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Air-water exchange of polycyclic aromatic hydrocarbons in the New York-New Jersey, USA, Harbor Estuary.

Polycyclic aromatic hydrocarbons (PAHs, n = 36) were measured in the gas and particle phases in the atmosphere and the dissolved and particle phases in the waters of the New York-New Jersey Harbor Estuary, USA, during a weeklong intensive field campaign in July 1998. Mean total (gas + particulate) phenanthrene and pyrene concentrations were 3.3 and 0.33 ng/m3, respectively, over Raritan Bay, and 14 and 1.1 ng/ml, respectively, over New York Harbor. Similar PAH profiles (p values < 0.01) in the atmospheric gas phase and the dissolved phase in water demonstrate the close coupling of the air and water compartments. Air-water exchange fluxes of PAHs estimated using shore-based air data lead to erroneous flux estimates when compared to those derived using over-water air samples. The gross absorptive air-water flux dominates atmospheric loadings (wet, dry particle, gas absorption) to the estuary for PAHs of molecular weight < 234 g/mol. Dry particle deposition is increasingly more important for the higher-molecular-weight, particle-bound PAH species. Gross volatilization dominates gross absorption for the majority of PAHs in the New York-New Jersey Harbor Estuary.

Air↗

Guillain-Barré syndrome in Greater New York-New Jersey.

Epidemiologic data on 176 patients with acute Guillain-Barré syndrome observed over a nine-year period in the New York-New Jersey metropolitan area are presented. A striking predilection for patients aged 16 to 25 years, with a second lesser peak between ages 45 to 60, was found. Seasonal clustering of patients occurred, with nearly half the patients afflicted during the four-month period of late summer and fall. The distribution between men and women was equal. In this series 23% of the patients required tracheostomy, and 5% had a fatal course.

Acute Disease↗

Public release of cardiac surgery outcomes data in New York: what do New York state cardiologists think of it?

BACKGROUND AND OBJECTIVE: Since 1990, risk-adjusted outcomes for patients undergoing coronary artery bypass graft surgery in New York state have been released to the public. The purpose of this study was to assess the extent to which referring cardiologists share these data with patients and use these data to make referrals. METHODS: A survey questionnaire was sent to all cardiologists in New York in the New York State Chapter of the American College of Cardiology. RESULTS: Four hundred fifty cardiologists responded to the survey. Most (94%) found the report "easy to read." A majority (67%) found the report to be "very accurate" or "somewhat accurate" in capturing differences in the performance of cardiac surgeons, whereas 33% found it to be "not at all accurate." Twenty-two percent reported that they "routinely discuss the reports with their patients," and 38% responded that the information has affected their referrals to surgeons "very much" or "somewhat." CONCLUSIONS: A majority of cardiologists has not generally changed their well-established referral patterns as a result of the New York coronary artery bypass graft surgery reports. However, there has been a modest impact on referrals resulting from the distribution of these reports. The findings also suggest that increased dialogue between clinicians and policy makers regarding the format and structure of public releases would be a valuable undertaking.

Adult↗

Public release of cardiac surgery outcomes data in New York: what do New York state cardiologists think of it?

BACKGROUND AND OBJECTIVE: Since 1990, risk-adjusted outcomes for patients undergoing coronary artery bypass graft surgery in New York state have been released to the public. The purpose of this study was to assess the extent to which referring cardiologists share these data with patients and use these data to make referrals. METHODS: A survey questionnaire was sent to all cardiologists in New York in the New York State Chapter of the American College of Cardiology. RESULTS: Four hundred fifty cardiologists responded to the survey. Most (94%) found the report "easy to read." A majority (67%) found the report to be "very accurate" or "somewhat accurate" in capturing differences in the performance of cardiac surgeons, whereas 33% found it to be "not at all accurate." Twenty-two percent reported that they "routinely discuss the reports with their patients," and 38% responded that the information has affected their referrals to surgeons "very much" or "somewhat." CONCLUSIONS: A majority of cardiologists has not generally changed their well-established referral patterns as a result of the New York coronary artery bypass graft surgery reports. However, there has been a modest impact on referrals resulting from the distribution of these reports. The findings also suggest that increased dialogue between clinicians and policy makers regarding the format and structure of public releases would be a valuable undertaking.

Attitude of Health Personnel↗

Trends in the first ten years of AIDS in New York City. The New York City Department of Health AIDS Surveillance Team.

With over 37,000 cases of acquired immunodeficiency syndrome (AIDS) reported by the end of 1991, New York City had reported nearly 20% of all US cases in the first decade of the AIDS epidemic. This report examines cases diagnosed through 1990 and reported through 1991 to describe rates and trends in the affected subpopulations. Case data were collected by the New York City Department of Health AIDS Surveillance Team, using a format standardized by the federal Centers for Disease Control. Deaths attributable to human immunodeficiency virus (HIV) infection were examined using data provided by the New York City Department of Health Bureau of Vital Statistics. From 1981 through 1990, 37,436 cases of AIDS were diagnosed: 83% in men over the age of 19 years, 15% in women over 19, 2% in children under 13, and less than 1% in teenagers aged 13-19. Cumulative rates in New York City adults were as high as 100 per 10,000 in nine neighborhoods. Predominant trends included a sustained plateau in reported incidence in men who reported having sex with men and a continuing rise in cases in injection drug users and women infected through heterosexual intercourse. HIV-related deaths in men, women, and children were continuing to rise at the end of the decade. During the first decade of the AIDS/HIV epidemic, case surveillance in New York City measured the visible portion of the epidemic and provided important data on subepidemics.

Acquired Immunodeficiency Syndrome↗

Pain as a mutual experience for patients, nurses and families: a perspective from New York.

New York was unique among the cities included in this study. The most striking finding was that the self-described ethnic background of both nurses and patients was so varied. Many patients and nurses were born elsewhere and were nonnative speakers. The results cannot be described as cross-countries when so many nations are represented. Multinational is, perhaps, a more accurate description, but even that seems inadequate to describe a population as diverse as was this one.

Adolescent↗

[Multiresistant tuberculosis in New York].

New Yorkers have to deal with a tuberculosis situation which is of greater extent and a health-care system which is less prepared than in the sixties. Poverty and the HIV epidemic have had a negative impact on the control of tuberculosis. The emergence of nosocomial multidrug-resistant tuberculosis has created an explosive situation. In 1991, rifampin resistance was 33% in patients who had received antituberculosis therapy and 10% among the patients who had never been treated.

AIDS-Related Opportunistic Infections↗

Evaluation of diagnostic criteria for ankylosing spondylitis: a comparison of the Rome, New York and modified New York criteria in patients with a positive clinical history screening test for ankylosing spondylitis.

The modified New York criteria for the diagnosis of ankylosing spondylitis were evaluated and compared to the older criteria in 151 patients, referred to hospital because of low back pain and who had a positive clinical history screening test for ankylosing spondylitis and in 31 controls with non-inflammatory back pain. Radiological examination of the sacro-iliac joints showed sacro-iliitis in 124 (82%) from the 151 with inflammatory back pain. In 110 (72%) of those patients a diagnosis of definite ankylosing spondylitis according to the classical New York criteria could be made and they had a prevalence of HLA-B27 of 84%. Application of the modified New York scheme increased the number of patients meeting the criteria for definite ankylosing spondylitis to all 124 patients with sacro-iliitis, and 82% of this group carried HLA-B27. The classical New York criteria of 'limitation of the lumbar spine in three directions' and of 'limitation of chest expansion' appeared to reflect disease duration rather than help in the initial diagnosis.

Adolescent↗

Beneficial use of dredged material for habitat creation, enhancement, and restoration in New York-New Jersey Harbor.

A comprehensive Dredged Material Management Plan (DMMP) has been developed by the US Army Corps of Engineers, New York District (USACE-NYD) and the Port Authority of New York and New Jersey (PANY/NJ). The primary objective of the DMMP is to identify cost-effective and environmentally acceptable alternatives for the placement of dredged material derived from ongoing and proposed navigation improvements within the PANY/NJ. A significant portion of this dredged material is classified as unsuitable for open-ocean disposal. One suite of alternatives presented within the DMMP is the beneficial use of dredged material for habitat creation, enhancement, and restoration within the NY/NJ Harbor Estuary. Proposed beneficial use/habitat development projects include the use of dredged material for construction of artificial reefs, oyster reef restoration, intertidal wetland and mudflat creation, bathymetric recontouring, filling dead-end canals/basins, creation of bird/wildlife islands, and landfill/brownfields reclamation. Preliminary screening of the proposed beneficial use alternatives identified advantages, disadvantages, potential volumes, and estimated costs associated with each project type. Continued study of the proposed beneficial use alternatives has identified areas of environmental research or technology development where further investigation is warranted.

Animals↗