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PubMed1998

First reported case of hantavirus pulmonary syndrome in Oklahoma.

Hantavirus Pulmonary Syndrome (HPS) is a condition of rapidly progressive pulmonary failure with a case-fatality rate of almost 50 percent. Rodents serve as the reservoir for hantaviruses and human infection occurs primarily via aerosolized virus in rodent excreta. The rodent reservoir for the disease is widespread across Oklahoma and the first case of HPS has recently been confirmed in an Oklahoma resident. Physicians should suspect HPS in a previously healthy person who develops a febrile illness and respiratory insufficiency and has potentially been exposed to the virus. Common laboratory findings include a left-shifted neutrophilic leukocytosis, elevated hematocrit and thrombocytopenia. Therapy is supportive. If HPS is suspected, the patient should be immediately transferred to a facility that can provide aggressive supportive care.

Adult↗
PubMedDate not supplied

Vaginal birth after cesarean section: a comparison of rural and metropolitan rates in Oklahoma.

The rate of cesarean delivery has risen steadily over the past fifteen years from a rate of 17% in 1980 to 24% in 1995. In an effort to curb medical expenses and reduce the risk associated with operative delivery, many suggestions have been proposed to reduce the rate of cesarean sections. The most promising of these is to reduce the number of repeat cesarean deliveries through vaginal birth after cesarean section (VBAC). For fifteen years the American College of Obstetrics and Gynecology has proposed VBAC as a safe alternative to repeat C-section. VBAC carries a 1% to 2% risk of uterine rupture and is contraindicated in the presence of previous classical uterine incision, multiple gestation, and certain abnormal presentations. In the absence of contraindications, VBAC is as safe or safer than repeat C-section. This study shows that VBAC rates are lower in two rural hospitals than in two urban hospitals in Oklahoma. Data was collected from two rural and two urban hospitals for the years 1993 through 1996. This data indicates that in urban hospitals the rate of vaginal deliveries (81%) is higher and the rate of C-sections (19%) is lower than in rural hospitals (68% and 31% respectively). Also, the rate of attempted VBAC (46%) and successful VBAC (36%) is higher in urban hospitals than in rural hospitals (30% and 18% respectively). The lower rate of VBAC in rural hospitals can be explained by several factors, including lack of in-house physicians, anesthesia, and surgical crews; inadequate neonatal intensive care units; difficulty of transfer; economic factors; physician training or experience; and physicians' attitudes. This study points to a need for a larger scale study of VBAC practices among rural and urban physicians in Oklahoma.

Cesarean Section, Repeat↗
PubMed1992

Humoral responses following immunization with Leishmania infantum (ex. Oklahoma): a comparison of adjuvant efficacy in the antibody responses of Balb-C mice.

Adjuvants are commonly used in immunization protocols for the purpose of augmenting immune responses to antigens. The antigenic profile of Leishmania infantum (ex. Oklahoma) is described and the efficacies of three adjuvants delivered coincidentally with killed promastigotes are compared, by measuring relative serologic responses of Balb-C mice to specific antigenic determinants. Western blotting techniques were employed to visualize humoral responses to isolated antigens; serologic profiles were compared and contrasted. Four immunization protocols utilizing Freund's complete adjuvant, glucan adjuvant, lipovant adjuvant or phosphate-buffered saline, in conjunction with killed L. infantum (ex. Oklahoma) promastigotes were executed in parallel. All groups receiving adjuvant protocols developed enhanced serologic responsiveness. Similar profiles were observed in mice treated with glucan or lipovant. Animals receiving promastigotes in Freund's complete adjuvant also developed strong humoral responses, binding cross-reactive epitopes not recognized by other groups. Our findings indicate that glucan and lipovant present effective adjuvant alternatives, to Freund's complete adjuvant and may be of value in immunization against visceral leishmaniasis.

Adjuvants, Immunologic↗
PubMed2002

Disaster mental health services following the 1995 Oklahoma City bombing: modifying approaches to address terrorism.

How did the 1995 Oklahoma City bombing differ from prior disasters and what implications did it have for disaster mental health services and service delivery? The federal disaster mental health approach in this country developed largely out of experiences with natural disasters. The 1995 Oklahoma City bombing differed in several important ways, including the large number of human casualties, higher rates of psychopathology, and an extended period of concern due to the criminal investigation and trials, which suggested the need to consider modifications in the program. Outreach was extensive, but psychiatric morbidity of direct victims was greater than that of victims of natural disasters, emphasizing the need for attention to the triage and referral process. Other concerns that warrant consideration include practices related to record keeping and program evaluation.

Journal Article↗
PubMed2000

Role of sea surface temperature and soil-moisture feedback in the 1998 Oklahoma-Texas drought.

The drought that affected the US states of Oklahoma and Texas in the summer of 1998 was strong and persistent, with soil moisture reaching levels comparable to those of the 1930s 'dust bowl'. Although other effects of the record-strength 1997-98 El Niño were successfully predicted over much of the United States, the Oklahoma-Texas drought was not. Whereas the response of the tropical atmosphere to strong anomalies in sea surface temperature is quite predictable, the response of the extratropical atmosphere is more variable. Here we present results from mechanistic experiments to clarify the origin and maintenance of this extratropical climate extreme. In addition to global atmospheric models, we use a regional model to isolate regional climate feedbacks. We conclude that during April and May 1998, sea surface temperature anomalies combined with a favourable atmospheric circulation to establish the drought. In June-August, the regional positive feedback associated with lower evaporation and precipitation contributed substantially to the maintenance of the drought. The drought ended in the autumn, when stronger large-scale weather systems were able to penetrate the region and overwhelm the soil-moisture feedback. Our results show the potential for numerical models including appropriate physical processes to make skillful predictions of regional climate.

Journal Article↗
PubMed1988

Characteristics of fatal gunshot wounds in the home in Oklahoma: 1982-1983.

Children are a unique group at risk of injury from firearms because of their immaturity, curiosity, and imitative behavior. All unintentional firearm deaths in persons younger than age 20 years that occurred in Oklahoma in 1982 and 1983 were reviewed. There were 32 unintentional deaths from firearms in children from birth to age 19 years. The death rate in rural counties was four times that of urban counties. Twenty-seven deaths (85%) occurred at home, with an adult present in only two cases. The home death rate for males was 5.2 times that of females, with 15- to 19-year-old males most at risk. The rates among whites and Native Americans were similar, at 1.5 and 1.2 per 100,000, respectively, with no deaths among the black population. This review concurs with previous studies that firearms are a significant cause of mortality in the pediatric age group. Counseling parents about the hazards of firearms may prevent deaths through better supervision and more responsible gun care and storage.

Accidents, Home↗
PubMed1996

Psychological response to the Oklahoma City bombing.

The bombing of the Alfred P. Murrah Federal Office Building in Oklahoma City was the most devastating terrorist activity that has occurred in America. Prevention of revictimization of persons seriously affected by the bombing was central to the planned response to this tragedy. Coordination and collaboration among local, state, and national agencies promoted effective clinical services provision, research facilitation, and prevention of revictimization. Information gathered from this cooperative effort will contribute to the effort to minimize the potential for such tragedies in the future as well as help to develop prevention and intervention strategies to reduce the effects when the next such disaster occurs.

Adaptation, Psychological↗
PubMed2004

Genetic signatures of pre-expansion bottleneck in the Choctaw population of Oklahoma.

Previous research showed that the Choctaw Indians of Oklahoma exhibit considerable linkage disequilibria (LD) in a number of regions of the genome that has allowed genetic fine mapping for potential susceptibility genes for the autoimmune connective tissue disease scleroderma, or systemic sclerosis (SSc). In principle, such enhanced background LD in the Choctaws could be caused by population bottleneck event(s) followed by recent population expansion. This investigation utilizes genome-scan data on 175 dinucleotide loci from 76 Choctaw individuals to seek genetic evidence of the demographic history of the Choctaw Nation. Of the 175 loci examined, 105 are in Hardy-Weinberg equilibrium. The average unbiased homozygosity over the 105 loci for the Choctaws (29.3%) is significantly higher than that in the European descent group (20.9%); and when adjusted for sample-size differences, the Choctaw also exhibit a significantly smaller number of segregating alleles (6.65 vs. 8.14) at these loci. Both of these observations are consistent with the trend expected in an isolated population. Comparison of the allele size variance and gene diversity yields an imbalance index (lnbeta) of 0.811 in the Choctaw. Of the 105 loci examined, 93 exhibit excess expected homozygosity in comparison to the expectations of a stepwise mutation model in a population of constant size. Taken together, these observations are consistent with a signature of the recent population size expansion of the Choctaws, preceded by bottleneck event(s).

Female↗
PubMed1996

Rheumatoid arthritis in a United States Public Health Service Hospital in Oklahoma: serologic manifestations in rheumatoid arthritis vary among tribal groups.

OBJECTIVE: To study the serologic manifestations of rheumatoid arthritis (RA) at a United States Public Health Service Hospital that serves numerous tribes in Oklahoma. METHODS: Forty-five patients with RA were identified, and serologic studies for antinuclear antibody (ANA), rheumatoid factor, and antibodies to extractable nuclear antigens were performed. Extraarticular manifestations of RA were also evaluated. RESULTS: Twelve of the 45 patients with RA were Kiowa. These patients were significantly more likely to have a positive ANA (75%) than the other patients with RA (28%). In addition, anti-Ro was significantly more common among Kiowa (33%) than among members of other tribes (3%). There was no difference in the extraarticular manifestations of the Kiowa compared with the other Native American tribes. CONCLUSION: RA can be distinctly characterized by serology among groups of American Indians living in the same geographic area.

Adult↗
PubMed1991

Characteristics and outcomes of insanity acquittees in Oklahoma.

The insanity defense is perhaps the most vigorously debated topic at the interface of the legal and mental health systems. This article addresses the need for empirical evidence by providing data on insanity acquittees and their later outcomes in Oklahoma, a jurisdiction not previously studied. Information was obtained on the demographic, legal, psychiatric, hospitalization, and post-hospitalization characteristics of all 61 defendants acquitted not guilty by reason of insanity (NGRI) and treated on the state forensic unit during a 5-year period. Insanity acquittees had few resources, significant psychopathology, and extensive involvement with the legal and mental health systems prior to the NGRI offense. Follow-up of three groups of discharged patients--those released at an initial court review, those who completed the NGRI treatment program, and those who absconded from the forensic unit--revealed that those who escaped from the unit had significantly more arrests and subsequent legal charges than regularly discharged patients.

Adolescent↗
PubMed1994

Cross-placental transfer of organochlorine pesticides in Mexican free-tailed bats from Oklahoma and New Mexico.

A total of 41 pregnant Mexican free-tailed bats (Tadarida brasiliensis) were collected from Carlsbad Caverns, New Mexico, and Vickery Cave, Oklahoma, in May and June 1990 and May 1991 for organochlorine pesticide analyses. Residues of p,p'-DDE were detected by gas chromatography in 40 embryos at levels highly correlated with brain concentrations (r = 0.496) but were not correlated mother's body tissues (r = 0.060). Embryonic levels also did not correlate with either embryonic fat content (r = 0.018) or maternal fat content (r = 0.300), suggesting that placental membranes offer only marginal protection for developing embryos against exposure to lipophilic organochlorine pesticides.

Animals↗
PubMed1996

Organochlorine pesticide accumulation and genotoxicity in Mexican free-tailed bats from Oklahoma and New Mexico.

The summer population of Mexican free-tailed bats (Tadarida brasiliensis) at Carlsbad Caverns, New Mexico, declined from an estimated 8.7 million in 1936 to 200,000 in 1974; thereafter, it increased to approximately 700,000 in 1991. This decline has been attributed primarily to organochlorine (OC) pesticide contamination and habitat disturbance. Similar declines have been observed in other populations of this species. This study examined the potential genotoxic effects of OC pesticide contamination on two populations of T. brasiliensis. Pesticide accumulation, frequencies of chromosomal aberrancy, and nuclear DNA content variation in spleen and testicular tissues were examined in specimens collected from Carlsbad Caverns and Vickery Cave, a maternity colony in northwestern Oklahoma, during the summers of 1990 and 1991. Pesticide residues in brain and carcass tissues were identified and quantified by electron capture gas chromatography. Genotoxicity was examined with the standard bone marrow chromosomal aberration assay and flow cytometry. Statistical relationships among pesticide content, observed chromosomal aberrancy, and nuclear DNA content variation were examined. Both populations demonstrated significant levels of DDE contamination; however, the Carlsbad Caverns population showed consistently higher pesticide loads. Males also demonstrated higher levels than females. No statistical differences in chromosomal aberrancy or nuclear DNA content variation were observed among sexes, sites, or collected periods. Positive correlations were detected between brain and carcass DDE concentrations for all bats examined. A significant negative relationship was found between brain DDE concentration and coefficients of variation in spleen DNA content only for males.

Analysis of Variance↗
PubMed1995

Seasonal distribution of pathogenic free-living amebae in Oklahoma waters.

Pathogenic free-living amebae cause serious human disease, including infection of the eye and the central nervous system. The purpose of this study was to sample aquatic environments in the Tulsa, Oklahoma, area year-round for the presence of these disease-causing amebae. A total of 34 pathogenic isolates were obtained from 2,016 processed water and swab samples. Pathogenicity was determined by the ability of amebae to cause death in mice after intranasal inoculation. Pathogenic amebae were isolated during every month of the year and were identified as Naegleria australiensis (38%), Acanthamoeba species (35%), N. fowleri (18%), and leptomyxid amebae (9%). Pathogenic leptomyxids have not previously been reported from the environment. The greatest percentage of recovery of pathogens occurred during the spring and autumn. The prevalence of pathogenic free-living amebae in the sampled waters was 1 pathogen/3.4 l water.

Acanthamoeba↗
PubMed1998

Oklahoma City: disaster challenges mental health and medical administrators.

Mental health and medical administrators responded to the Oklahoma City bombing with cooperative and overlapping efforts to meet community needs in the wake of terrorism. The major agencies assisted in the immediate rescue response, organized crisis hotlines, prepared mental health professionals to counsel bereaved families and victims, organized debriefing of rescuers, assessed mental health needs of local school children, planned for longer term treatment, and coordinated research efforts to learn from the disaster. Implications to mental health administrators responding to significant acts of terrorism are discussed.

Adult↗
PubMed2000

Predictors of post-traumatic stress symptoms in Oklahoma City: exposure, social support, peri-traumatic responses.

Eighty-five adults seeking mental health assistance six months after the Oklahoma City bombing were assessed to determine which of three groups of variables (exposure, peri-traumatic responses, and social support) predicted development of post-traumatic stress disorder (PTSD) symptoms. Variables most highly associated with subsequent PTSD symptoms included having been injured (among exposure variables), feeling nervous or afraid (peri-traumatic responses), and responding that counseling helped (support variables). Combining primary predictors in the three areas, PTSD symptoms were more likely to occur in those reporting counseling to help and those feeling nervous or afraid at the time of the bombing. Implications of these findings are discussed for behavioral health administrators and clinicians planning service delivery to groups of victims seeking mental health intervention after terrorist attacks and other disasters.

Adult↗
PubMed2006

Carbon substrate utilization, antibiotic sensitivity, and numerical taxonomy of bacterial isolates from the Great Salt Plains of Oklahoma.

The current work extends the phenotypic characterization of a bacterial culture collection from the Great Salt Plains of Oklahoma. This barren expanse of mud flats is typically crusted with thalassohaline salt evaporites. The initial account of the aerobic heterotrophic bacteria from the Great Salt Plains described 105 halotolerant isolates that represented 47 phylotypes. Extensive phenotypic analyses were performed on 76 isolates representing 37 unique phylotypes. The current report extends these observations for 60 of the isolates by measuring a wider set of phenotypic characteristics. Utilization patterns for 45 carbon substrates were used to assign the isolates into seven coherent phenons, along with several singletons and a group of isolates that did not grow on single carbon substrates. Most of the isolates were able to utilize nearly all of the nitrogen sources tested, with nitrate being the least utilized. Little antibiotic resistance was seen in the collection as a whole; however, certain phenons were enriched for antibiotic-resistant organisms. A total of 81 phenotypic characteristics were used to generate dendrograms. The numerical taxonomy trees essentially agreed with those generated using 16S rRNA gene sequences. The pattern of carbon substrate utilization showed substantial changes at different salinities that may have relevance to the variable salinities microbes experience at the Salt Plains over time.

Anti-Bacterial Agents↗
PubMed2005

Zinc and lead poisoning in wild birds in the tri-state mining district (Oklahoma, Kansas, and Missouri).

The Tri-State Mining District (Oklahoma, Kansas, and Missouri) is contaminated with Pb, Cd, and Zn from mining, milling and smelting. Metals have been dispersed heterogeneously throughout the District in the form of milled mine waste ("chat"), as flotation tailings and from smelters as aerial deposition or slag. This study was conducted to determine if the habitat has been contaminated to the extent that the assessment populations of wild birds are exposed to toxic concentrations of metals. American robins (Turdus migratorius), northern cardinals (Cardinalis cardinalis), and waterfowl had increased Pb tissue concentrations (p < 0.05) compared with Pb tissue concentrations from reference birds, and the exposure of songbirds to Pb was comparable with that of birds observed at other sites severely contaminated with Pb. Mean activities of the Pb-sensitive enzyme delta-aminolevulinic acid dehydratase (ALAD) were decreased by >50% in red blood cells in these birds (p < 0.05). Several birds had tissue concentrations of Pb that have been associated with impaired biological functions and external signs of poisoning. Cadmium was increased in kidneys of songbirds (p < 0.05), but no proximal tubule cell necrosis associated with Cd poisoning was observed. Zinc concentrations in liver and kidney of waterfowl were significantly higher (p < 0.05) than reference values. The increased environmental concentrations of Zn associated with mining in the District accounted for the pancreatitis previously observed in five waterfowl from the District. The District is the first site at which free-flying wild birds have been found to be suffering severe effects of Zn poisoning.

Animals↗
PubMed2005

Concentrations of cadmium, lead, and zinc in fish from mining-influenced waters of northeastern Oklahoma: sampling of blood, carcass, and liver for aquatic biomonitoring.

The Tri-States Mining District (TSMD) of Missouri (MO), Kansas (KS), and Oklahoma (OK), USA, was mined for lead (Pb) and zinc (Zn) for more than a century. Mining ceased more than 30 years ago, but wastes remain widely distributed in the region, and there is evidence of surface- and groundwater contamination in the Spring River-Neosho River (SR-NR) system of northeastern OK. In October 2001, we collected a total of 74 fish from six locations in the SR-NR system that included common carp (Cyprinus carpio), channel- and flathead catfish (Ictalurus punctatus and Pylodictis olivaris), largemouth- and spotted bass (Micropterus salmoides and Micropterus punctulatus), and white crappie (Pomoxis annularis). We obtained additional fish from locations in MO that included three reference sites and one site that served as a "positive control" (heavily contaminated by Pb). Blood, carcass (headed, eviscerated, and scaled) and liver (carp only) samples were analyzed for cadmium (Cd), Pb, and Zn. Our objectives were to assess the degree to which fish from the OK portion of the SR-NR system are contaminated by these elements and to evaluate fish blood sampling for biomonitoring. Concentrations of Cd and Pb in carp and catfish from OK sites were elevated and Pb concentrations of some approached those of the highly contaminated site in MO, but concentrations in bass and crappie were relatively low. For Zn, correlations were weak among concentrations in the three tissues and none of the samples appeared to reflect site contamination. Variability was high for Cd in all three tissues of carp; differences between sites were statistically significant (p < 0.05) only for blood even though mean liver concentrations were at least 100-fold greater than those in blood. Blood concentrations of Cd and Pb were positively correlated (r2 = 0.49 to 0.84) with the concentration of the same element in carp and catfish carcasses or in carp livers, and the corresponding multiple regression models were highly significant (p < or = 0.001). Our data indicate that potentially nonlethal blood sampling can be useful for monitoring of selected metals in carp, catfish, and perhaps other fishes.

Animals↗