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At least 217 records · Page 12Linked to original sources
PubMed2000

Glaucoma and race: a case for screening in Connecticut.

This study is a review of the current literature regarding the relationship of primary open angle glaucoma and race. There is strong evidence that blacks have a much higher prevalence rate of this disease. They also tend to have a more severe clinical course. Glaucoma is the leading cause of irreversible blindness in blacks. The number of blacks in Connecticut with glaucoma is estimated to be between 14,000 and 21,000, and it is estimated that up to half of these cases are currently undetected. New technology has made screening for glaucoma more practical and cost-effective. This study suggests that glaucoma screening would be beneficial for the black population of Connecticut.

Black People↗
PubMed2000

Adoption of perinatal group B streptococcal disease prevention recommendations by prenatal-care providers--Connecticut and Minnesota, 1998.

Group B streptococcal (GBS) infections are the leading bacterial cause of serious neonatal disease in the United States (1). In 1996, in collaboration with the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, CDC issued consensus guidelines for preventing perinatal GBS disease (2-4). These guidelines recommend using either a screening-based or a risk-based strategy to identify women who should receive intrapartum antimicrobial prophylaxis. To assess adoption of the GBS disease prevention guidelines, the Connecticut and Minnesota state health departments surveyed prenatal-care providers during January-April 1998. This report presents the survey findings, which indicate that most prenatal-care providers in Connecticut and Minnesota have adopted perinatal GBS disease prevention policies and that strategy choice may vary by state and provider type.

Connecticut↗
PubMedDate not supplied

Birth weight, maternal age, and education: new observations from Connecticut and Virginia.

It has been well established that increased maternal education, income, and social status contribute to increased birth weight, as well as reduced risk for low or very low birth weight offspring. However, there remains controversy about the mechanism(s) for this effect, as well as the interactions between these factors, maternal age, and race. Presented here is the analysis of a large, recent sample of over 20,000 consecutive live births in 12 hospitals, about half in Connecticut and half in Virginia, including a maternal population that is educationally and racially diverse. Although information on potentially relevant details such as prenatal care, smoking, occupation, and neighborhood is lacking the data set, there is sufficient information to explore the previously noted strong effect of maternal education on birth weight, as well as the large racial difference in outcome at every educational level after adjustment for the effects of age, marital status, state of residence, and gender of the offspring. However, this relationship was not monotonic, and there were differences in the effect between the white and black families, with black women showing a linear and consistent benefit from education across the range, while whites show a sharp benefit from completion of primary education, less from subsequent schooling. A surprising result was the apparent negative impact of very advanced education (>16 years), with lowered birth weights and higher risk of low birth weight offspring in the women with post-college training. The data also shed some addition light on the effect of age and birth weight. Whites show established improvement in birth outcome to about age 30, with slight decline thereafter, whereas in blacks there was progressive decline in birth weight with rising age starting in adolescence, as previously demonstrated by Geronimus. An additional unexpected observation was a sizable difference between births in Connecticut (larger, fewer low birth weight) than Virginia, correcting for all other covariates. It is hypothesized that this may reflect differences in services used, prenatal care in particular given similarities in smoking rates and other predictors. Because of the non-representativeness of and the limited information available in the present study, the conclusions should be taken as hypotheses for further research rather than definitive.

Adolescent↗
PubMed2000

Confidentiality of medical records: an overview for the Connecticut physician.

An ongoing concern for physicians and their patients is protecting the confidentiality of medical records. The proliferation of electronic methods for collecting and storing medical information, along with the growing complexity of the health-care system, has created the need for new means to protect confidentiality. Currently, a patchwork of protections requires that physicians keep patients' medical information confidential. This article reviews the three major sources of medical confidentiality protections: Connecticut law, federal law, and professional standards, all of which provide an array of protections. A brief summary of proposed federal and state legislation is also included. The challenge of effectively maintaining confidentiality in today's electronic age has prompted the Connecticut General Assembly, Congress, and other federal agencies to consider additional safeguards. The article summarizes the relevant legal framework in order to orient medical professionals to the complexities, practice challenges, and legal aspects of maintaining confidentiality.

Confidentiality↗
PubMed2001

Serosurveys for West Nile virus infection--New York and Connecticut counties, 2000.

In 2000, 21 persons were reported with acute illness attributed to West Nile virus (WNV) infection; 19 were hospitalized with encephalitis or meningitis. Of the 21, 10 resided in the Staten Island borough (Richmond County) of New York City. Other ill persons resided in nine other counties--Kings (Brooklyn), New York (Manhattan), and Queens counties in New York; Hudson, Passaic, Monmouth, Morris, and Bergen counties in New Jersey; and Fairfield County in Connecticut. Because ill persons represent only a fraction of the persons who are infected, many more persons probably were infected in 2000. To determine the prevalence of recently acquired WNV infection and associated risk factors for infection, random household cluster serosurveys were conducted in Staten Island and portions of Fairfield County, Connecticut, and Suffolk County, New York, during October-November 2000. All three areas had intense WNV epizootics as determined by avian mortality and mosquito surveillance systems. This report summarizes the preliminary results of this survey and indicates that in areas with intense epizootic WNV activity, asymptomatic or mildly symptomatic human infections can occur.

Adolescent↗
PubMed1975

The Model Postmortem Examinations Act in the State of Connecticut, 1969-1974.

Five years following the 1969 passage of legislation patterned after the Model Postmortem Examinations Act, Connecticut has a central laboratory with administrative, autopsy, and toxicology facilities; 24-hour statewide reporting deaths; a records and data-processing system; and affiliation with a university health center. The state's population density, number and size of municipalities and police departments, absence of county government, and judicial appointment of coroner's were unique geographic-political features confronting implementation of the legislation. To effect a transition from the preexisting system, and because of the number of deaths reported and physicians involved, a dual system was developed for examinations and certification of deaths which differentiated autopsies performed at the central laboratory from those at community hospitals. Dissemination of procedures and forms for medicolegal autopsies conducted at community hospitals is planned in the near future. Although educational programs for graduates and law enforcement personnel have been initiated, there still exists a need for more active undergraduate and postgraduate training and a program of research and statistical reporting. Implementation of the statutes during a five-year period in which supplemental legislation and regulations were passed, changes that occurred in state administration, and budgetary restrictions mandated by economic recession has, however, resulted in the nucleus of a modern state medicolegal investigative system--a separately budgeted medical examiner's office, supervised by an independent administrative commission and located on the grounds of the University of Connecticut Health Center in Farmington.

Administrative Personnel↗
PubMed2002

Connecticut RxData project.

The Connecticut Hospital Association has developed a data resource for inpatient pharmacy information. The RxData project collects drug dispensing information from member hospitals and joins it to administrative discharge data in the Chime database. The resulting dataset is useful for descriptive epidemiology of drug use patterns as well as surveillance, quality improvement, and some hypothesis testing. The drug identity is derived from the National Drug Code submitted by hospital pharmacies. A drug reference file is used together with these codes for hierarchical analysis. Data are accepted from participating facilities in a variety of formats and mapped to a common schema. The program uses locally developed roll-up logic to overcome the lack of consistent standards for recording inpatient drug order and dispense information. Dispensing records at different levels of aggregation are collected from source pharmacy information systems and converted to a standard "regimen" based on continuous dispensing of the same drug. The resulting record structure allows direct comparison of data from dissimilar systems. Data are currently available for eleven acute care hospitals and most of their associated emergency and outpatient surgery facilities. The program is expected to expand to cover most if not all Connecticut hospitals over the next two to three years.

Clinical Pharmacy Information Systems↗
PubMed2002

How can we improve care at the end of life in Connecticut? Recommendations from focus groups.

A qualitative study to elicit views among residents of Connecticut about death, dying, preferences for care, and gaps in available care was conducted for the Connecticut Coalition to Improve End-of-Life Care. Twenty-eight focus groups were convened across the state between May 1999 and March 2001. The focus groups included adolescents and adults from diverse religious, ethnic, and professional backgrounds. A total of 196 individuals participated in the 90-minute sessions. Trained moderators conducted the discussion groups following a guide. Transcriptions of the groups were coded to identify themes. Thirty-two recommendations to improve care based on the focus group discussions are presented. These are grouped under the following actions: 1) enhance public education; 2) offer better professional provider education and support; and 3) augment services. The recommendations are illustrated with quotations from the focus groups.

Connecticut↗
PubMed2002

Neonatologists' opinions regarding resuscitation of extremely premature infants in Connecticut and Rhode Island.

OBJECTIVE: To characterize the range of opinions among neonatologists in Connecticut and Rhode Island regarding the gestational age at which they would support parental resuscitation or nonresuscitation requests for infants born at 21-27 weeks. METHODS: Anonymous questionnaire mailed to 70 Connecticut and Rhode Island neonatologists detailing specific resuscitation scenarios and hypothetical guidelines regarding management of premature infants. RESULTS: Response rate was 69%. Nine percent of neonatologists would never reject a parental resuscitation request. Ninety-one percent would reject a resuscitation request at 21 weeks, 67% at 22 weeks, and 11% at 23 weeks. Fifty-three percent would refuse a nonresuscitation request at 24 weeks, 96% at 25 weeks, and 100% at 26 weeks. CONCLUSIONS: The majority of neonatologists would not resuscitate infants born at < or = 22 weeks and would resuscitate infants born at > or = 25 weeks gestational age despite parental wishes to the contrary.

Adult↗
PubMed2003

A checklist of the mosquitoes of Connecticut with new state records.

Distribution and collection records for 3 previously unrecognized species, Anopheles barberi, Culex erraticus, and Ochlerotatus diantaeus, are included herein. This brings to 48 the number of recognized species from 11 genera in Connecticut. Also, an updated checklist of the mosquitoes of Connecticut that reflects the recent elevation of the subgenus Ochlerotatus to generic rank is presented.

Animals↗
PubMedDate not supplied

Surgery for congenital heart disease in low-birth weight neonates: a comprehensive statewide Connecticut program to improve outcomes.

Low-birth weight (LBW) remains a significant risk factor in surgery for congenital heart disease (CHD). The timing of surgery and the choice of complete repair vs palliative measures are controversial issues. Delay of surgery to achieve weight gain may result in poorer outcomes. The results of a statewide, cardiac surgery protocol in LBW infants using specific selection criteria for repair vs palliation or delay over a 42-month period are reviewed. From September 1999 through February 2003, 32 low-birth weight infants (1,320 to 2,500 grams) underwent surgery for congenital heart disease in Connecticut. The congenital heart surgery programs in the two major pediatric centers in the state (Yale-New Haven Hospital and Connecticut Children's Medical Center) were amalgamated to form a joint program, with the same surgical team involved in all cases. Median gestational age was 34 weeks with 18 (60%) premature (< or = 37 wks). Median age at operation was eight days. Fourteen infants (44%) had recognized syndromes. Primary diagnoses included variant of single ventricle (8), ventricular septal defect (VSD) (4), tetralogy of Fallot (TOF) (2), pulmonary atresia (PA) with VSD (3), simple transposition of the great arteries (TGA) (1), TGA with VSD (TGA/VSD) (2), atrioventricular canal (AVC) (4), double outlet right ventricle (DORV) (3), aortic coarctation (CoA) (2), and interrupted aortic arch with VSD (IAA/VSD) (3). Eighteen patients (56%) were able to undergo procedures resulting in normal biventricular physiology. Eight patients (25%) had palliation for single ventricle, including two Norwood procedures. Seven patients potentially suitable for biventricular repair underwent palliative surgery because of contraindications to complete repair that were unrelated to weight. Follow-up (100%) ranged from two to 41 months. There were two early deaths (6%), one cardiac related (Norwood with ischemia), and one with sepsis. There was one early reintervention (PA stenosis following arterial switch). There were seven late deaths (22%), two cardiac related (one sudden death following Blalock-Taussig (BT) shunt, one sepsis related to low output), and four noncardiac. In three patients who received pulmonary artery banding (PAB), delay of surgery may have contributed to death due to progressive pulmonary disease. Of 23 long-term survivors, five have undergone biventricular repair following palliation, and two have had further palliation for univentricular heart physiology. A strategy of early surgical intervention favoring primary repair, or surgical palliation for those patients with single ventricle, results in good overall survival in symptomatic low-birth weight neonates with congenital heart disease. Delay in surgery due to LBW may not be beneficial in most cases and could result in lower overall survival and increased cost. A program utilizing statewide resources results in excellent outcomes for this challenging group of patients.

Connecticut↗
PubMed1992

Community awareness and use of HIV/AIDS-prevention services among minority populations--Connecticut, 1991.

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS)-prevention efforts supported by the federal government include programs offered through community-based organizations (CBOs) and state and local health departments (1). To assess the extent of community awareness and use of these HIV/AIDS-prevention services among Hispanics and non-Hispanic blacks in three cities in Connecticut, the Connecticut State Department of Health Services (CSDHS) included questions on HIV/AIDS-prevention programs in its population-based chronic disease and health risk survey. This report summarizes survey results regarding awareness and use of these community-based programs during 1991.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Hepatitis C virus and risk of non-Hodgkin lymphoma: a population-based case-control study among Connecticut women.

OBJECTIVES: Previous epidemiologic studies of hepatitis C virus (HCV) infection and B-cell non-Hodgkin lymphoma (B-NHL) have yielded conflicting results, perhaps due to differences in the classification of B-NHL and the choice of non-population-based control groups that may not reflect the background population prevalence of HCV. To further investigate the link between HCV and NHL, we conducted HCV testing on serum samples of 998 women (464 cases; 534 controls) from a population-based case-control study of women in Connecticut. METHODS: Serum samples were screened for HCV antibodies using an enzyme immunoassay; positive samples were confirmed by additional testing for HCV antibodies and for serum HCV RNA. RESULTS: Approximately 2% (8 of 464) of cases and 1% (5 of 534) of controls tested positive for HCV. The risk of NHL associated with HCV infection appeared to be concentrated among B-cell lymphomas [odds ratio (OR) 2.0; 95% confidence interval (CI) 0.6, 8.2], particularly among follicular lymphomas (OR 4.1, 95% CI 0.8, 19.4). CONCLUSIONS: The primary strength of this study is our use of a population-based study design, although the low prevalence of HCV among women in Connecticut resulted in wide CIs for the estimated association between HCV and B-NHL subtypes. Our study suggests that HCV may be associated with increased risk of development of B-NHL, and that this risk may vary by B-NHL subtype among women. Due to the relatively low prevalence of HCV in our study population and the scarcity of population-based epidemiological research on this subject, our study highlights the need for additional large, population-based studies of the role of HCV in the etiology of B-NHL.

Adult↗
PubMed2004

Aseptic meningitis outbreak associated with echovirus 9 among recreational vehicle campers--Connecticut, 2003.

Aseptic meningitis is an inflammation of the tissues covering the brain and spinal cord and caused by a virus, most frequently an enterovirus. In August 2003, the Connecticut Department of Public Health (CDPH) received a report of three viral meningitis cases among recreational vehicle (RV) campers staying at a campground in northeastern Connecticut. CDPH, assisted by CDC, conducted an investigation, which 1) identified a total of 12 cases of aseptic meningitis and 24 cases of enterovirus-like illness among 201 campers interviewed, 2) demonstrated how transmission of enterovirus from persons with mild illness contributed to the aseptic meningitis outbreak, and 3) determined that crowded conditions inside RVs and in the campground swimming pool likely facilitated spread of enterovirus. Pool operators should check chlorine and pH levels frequently, particularly during peak pool occupancy; adults should take precautions against passing enterovirus to children, who are at greater risk for severe illness.

Adolescent↗
PubMedDate not supplied

[Medicolegal investigation system in the state of Connecticut].

The paper explains the organization of medicolegal investigation system conducted in the State of Connecticut and regulated by the law of that state. The author presents issues connected with reportable deaths, possible types of medicolegal investigations, people responsible for deciding whether autopsy should be performed, individuals responsible for conducting autopsy, and other responsibilities of medical examiners in association with medicolegal investigations. The paper does not provide a detailed description of the organizational structure and legal basis of the medical examiner system in Connecticut due to space limitations.

Autopsy↗
PubMed2006

Profiling variations in outpatient care for Medicare beneficiaries in Connecticut.

Qualidigm, the Medicare Quality Improvement Organization for Connecticut, is reporting the rates of four outpatient services for Medicare beneficiaries on its website (www.qualidigm.org). These measures include screening for breast cancer (mammography) and chronic disease management for diabetes (HbAlc, eye exam and lipid profile). Maps of Connecticut illustrate the rates for Whites and Non-whites by Health Service Area. The maps highlight variation across small local areas and between Whites and Non-whites. By reporting these rates publicly, Qualidigm hopes to facilitate ongoing efforts by community organizations and health care providers to make improvements in care, especially for the underserved populations throughout the state.

Ambulatory Care↗
PubMed2007

Laboratory-confirmed non-O157 Shiga toxin-producing Escherichia coli--Connecticut, 2000-2005.

Shiga toxin-producing Escherichia coli (STEC) infection causes diarrhea that is often bloody and can result in potentially life-threatening hemolytic uremic syndrome (HUS). Escherichia coli O157:H7 is the most common cause of STEC infection in the United States, producing 73,000 illnesses annually, according to the last estimate in 1999. Unlike O157, however, little is known about the incidence of non-O157 strains. Because STEC other than O157 are not commonly identified, the incidence, trends, and epidemiology of non-O157 STEC are not well understood. To assess trends in Shiga toxin enzyme immunoassay (Stx EIA) testing by local clinical laboratories, the Connecticut Department of Public Health (CTDPH) analyzed results of confirmatory testing conducted in the state laboratory during 2000--2005. The findings indicated that a total of 403 STEC infections were reported by clinical laboratories in Connecticut, including 207 identified as STEC by Stx EIA testing alone, and that the use of Stx EIA increased from 2000 to 2005. Use of Stx EIA without prompt culture confirmation can delay or prevent serotyping and subtyping of isolates and detection of both O157 and non-O157 STEC outbreaks. Public health authorities in all states should ensure that clinical laboratories forward Stx EIA-positive specimens to the state laboratory for isolation and identification of STEC, as recommended by the Association of Public Health Laboratories and CDC.

Clinical Laboratory Techniques↗
PubMed1992

Early childhood vaccination levels among urban children--Connecticut, 1990 and 1991.

In the United States, the high incidence of measles among urban preschool-aged children who had not received age-appropriate vaccination has focused attention on the adequacy of and barriers to early childhood vaccinations. To assess early childhood vaccination levels of urban Connecticut children, during fall 1990 and spring 1991, the Connecticut Department of Health Services conducted retrospective surveys of first-grade students in Hartford and New Haven, both with populations greater than 100,000 persons.

Child, Preschool↗