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PubMedDate not supplied

HIV antibody seroprevalence among childbearing women surveyed in Maryland.

Because blood specimens from newborns reflect the antibody status of the mother, seroprevalence rates among childbearing women are obtainable from analysis of the specimens. A blinded survey of human immunodeficiency virus (HIV) antibody seroprevalence among childbearing women was conducted in Maryland. The survey used 31,273 dried filter paper blood spot specimens obtained from newborns screened for hereditary disorders. Overall, 99 specimens were positive on two enzyme-linked immunoassays and on Western blot, providing a seroprevalence rate of 0.32 percent. The rate for child-bearing women residing within the City of Baltimore, 0.7 percent, was significantly higher than the rate for those residing elsewhere in Maryland, 0.1 percent. The statewide rate for nonwhite women, 0.8 percent, was higher than for white women, 0.007 percent. No statistically significant associations were found with residence in an inner city area, as opposed to residence in other areas of the city; birth weight group; reported health of the infant; or the infant having received a transfusion.

Adolescent↗
PubMed1990

The emergency petition process in Maryland.

Maryland's Emergency Petition statute allows a violent or suicidal person with a mental disorder to be brought to an emergency facility for rapid evaluation regarding the need for emergency treatment. Although many states have similar laws, little has been written in the psychiatric literature about the emergency petition process. The investigators evaluated emergency petition documents, demographic data, and the adequacy of emergency room records for all patients brought to a large county hospital in Prince Georges County, Maryland, by emergency petition during a one-month period. All emergency petition patients in Prince Georges County are brought to this hospital site. Of 94 petitioned patients examined during the study period, 92 records were available for review. The emergency petition was found to meet appropriate legal criteria in 94 percent of cases. More than half of all patients evaluated were intoxicated on alcohol or illicit drugs, and the majority of these patients were released from the emergency room as no longer dangerous after their acute intoxication resolved. In contrast to previous studies most of the patients evaluated were affluent, had health insurance, and were employed.

Adolescent↗
PubMed1990

The passage of Maryland's gun law: data and advocacy for injury prevention.

In 1988 the Maryland legislature passed an innovative law designed to limit the availability of certain types of handguns within the state. Pro-gun forces opposed the law and gathered the requisite number of petitioning signatures to refer the law to a public referendum on election day. The months preceding the referendum saw intense political campaigning over the gun law, with pro-gun forces spending $6.6 million, more money than had ever been spent in a Maryland political campaign. The handgun law was recognized to be a public health issue. This article reviews the activity involved in the passage of the law and the referendum, and discusses the role played by the Johns Hopkins injury prevention faculty in providing information to decision makers.

Adolescent↗
PubMedDate not supplied

Suicide in the State of Maryland, 1970-80.

A univariate and multivariate analysis of factors associated with suicide for residents of the State of Maryland was conducted. The investigation was statistically oriented in its approach, examining the relationships of age, race, sex, marital status, and month of death with suicide. Besides the usual death rates, percentages, and age-specific rates, a discriminant analysis was performed to test this approach. Data were obtained on all suicides of Maryland residents, regardless of where the deaths occurred. Univariate analysis showed that the relationships between suicide and age, race, sex, and marital status are consistent with those in the literature. No significant relationship appeared to exist between the month of death and suicide. During multivariate analysis, the discriminant function correctly predicted 80 percent of all the deaths, 74 percent of suicides, and 80 percent of all other causes, in their respective categories.

Adult↗
PubMed1989

The prevalence of urethral catheterization in Maryland nursing homes.

Urinary incontinence is common in the increasing numbers of aged people and is often the precipitating factor for nursing home admission. Recalcitrant incontinence may be managed by urethral catheters. In this study of a random stratified sample of Maryland nursing homes (4259 patients), we found that the daily prevalence of urethral catheter use in Maryland nursing homes was 7.5%. More than 80% of urethral catheter users were women. Among men, we found equal prevalences of urethral and condom catheter use. Previous studies have demonstrated long-term use of urethral catheters to be associated with almost universal bacteriuria of a polymicrobial and dynamic nature. Combining these data suggests that long-term catheter-associated bacteriuria is the most common infection in American health care facilities.

Aged↗
PubMed1989

Suicide mortality in the Maryland state prison system, 1979 through 1987.

Prisoners are reported to have a higher suicide rate than the community. We studied suicides in the Maryland prison system to determine the level of risk and risk factors for inmate suicide. There were 37 male inmate suicide deaths between 1979 and 1987 (39.6 suicides per 100,000 male inmates), which is significantly higher than the age- and race-adjusted male suicide rate in the general population of Maryland (22.0 per 100,000). Risk of male inmate suicide was increased for the following characteristics: white race (relative risk [RR], 2.0; 95% confidence interval [CI], 1.1 to 3.9), age 25 to 34 years (RR, 1.8; 95% CI, 1.0 to 3.4), major crime committed against person (RR, 3.4; 95% CI, 1.7 to 6.7), life sentence (RR, 4.7; 95% CI, 2.2 to 10.0), and classification to the major maximum security institution in the prison system (RR, 5.1; 95% CI, 2.7 to 9.8). The methods of suicide chosen by inmates were hanging (86%), cutting wound (5%), antidepressant overdose (5%), and fall from height (3%). We conclude that inmate suicide represents a significant correctional health and public health problem. Specific implications for prevention of inmate suicide are examined.

Black or African American↗
PubMed1989

Hospitalized head-injured patients in Maryland: incidence and severity of injuries.

Hospital discharge data collected from all acute care hospitals in Maryland were used to examine severity-specific rates of hospitalized head injuries in 1986. Findings indicate that males are at twice the risk of females for hospitalization for head injury; whites and nonwhites are at similar risk. Evidence that the rate of hospitalization for head injury may be increasing underscores the importance of head injury as a major public health problem in Maryland.

Adolescent↗
PubMed1986

The IAIMS initiative at the University of Maryland at Baltimore.

With support from the National Library of Medicine, the University of Maryland at Baltimore is creating an Integrated Academic Information Management System (IAIMS) that will serve as a prototype for academic health centers. A campus-wide undertaking, the IAIMS initiative at Maryland is characterized by its functional comprehensiveness and its planning model. The resulting strategic plan is serving as a guide in the ongoing model development within an interdisciplinary Hypertension Center.

Academic Medical Centers↗
PubMedDate not supplied

Public awareness survey: the Maryland Poison Center and Mr. Yuk, 1981 and 1975.

A telephone survey of residents of metropolitan Baltimore was conducted in 1981 to assess awareness of the Maryland Poison Center and a program based on the Mr. Yuk poisoning warning symbol. The results of 280 telephone interviews are compared with a similar survey conducted 6 years earlier by the Maryland Poison Center. When faced with a harmful exposure, the most common response in the 1981 survey (32.9 percent) was to call the poison center. That response was only the fourth most frequent answer (14.5 percent) in the 1975 survey. Calling a physician or taking the person to a physician was the most frequent response in 1975 (29.5 percent) but only the fourth most frequent in 1981 (15.0 percent). Of the respondents who would call a poison center, 55.7 percent in the 1981 survey knew the center's telephone number or had ready access to it. Public awareness of Mr. Yuk remained at approximately 60 percent in both surveys. Persons familiar with the warning symbol in the latest survey were three times as likely to call the poison center as those who were not aware of it.

Attitude to Health↗
PubMed1993

Organophosphorous insecticide susceptibility of mosquitoes in Maryland, 1985-89.

From 1985 to 1989, the susceptibility of the 9 major culicine mosquito species in Maryland to the larvicide temephos or the adulticide malathion was studied. The susceptibility of Culex spp. to temephos has declined in most areas of Maryland since 1967; however, only one strain of Culex pipiens was found to be temephos resistant in this study. Aedes sollicitans, Ae. albopictus and Ae. taeniorhynchus were temephos susceptible. All mosquitoes tested in the adult stage were susceptible to malathion.

Aedes↗
PubMedDate not supplied

Antibiotic therapy for Lyme disease in Maryland.

The recommended treatment of Lyme disease is evolving and important questions remain unanswered, such as (a) Are inexpensive oral regimens effective in curing acute illness and preventing arthritic, neurologic, and cardiac manifestations or are much more costly, and potentially toxic, intravenous antibiotics required? (b) Are relatively short 2- to 3-week courses of antibiotics sufficient or are prolonged regimens of a month, or more, better? This study reviews antibiotic therapy prescribed by Maryland physicians for the 283 cases reported in 1991 that meet the Centers for Disease Control and Prevention's case definition for Lyme disease. The purpose of the review was to obtain baseline information on the antibiotics being used by physicians in practice to treat patients that they believe have Lyme disease. The most frequently prescribed antibiotics for either the 60 percent of patients presenting with erythema migrans or the 40 percent with arthritic, neurologic, or cardiac manifestations were oral doxycycline (47 percent), tetracycline (11 percent), and amoxicillin (13 percent). Seventy-one percent of therapeutic courses were for 2 to 3 weeks. Amoxicillin was used in two-thirds of children younger than 8 years. Sixty (21 percent) received intravenous therapy, of which ceftriaxone, with or without other antibiotics, was almost always (95 percent) used. Intravenous therapy was more frequently given to those with arthritic, neurologic, and cardiac manifestations than to those with erythema migrans (odds ratio = 3.7) and to those with these systemic symptoms along with erythema migrans than to those with erythema migrans alone (odds ratio = 3.8). The average course was 2 days longer in treating those with arthritic, neurologic, or cardiac manifestations than in treating those with erythema migrans alone(P = 0.05).An epidemiologic assessment of antibiotics prescribed by the physicians in Maryland to treat Lyme disease in 1991 shows the choices, dosage, and duration of drugs generally followed those most frequently recommended in the literature. Also, it shows that efforts to educate physicians should be directed more towards the diagnosis rather than the treatment of Lyme disease.

Administration, Oral↗
PubMed1994

Cancer mortality in Maryland: when being a leader is not best.

Maryland has the second highest statewide cancer mortality rate in the nation. This ranking is primarily due to high death rates for the most prevalent cancers: lung, breast, colon, and prostate. Based on the recent literature and the October 1991 preventive medicine grand rounds at the Johns Hopkins University School of Hygiene and Public Health, this paper summarizes several current viewpoints on cancer mortality in Maryland and the progress that has been made by recently instituted state and community initiatives.

Female↗
PubMed1995

Hospital admissions of HIV-infected patients from 1988 to 1992 in Maryland.

To determine how the patterns of inpatient hospital care for HIV-infected patients have evolved in recent years, we analyzed data obtained from a statewide hospital discharge database from Maryland for the years 1988, 1990, and 1992. For each of these years, we compared demography, diagnoses, lengths of stay, use of the intensive care unit, third-party payer, and hospital charges (inflation-adjusted to 1992 dollars). HIV-infected patients accounted for 0.42% of all Maryland's hospital admissions in 1988, 0.68% in 1990, and 1.1% in 1992, with progressively more women and African-Americans hospitalized. Average lengths of stay fell from 11.7 days (1988) to 10.7 days (1990) and 9.5 days (1992) (p < 0.0001). Average charges per admission fell from $11,634 (1988) to $9,938 (1990) and $8,618 (1992) (p < 0.0001). Medicare or Medicaid paid for 50.9% of hospital admissions in 1988, 56.8% in 1990, and 66.8% in 1992 (p < 0.001). In-hospital mortality rates (7.8% in 1988, 7.9% in 1990, and 7.7% in 1992; p = 0.783) were stable, as was severity of illness. P. carinii pneumonia (PCP) was the most common principal diagnosis, but it declined in prevalence from 13.6% in 1988 to 9.1% in 1992 (p < 0.0001). Principal diagnoses of other opportunistic infections remained stable (8.0% in 1988, 9.9% in 1990, 8.6% in 1992; p = 0.90), as did other nonopportunistic infections (32.8% in 1988, 27.2% in 1990, and 30.0% in 1992; p = 0.16). Non-PCP pneumonias increased from 7.6% (1988) to 10.2% (1992) (p < 0.0001). Substance abuse as a principal or secondary diagnosis increased from 30.9% (1988) to 34.3% (1992) (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1993

Multistate outbreak of viral gastroenteritis related to consumption of oysters--Louisiana, Maryland, Mississippi and North Carolina, 1993.

On November 17, 1993, the state health departments of Louisiana, Maryland, and Mississippi notified CDC of several outbreaks of gastroenteritis occurring in their states since November 12. Preliminary epidemiologic investigations identified consumption of oysters as the primary risk factor for illness. On November 16, the Louisiana Department of Health and Hospitals (LDHH) had identified the Grand Pass and Cabbage Reef harvesting areas off the Louisiana coast as the source of oysters associated with outbreaks in Louisiana and Mississippi. Tagged oysters associated with outbreaks in Maryland were traced to the same oyster beds. The oysters harvested from these areas had been distributed throughout the United States. On November 18 and 19, the LDHH and CDC notified state epidemiologists of the potential for oyster-associated illness; outbreaks of oyster-associated gastroenteritis subsequently were identified in Florida and North Carolina. Collaborative investigations by state health officials, the Food and Drug Administration (FDA), and CDC were initiated to determine the magnitude and characteristics of the multistate outbreak, identify the etiologic agent, and trace the oysters. This report summarizes the preliminary findings of the ongoing investigation.

Acute Disease↗
PubMed1993

Handwashing and glove use in a long-term-care facility--Maryland, 1992.

Residents of long-term-care facilities (LTCFs) are at risk for acquiring facility-associated infections and consequent mortality (1,2). Despite this risk, no national guidelines exist for infection-control practices in LTCFs, and information regarding the nature of infection-control practices in LTCFs is limited. To evaluate glove use and handwashing practices in an LTCF, and to determine factors associated with compliance with infection-control policies and the frequency of microbial transmission, Maryland Department of Health and Mental Hygiene (DHMH) and CDC staff observed glove use and handwashing practices on a chronic-care ward of an LTCF in Maryland for a 1-month period during 1992. This report summarizes the findings of this study.

Gloves, Surgical↗
PubMedDate not supplied

Congenital syphilis in Maryland, 1989-1991: the effect of changing the case definition and opportunities for prevention.

BACKGROUND: The reported incidence of congenital syphilis in the United States rose dramatically during the 1980s. Although lack of prenatal care has been associated with congenital syphilis, little has been published regarding missed opportunities for prenatal intervention. GOAL OF THIS STUDY: To determine whether congenital syphilis increases in Maryland between 1989 and 1991 resulted from a true increase in congenital syphilis incidence or a change in the surveillance case definition, and to describe missed opportunities for prenatal intervention. STUDY DESIGN: This was a retrospective cohort study. RESULTS: When the revised case definition was used, a 473% increase in the number of cases was seen. Among infants who met the revised definition, 45% of mothers had received no prenatal care. Among those whose mothers had received prenatal care, opportunities to intervene were missed for 53%. CONCLUSIONS: Although a true increase in congenital syphilis incidence occurred before 1990, the increase reported in Maryland between 1989 and 1991 was primarily due to the change in case definition. Many cases of congenital syphilis could have been prevented with early and adequate prenatal care.

Adolescent↗
PubMedDate not supplied

Field investigation of Mycoplasma gallisepticum infections in house finches (Carpodacus mexicanus) from Maryland and Georgia.

A field study investigating the occurrence of Mycoplasma gallisepticum (MG) in house finches (Carpodacus mexicanus) was conducted in Maryland and Georgia. Eighty-eight finches were captured and examined grossly and microscopically for MG-related conjunctivitis. Serum samples were obtained for serum plate agglutination (SPA) and hemagglutination inhibition (HI) testing. Swabs from conjunctiva, sinus, and choanal cleft were inoculated into two mycoplasma broth media for culture and polymerase chain reaction (PCR) testing. From Maryland, 12 of 57 birds examined had gross conjunctival lesions. MG was isolated from 9 of the 12 affected birds and from three birds without gross lesions. Fourteen of 22 finches tested by PCR were positive for MG. Sixteen of 38 birds were positive for MG by SPA, and 9 of these had HI titers of 1:40 or 1:80. From Georgia, 3 of 31 finches examined had gross lesions; two of these were both culture and PCR positive for MG. Twelve birds were positive by SPA, and two of these had HI titers of 1:80. Histologic findings in birds with gross conjunctivitis from both locations were characterized by extensive epithelial and lymphoid hyperplasia as well as lymphoplasmacytic inflammation in conjunctival tissues; keratitis was rarely present. The source of MG infection in house finches is unknown, and further research is warranted to determine the prevalence and impact of this newly described disease.

Agglutination Tests↗
PubMed1996

Human ehrlichiosis--Maryland, 1994.

Ehrlichiosis is an emerging tickborne infectious disease caused by obligate intracellular, gram-negative rickettsia that infect leukocytes. Human monocytic ehrlichiosis (HME) is caused by Ehrlichia chaffeensis and is believed to be transmitted by Amblyomma americanum (the Lone Star tick). Most HME cases have been reported in southeastern and south-central states. During May-July 1994, five cases of serologically confirmed HME were identified among residents of Maryland. All five persons lived near the Chesapeake Bay and had antecedent histories of tick exposure. This report summarizes the clinical and epidemiologic features of these cases and the results of serologic testing at CDC of specimens from Maryland residents with suspected tickborne infection.

Adult↗