume a low risk for use of smallpox as a terrorist biological agent and vaccination is currently recommended for selected groups of individuals such as health care workers, public health authorities, and emergency/rescue workers, among others. Information about adverse reactions to the smallpox vaccine is based upon studies completed during the 1950s and 1960s. The prevalence of various diseases has changed over the last four decades and new disease entities have been described during this period. The smallpox vaccination may be contra-indicated in many of these conditions. This has made pre-screening of potential vaccines necessary. It is believed that at present, the risks of vaccine-associated complications far outweigh the potential benefits of vaccination in the general population.

Humans↗

Comparison of Native American births in upstate New York with other race births, 1980-86.

The purpose of this study was to describe the neonatal characteristics of Native American (Indian) infants and the antenatal characteristics of their mothers as compared with white, black, and other race infants. The study population comprised 979,444 live births to upstate New York (exclusive of New York City) resident mothers between 1980 and 1986. Data were abstracted from vital records (birth certificates) and analyzed using a variety of descriptive statistics. Mothers of Native American and black infants had similar antenatal profiles (that is, younger, higher parity, lower educational attainment, and delayed initiation of prenatal care), which differed from mothers of white or other race infants. Despite having at-risk mothers, Native American infants were similar to white and other race infants with respect to the percentage of births that were considered low birth weight or premature. Black infants were twice as likely as the other three groups of infants to be low birth weight or premature. These findings suggest that other factors appear to be important in determining neonatal outcome and that typical at-risk antenatal profile of mothers may not be consistent across all racial groups.

Adolescent↗

Fatal motor vehicle traffic accidents among Native Americans.

An atypical number of motor vehicle-related deaths has been observed among Native American populations. Little is known about why Native groups exhibit increased mortality from this cause. To better understand factors influencing these occurrences, I examined fatal motor vehicle traffic accidents between 1980 and 1986 involving persons of Native American descent in New York State, exclusive of New York City. Data were obtained from a review of death certificates and coroner reports. Fatal motor vehicle collisions among Native Americans generally occurred among men (74%), in rural areas (55%), between 9:00 p.m. and 3:00 a.m. (62%), and during weekends (78%). A sizable percentage of motor vehicle deaths resulted from collisions with pedestrians (28%). Death frequently occurred before the accident victim reached a hospital (74%). Median age at death for male victims was eight years greater than for female victims. These data suggest the need for immediate efforts focusing on primary prevention to minimize risk-taking behaviors likely to result in motor vehicle accidents. I discuss behavioral and environmental factors influencing these observations.

Accidents, Traffic↗

Years of potential life lost among a Native American population.

The determination of years of potential life lost (YPLL) can aid in monitoring changes in premature mortality among various population groups. While premature mortality has been shown to differ among blacks and whites, patterns of YPLL have not been well established among other racial groups. The Seneca Nation of Indians (SNI) is a Native American group residing primarily in western New York State (NYS). A review of SNI necrology records revealed that 55 percent (510 of 924) of the deaths between 1955 and 1984 occurred before 65 years of age. The proportion of premature deaths among males exceeded the proportion in females. SNI males demonstrated an increased risk of premature death (odds ratio = 1.43) relative to SNI females. Both the percentage of premature deaths and the number of YPLL per death were greater among SNI members compared with NYS residents. Almost one-half of all YPLL among the SNI were attributable to accidents and injuries. Heart disease, digestive diseases, and malignant neoplasms also represented important contributors to YPLL for both SNI males and females. This investigation identifies important causes of premature death among a Native American population and underscores the preventable nature of premature loss of life.

Age Factors↗

Racial variation in spontaneous fetal deaths at 20 weeks or older in upstate New York, 1980-86.

The distribution of spontaneous fetal deaths (at age 20 weeks or more) by maternal race has received considerably less study than other adverse pregnancy outcomes. The purpose of this study was twofold--(a) to describe spontaneous fetal deaths among white, black, and American Indian women and (b) to determine if there was any variation by International Classification of Diseases, Ninth Revision (ICD-9) cause of death, gestational age at death, or maternal age at loss among these groups of mothers. Using the fetal death certificate registry maintained by the New York State Department of Health, 8,592 spontaneous fetal deaths at age 20 weeks or more were identified among upstate (exclusive of New York City) mothers between 1980 and 1986. By race it was 7,300 for white women, 1,257 for black women, and 27 for American Indian women. Spontaneous fetal death rates varied by maternal race as listed on vital records--black, 13.5 per 1,000 total births, white, 8.3, and American Indian, 8.1. The three leading causes of death (ICD-9,779, 762, and 761) did not vary by maternal race. Gestational age at death, imputed from last menstrual period, did vary by maternal race. Fetal deaths to white and black mothers were observed to occur most often between 24 weeks of pregnancy (39 percent) and 32 weeks (43 percent), while American Indian fetal deaths generally occurred later (more than 33 weeks) in pregnancy (41 percent). Most spontaneous fetal deaths occurred to mothers ages 20-29 regardless of race. Black teenage mothers, however, experienced the largest proportion of losses(23 percent) compared with white (10 percent) and American Indian (I I percent) teenage mothers.

Adolescent↗

A bibliometric analysis of cancer among American Indians & Alaska Natives, 1966-1993.

A bibliometric analysis was employed to objectively assess scientific studies published between 1966 and 1993 which have described cancer among American Indians and Alaska Natives. Searches of the MEDLINE (1966-1993) and CANCERLIT data bases (1983-1994) were used to identify relevant publications. In addition to examining publication sources and quantitative temporal trends, further bibliometric analyses were completed by considering a subset of papers published between 1982 and 1992. A total of 128 studies of cancer among American Indians and Alaska Natives were published between 1966 and 1993; 62 of these articles (48%) appeared between 1988 and 1993. Nine journals accounted for 53% of the total publications. The subset of 68 papers published between 1982 and 1992 were cited a total of 388 times in 136 different journals; the median number of citations was 2. Results demonstrate a limited number of published papers on cancer among American Indians and Alaska Natives. It is hoped that this paper will increase the awareness of cancer as an important health problem among American Indian and Alaska Natives and thereby serve to stimulate additional cancer-related research activities involving these groups.

Alaska↗

Mortality patterns among the youth of a northeastern American Indian cohort.

Mortality patterns prevalent among American Indian youth have not been well documented. This investigation reports on mortality patterns among the Seneca Nation of Indians from January 1, 1955, through December 31, 1989. The study cohort consisted of 3,033 Seneca tribal members born during the study period. Deaths occurring among cohort members younger than age 25 were identified through a computer match against New York State vital record files. Sex-specific standardized mortality ratios were calculated on the basis of mortality patterns exhibited by the general population of New York State, exclusive of New York City. Males exhibited significantly elevated mortality for all causes combined, for deaths due to all accidents combined, for motor vehicle accidents, and for suicide. Females demonstrated significantly elevated mortality from all accidents combined, for motor vehicle accidents, and for all other types of accidents. Age-specific mortality patterns also varied both by sex and by calendar time. These findings are important to consider in the design of programs aimed at reducing premature mortality among American Indian populations from preventable causes of death.

Accidents↗

Tribal-based cancer control activities among Alaska Natives: services and perceptions.

Cancer has become a significant health problem in American Indian and Alaskan Native (AI/AN) communities. Despite the precipitous rise in cancer rates, limited data are available concerning cancer control services operative in these communities. To address this issue, a cross-sectional survey of all federally recognized tribes was undertaken to ascertain the breadth of cancer control activities offered and Tribal Health Directors perceptions of and priorities ascribed to cancer. This article presents responses given by AN Health Directors juxtaposed to those proffered by AI Health Directors. Nearly three-quarters (71%) of respondents perceived cancer rates to be increasing. Cancer was found to rank third, fifth among AI Health Directors, among seven health conditions when Directors were asked to rank their Tribe's commitment to confronting each one. Awareness of cancer as a public health concern coupled with competing health problems relegates cancer control activities to a lower priority. Findings underscore the need to elevate the issue of cancer in Indian Country as well as to educate investigators to become more sensitive and responsive to other Tribal health issues.

Alaska↗