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Mediastinal yolk sac tumor. The Indiana University experience, 1976 to 1988.

Mediastinal yolk sac tumor (endodermal sinus tumor) is an extremely rare extragonadal germ cell neoplasm that has been associated with a grave prognosis. Twenty-one male patients with mediastinal yolk sac tumor received treatment at Indiana University between 1976 and 1988. Fourteen were seen after initial diagnosis, and their disease was treated with cisplatin-based chemotherapy in association with complete surgical resection if possible. Five are currently alive and disease free (36%). Seven were referred for salvage chemotherapy after relapse of their disease. Despite aggressive chemotherapy, these patients all died; they had a median survival time of 6 months. Our experience suggests that an aggressive combined modality approach with cisplatin-based chemotherapy followed by surgical resection of residual disease is the optimal management of this tumor. New regimens need to be explored for relapse of the disease after initial chemotherapy.

Adolescent↗

Update on legal processes for adoption in Indiana.

In this article, we review the process of adoption in Indiana. Comments about the legal process, the right to know issue and the process of adoption from the viewpoint of the potential adoptive parents are discussed.

Adoption↗

Cardiac myxoma: the Indiana Heart Institute experience.

Surgical resection of a cardiac myxoma was performed in 14 patients at the Indiana Heart Institute at St. Vincent Hospital and Health Care Center in Indianapolis from 1974 to 1989. Thirteen were located in the left atrium and one in the right atrium. The 10 women and four men ranged in ages from 28 to 75 years. Surgical complications included one perioperative death, one late death and one late recurrence requiring reoperation. Physicians must be highly suspicious to correctly diagnose this unusual but surgically correctable entity. Two-dimensional echocardiography is the diagnostic technique of choice for both early diagnosis of a cardiac myxoma and late follow-up after resection.

Adult↗

The eradication of Aedes albopictus in Indianapolis, Indiana.

From September 16, 1986, to September 15, 1987, the Vector Borne Disease Prevention Unit of Marion County utilized different monitoring techniques, immediate chemical control measures and an intensive source reduction program to successfully eradicate Aedes albopictus from Indianapolis, Indiana. Monitoring in 1988 and 1989 failed to show any signs of continuing infestation.

Aedes↗

Indiana dentists acceptance of universal precautions.

Dentistry along with other health care disciplines is evaluating infectious control procedures for the protection of patients and staff. The AIDS scare of the early 80s precipitated many concerns leading up to the practice changes reported in this article. The authors have collected survey data over a three-year period, from 1985 to 1988, to document the response of Indiana dentists to new infectious disease control requirements.

Attitude of Health Personnel↗

Population size and survivorship of adult Aedes triseriatus in a scrap tireyard in northern Indiana.

Population size and probability of daily survival of adult Aedes triseriatus were measured in a 0.03 ha section of scrap tireyard in South Bend, Indiana, using single-release, multiple-recapture methods. Average population size estimates ranged from 1,349 to 4,492 females (999 males in one experiment), demonstrating that population densities of Ae. triseriatus can reach levels in tireyards far exceeding densities in woodlots. The probability of daily survival was equivalent between males and females (0.78-0.82). When laboratory-reared small and large mosquitoes were released, small mosquitoes of both sexes were recaptured at lower rates than large mosquitoes, suggesting that experimental populations of small and large mosquitoes behave differently once released into the field, but that mark-recapture methods may not be sensitive enough to detect differences in survivorship.

Aedes↗

Species composition and feeding success of mosquitoes attracted to caged dogs in Indiana.

A field study using caged dogs in mosquito bait traps was conducted in eastcentral Indiana to determine the species composition of mosquitoes coming to feed. Fourteen species of mosquitoes from 5 genera were collected; Aedes trivittatus predominated. Feeding success rates were measured as the percentage of mosquitoes collected that had a fresh blood meal. The species having the highest rates were: Culex erraticus, Aedes stimulans and Ae. trivittatus. Aedes vexans and Cx. pipiens/restuans had markedly lower feeding success rates. A New Jersey light trap operated at the same site each year yielded a different species composition. Because of its propensity for feeding on dogs, Ae. trivittatus may be considered as a major potential vector of heartworm disease in dogs, even where it is one of several possible vector species present in abundance.

Animals↗

Urban distribution of Aedes triseriatus in northern Indiana.

Ovitraps were used to determine the distribution of Aedes triseriatus among forty-eight 1.2 km2 quadrants in urban South Bend and Mishawaka, Indiana. Oviposition paddles from 96 ovitraps were collected for 13 weeks from June to September, 1986. A total of 82,974 eggs was collected. Eggs were present in each quadrant at least once and were found in most quadrants on 6 or more collection dates. Ninety-two percent of the ovitraps were positive at least once, indicating ubiquitous distribution throughout the urban area. The eggs collected were 80-90% Ae. triseriatus, the remainder being Ae. Hendersoni. Effectiveness of large (3,100 ml) and small (350 ml) ovitraps was compared. The large ovitraps exceeded the small by 319% for eggs/positive ovitrap and 486% in numbers of positive ovitraps.

Aedes↗

Salmonella serotypes isolated from the aquatic environment (Wabash River, Indiana, 1973-1976).

During 1973-1976, 833 isolations of salmonellae were made from the aquatic biosphere of the Wabash River, Lafayette, Ind. Of the isolants, 643 were definitively serotyped. Salmonella typhimurium represented 34.4% of the cultures. Salmonella eimsbuettel previously had not been recognized in Indiana. A total of 35 serotypes and 1 untypable group C1 was obtained from the aquatic samples, ie, river water, river bottom sediment, fish, and mussels. Most of the isolants were presumed to be of human origin, because many samplings were made in close proximity to sewage treatment plant outfalls. During the survey period, epidemic salmonellosis had not been reported for the Lafayette-West Lafayette metropolitan area.

Indiana↗

The biology of Aedes thibaulti in northern Indiana.

The biology of Aedes thibaulti was studied in a northern Indiana woodlot. There was a single generation in 1984. Adult emergence began in late May and was complete by mid-June. Females were captured into early August. Female daily survivorship was estimated at 0.954, while female population density peaked at over 2100/ha. Precipitin tests on blood-fed females indicated that Ae. thibaulti fed on vertebrates found in the same woodlot, with deer providing 70% of the meals. Adults were also collected in southwestern Michigan, a new state record for this species.

Aedes↗

Cross-neutralization between vesicular stomatitis virus type Indiana and Chandipura virus.

Using highly potent immune sheep sera, it was possible to demonstrate that: (1) Two rhabdoviruses, classified in the Vesiculovirus genus on morphological grounds but previously considered unrelated, viz., the vesicular stomatitis virus type Indiana (VSV), and Chandipura virus (ChV), show a low-level, but distinct cross-neutralization. This was, in most combinations, considerably increased by complement. (2) The species of cells used for growing the viruses for immunization and for neutralization tests, influenced the level of cross-neutralization. (3) No cross-reaction between VSV and ChV could be detected in the immunodiffusion reaction. (4) Immune sera, raised in sheep by immunization with the two purified rhabdoviruses contained complement-dependent cytotoxic antibodies specifically reacting with the cell species used for growing the viruses.

Antigens, Viral↗

Dirofilaria immitis infection in foxes and coyotes in Indiana.

Between October 1976 and January 1977, carcasses or hearts and lungs from 202 wild foxes and coyotes in Indiana were collected to determine the prevalence of Dirofilaria immitis infection. Three of 113 (2.7%) red foxes (Vulpes fulva), 3 of 81 (3.7%) gray foxes (Urocyon cinereoargenteus), and 1 of 8 (12.5%) coyotes (Canis latrans) were infected with D immitis. An average of 5 worms (range, 1 to 10) were recovered from foxes and 11 worms were recovered from the coyote. Worms from the coyote were of normal length and all female worms contained developing embryos and microfilariae. Worms from foxes were small, and none of the female worms contained developing embryos.

Animals↗

Trichophyton verrucosum in Indiana. Infection in two cases.

Presented herein are two cases of dermatomycosis that occurred in Indiana. The causative agent in each case was Trichophyton verrucosum. The first patient had onychomycosis, tinea pedis, and tinea cruris. Although of long duration, his condition cleared readily after the administration of griseofulvin. The second patient, a recent immigrant from Yugoslavia, had erythematous, minimally scaling lesions was more typical, since T. verrucosum is commonly found on exposed parts of the skin. In this patient, also, lesions cleared after the administration of griseofulvin therapy.

Female↗

Characteristics of hospital pharmacy practice in Indiana.

Hospital pharmacy practice in Indiana was surveyed to determine drug distribution services, additional services, staffing and salaries. Questionnaires were mailed to the directors of the 113 licensed hospital pharmacies in the state; 63% responded. Unit dose drug distribution systems were used by 19% of the hospitals for all beds; by 16% for some of their beds. Intravenous admixture services were provided by 43% of the respondents. Drug use review, patient education and inservice education were all provided by more than 10 of the respondents; in general, clinical services were not well developed. Salaries for directors were related more to hospital bed size than to years of experience as a pharmacist. Howeever, salaries for staff pharmacists were related more to years of experience than to hospital bed size. It appeared that staff pharmacists who want to earn more income must consider an administrative position.

Indiana↗

Cost of discarded medication in Indiana long-term care facilities.

The cost of discarded medication was studied in 17 Indiana intermediate-care and skilled-nursing facilities with varying bed capacities and drug-distribution systems. During visits to each facility, one or two pharmacists collected data on patients' drug regimens and the quantities of medication dispensed and discarded over periods of one to seven months. A total of $ 5,620 worth of medication ($ 4,472 excluding topical medications) was destroyed in the facilities during the study period. The projected annual cost of discarded medication was approximately $ 15,800 ($ 12,460 excluding topical medications). In the 13 facilities using some type of unit dose drug distribution system, the mean projected annual cost of discarded medication per patient ($ 4.07) was significantly less than for the four facilities using traditional drug-distribution systems ($ 23.54). There was an inverse relationship between bed capacity and mean projected annual cost of discarded medication per patient. The use of unit dose drug distribution systems in all long-term care facilities would be expected to result in substantial savings in the costs of discarded medications.

Costs and Cost Analysis↗

An outbreak of influenza B at an Indiana boarding school: estimate of vaccine efficacy.

During the influenza season of 1979-80, influenza B accounted for most cases of influenza in the United States. The midwestern States experienced widespread influenza B activity beginning in mid-December. From late January to mid-February an outbreak of influenza-like illness occurred at a private boarding school for boys in northeastern Indiana. Most of these boys had been vaccinated against influenza. An influenza B virus was isolated in 1 instance, and 5 of the 24 boys from whom acute- and convalescent-phase serum specimens were obtained showed evidence of influenza B infection.Through a questionnaire survey, it was determined that 18 percent of the boys had had an influenza-like illness; the attack rate was 39 percent for the unvaccinated and 14 percent for the fully vaccinated. The vaccine efficacy was thus estimated to be 63 percent. As was true of many of the influenza B viruses isolated in the 1979-80 influenza season, the virus isolated at the school demonstrated some variation from the B/Hong Kong/5/72 virus used in the vaccine.

Disease Outbreaks↗

Eye worms in cattle in Indiana.

Of 320 Indiana cattle examined for eye worms between Aug 31, 1977 and July 12, 1979, 88 (28%) were found to be infected with Thelazia gulosa and Thelazia skrjabini. Seventeen cattle had eye worms in both eyes and 65 cattle had therm in a single eye (worms from 6 cattle were pooled, thus not included). From 1 to 28 eye worms (mean, 6) were found per infected animal. Breed predilection was not evident, and 3-year-old cattle had the highest proportion of infection.

Animals↗

Gastrointestinal helminths in dogs from a humane shelter in Indiana.

Between January 1975 and August 1976, the alimentary tracts of 104 euthanatized dogs from a humane shelter in Tippecanoe County, Indiana, were examined to determine the prevalence of gastrointestinal helminths. The survey was restricted to dogs greater than 1 year old. Their average age was estimated at approximately 2 years. Parasitism was detected in 86.5% of the dogs examined. Ancylostoma caninum was found most often (58.7%), followed by Trichuris vulpis (51.9%), Taenia sp (31.7%), Toxocara canis (18.3%), Dipylidium caninum (16.3%), Toxascaris leonina (8.7%), and Physaloptera rara (3.8%). Monospecific infections were found in 22.1% of the dogs, whereas concurrent infections with 2 or more species were found in 64.4% of the dogs. Most commonly encountered were dogs infected with 2 species of parasites (39.4%), of which hookworms plus whipworms were found most often (32.7%). Male dogs had a higher percentage of multiple infections than did female dogs.

Ancylostomiasis↗