SEARCH · Search PubMed

Results for “MARYLAND”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed2004

Occurrence of Irgarol 1051 and its major metabolite in Maryland waters of Chesapeake Bay.

Irgarol and its major metabolite (GS26575) were measured in Maryland waters of Chesapeake Bay: (1) in and near 10 marinas, a mainstem Bay site and two Severn River locations during a general survey in July and December of 2002; (2) at various sites in the Port Annapolis Marina and the Severn River area during March of 2002 before the boating season began; and (3) during July (peak boating season) in the same Port Annapolis Marina and Severn River sites area during both an ebb and flood tide. Irgarol concentrations ranged from 1.82 ng/l at the mid-Bay site to 585 ng/l in Port Annapolis marina during the July and December general survey. An Irgarol 90th centile of 239 ng/l was reported for the 10 marina sites, two Severn River sites and one mainstem site sampled during the general survey conducted in July and December. Temporal analysis of all pooled data showed that 90th centiles were over seven times higher in July when compared to December. A comparison of Irgarol concentrations at 12 sites in the Port Annapolis marina and Severn River area during both an ebb and flood tide in July showed no consistent trend with tidal cycle by site although significant reductions in concentrations were reported with distance from the three Port Annapolis marina sites. Ecological risk from Irgarol exposure was judged to be low for most Chesapeake Bay sites sampled. Possible exceptions were Port Annapolis marina, Severn River sites in close proximity to this marina and Chesapeake Harbor marina where Irgarol concentrations exceeded a conservative effects threshold during the peak boating season in July. Ecological risk from GS26575 exposure was low for all sites.

Ecosystem↗

PubMed2006

Inverse estimation of nonpoint sources of fecal coliform for establishing allowable load for Wye River, Maryland.

An estimation of the nonpoint sources of fecal coliform (FC) has been formulated as an inverse parameter estimation problem, using FC observation data from the receiving waters. An inverse algorithm was integrated into the three-dimensional transport model, HEM-3D. The modified Gauss-Newton method was used for the optimal estimation of the loads. The approach is straightforward and requires less effort in modification of the existing hydrodynamic model. Model experiments were conducted to investigate the feasibility of load estimation in a tidal river. The parameter uncertainty and accuracy associated with load estimation are discussed using data sets with different sampling sizes. The inverse model was applied to the tidal Wye River, Maryland, USA, to estimate FC nonpoint sources and to develop an allowable load for the river to attain water quality standards. The model results suggest that the inverse modeling approach is suitable for estimating FC nonpoint sources. The inverse method not only provides an efficient approach to assess the contribution of nonpoint sources, but has the additional advantage of addressing the problems of the uncertainty and error associated with FC simulation in the estuary using hydrodynamic models.

Feces↗

PubMed2004

Ovarian cancer surgery in Maryland: volume-based access to care.

PURPOSE: To characterize the patterns of primary surgical care for ovarian cancer in a statewide population according to annual surgeon and hospital case volume. METHODS: The Maryland hospital discharge database was accessed for annual surgeon and hospital ovarian cancer case volume for the time intervals: 1990-1992, 1993-1995, 1996-98, and 1999-2000. Annual surgeon case volume was categorized as low (</=4), intermediate (5-9), or high (>/=10). Annual hospital case volume was categorized as low (</=9), intermediate (10-19), or high (>/=20). Logistic regression models were used to evaluate for significant trends in case volume distribution over time and factors associated with access to high-volume care. RESULTS: Overall, 2417 cases were performed by 531 surgeons at 49 hospitals. The distribution according to annual surgeon case volume was low (56.3%), intermediate (9.2%), and high (34.5%). Between 1993 and 2000, there was no significant increase in the proportion of cases performed by high-volume surgeons (OR = 1.03, 95% CI = 0.81-1.33, P = 0.79). Access to high-volume surgeons was positively associated with care at high-volume hospitals and negatively associated with residence >/=50 miles from a high-volume hospital. The overall hospital volume case distribution was low (49.6%), intermediate (27.6%), and high (22.8%). There was a statistically significant decrease in access to high-volume hospitals between 1990 and 1998 (OR = 0.39, 95% CI = 0.30-0.50, P < 0.0001). CONCLUSION: A large proportion of primary ovarian cancer surgeries are performed by low-volume surgeons at low-volume hospitals. In light of positive volume-outcomes data for malignancies treated with technically complex operative procedures, increased efforts to concentrate the surgical care of women with ovarian cancer are warranted. Condensed abstract. A large proportion of primary ovarian cancer surgeries are performed by low-volume surgeons at low-volume hospitals. In light of positive volume-outcomes data for malignancies treated with technically complex operative procedures, increased efforts to concentrate the surgical care of women with ovarian cancer are warranted.

Adolescent↗

PubMed2002

Characteristics of traffic crashes in Maryland (1996-1998): differences among the youngest drivers.

Motor vehicle crashes (MVCs) are the leading cause of death among teenagers in the US. The present study examines how crash rates and crash characteristics differed among drivers aged 16-21 in the state of Maryland from 1996 to 1998. The results show that, based on police reports. the youngest drivers have the highest rate of MVCs per licensed driver and per annual miles driven. Furthermore, crash characteristics suggest that inexperience rather than risky driving may account for the differing rates. Drivers closer to the age of 16 had their crashes under the safest conditions: during the day in clear weather while drinking less.

Accidents, Traffic↗

PubMed1998

Resource use and quality of care for Medicare patients with acute myocardial infarction in Maryland and the District of Columbia: analysis of data from the Cooperative Cardiovascular Project.

This study sought to evaluate the quality of care rendered to Medicare beneficiaries with acute myocardial infarction by establishing the use patterns of well-proven therapies in this population. We analyzed the quality of care rendered to 4300 Medicare beneficiaries seen at Maryland and District of Columbia hospitals with retrospectively confirmed acute myocardial infarction by evaluating the use of proven therapies. The proportion of patients ideal for therapies ranged from 10% for reperfusion to 100% for smoking cessation counseling. For ideal patients the following therapies were implemented: aspirin (87%), reperfusion therapy (64%), beta-blockers on discharge (60%), and smoking cessation counseling (41%). A substantial proportion of Medicare patients with acute myocardial infarction has one or more relative or absolute contraindications to standard regimens and therefore are not ideal therapeutic candidates. In the group of ideal patients, those with no therapeutic contraindications, a significant proportion do not receive these treatments.

Adrenergic beta-Antagonists↗

PubMed1983

Problems in health data analysis: the Maryland permanent pacemaker experience in 1979 and 1980.

In a recent report the Maryland statewide health data base, which is derived from "face sheet" data, was used to determine the appropriateness of permanent pacemaker insertion. In the present study the same indications were utilized and both the complete medical records and the face sheet were reviewed for those patients who had been classified as having permanent pacemakers inserted for inappropriate or questionable reasons. In 32 hospitals, 75% of the records were reviewed (610 of 817 patients). Although coded as having received permanent pacemakers, 16% had received temporary pacemakers, battery change, and the like. Diagnoses justifying permanent pacemaker insertion had been omitted in 53% of the face sheet s, and coding errors were found in 39%. Although none of the 610 medical records reviewed had a valid indication for permanent pacemaker insertion listed on the face sheet, complete medical record review demonstrated valid indications in 95%. Inherent difficulties arise in attempting to list rigid indications for permanent pacemaker insertion. The face sheet does not provide adequate data for assessing the appropriateness of permanent pacemaker insertion.

Arrhythmias, Cardiac↗

PubMed2001

Hospital volume is related to clinical and economic outcomes of esophageal resection in Maryland.

BACKGROUND: Previous studies have documented a relationship between hospital volume and perioperative and economic outcomes. Our objective was to determine the effect of hospital volume on outcomes of esophageal resection. METHODS: Statewide database was analyzed for patients who underwent esophageal resection in Maryland (n = 1,136 patients) from 1984 to 1999. Multivariate regression was used to determine the association of hospital volume with in-hospital mortality, length of stay, and charges after adjusting for case mix and time period. RESULTS: Unadjusted in-hospital mortality rates were lower in high volume hospitals (2.7%) than medium (12.7%) and low (16%) volume hospitals (p < 0.001). High hospital volume was associated with (1) fivefold reduction in the risk of death (odds ratio, 0.21; 95% confidence interval, 0.10 to 0.42; p < 0.001); (2) a 6-day (95% confidence interval, 5 to 7 days; p < 0.001) reduction in length of stay; and (3) $11,673 (95% confidence interval, $9,504 to $12,841; p < 0.001) decrease in hospital charges. Conclusions. Hospitals that perform high volumes of esophageal resection have superior clinical and economic outcomes. By referring these patients to high volume centers, we may improve quality and reduce costs.

Aged↗

PubMed2001

Concentration of mercury, methylmercury, cadmium, lead, arsenic, and selenium in the rain and stream water of two contrasting watersheds in western Maryland.

Weekly wet deposition and throughfall rain samples were collected in the Blacklick Run (BLK) and Herrington Creek Tributary (HCRT), two streams in western Maryland (MD). Samples were analyzed for total mercury (Hg), methylmercury (MMHg). arsenic (As), selenium (Se), cadmium (Cd), and Icad (Pb). Hg concentrations generally fell between 50 and 100 pM. comparable to concentrations in wet deposition measured at other MD sites. While Hg concentrations decreased with rainfall amount, a similar washout trend was not seen for MMHg. Cd, Pb, As, and Se concentrations were comparable overall to those measured in the region. Concentrations of Hg, Cd, and Pb in throughfall were similar between sites and equivalent or higher than wet deposition concentrations. As and Se concentrations were similar in throughfall at the two sites, though throughfall at BLK seemed to be punctuated with slightly higher concentrations of these two metals. Concentrations of Hg, MMHg, Cd, Pb, As, Se, and SPM were measured in monthly stream collections and compared with concentrations found in other MD rivers. In addition to the monthly collections, four storm events were sampled. These measurements demonstrate the importance of storm events in trace metal transport, especially for Hg, Pb and MMHg. For these metals, a strong correlation between metal and suspended particulate concentration was evident. Retention efficiencies of the watersheds for the metals were calculated for each watershed. Of all the metals, Hg is the most and As is the least strongly retained in the watershed.

Arsenic↗

PubMed2003

Final results of the Maryland WIC Food for Life Program.

BACKGROUND: The few randomized community trials in middle-income populations that tried to modify multiple dietary risk factors for cancer only demonstrated small changes. This trial sought to decrease the percent of calories derived from fat and to increase fruit, vegetable, and fiber intake among low-income women served by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Maryland. METHODS: We conducted six-month intervention programs for 1055 women at ten WIC sites; 1011 women served as controls. Intervention participants were invited to five interactive nutrition sessions and were sent written materials. Controls received usual care. Women were surveyed at baseline, two months post intervention, and one year later. All analyses conducted used an intention-to-treat paradigm. RESULTS: Mean differences (intervention-control) in change from baseline were for percent calories from fat -1.62 +/- 0.33% (P < 0.0001), for consumption of fruits and vegetables 0.40 +/- 0.11 servings (P = 0.0003), and for fiber intake 1.01 +/- 0.31 grams (P = 0.001). These differences in change were related in a dose-response relationship to the number of sessions women attended and remained significant one year post-intervention for the first two outcomes. CONCLUSIONS: Multiple dietary improvements can be achieved in a low-income population with an effective, multi-faceted intervention program. The changes in this trial exceeded those in previous community trials conducted in higher SES populations.

Adolescent↗

PubMed1997

The Maryland Psychiatric Research Center scale and the characterization of involuntary movements.

The Maryland Psychiatric Research Center involuntary movement scale (MPRC scale) has been used in the evaluation of 1107 patients referred for drug-induced movement disorders. The scale has increased discrimination of body area and severity compared to other scales. Validity was examined using principal component analyses, pharmacologic response studies and associations with AIMS, global judgement and motor diagnosis. Reliability was examined using Cronbach's alpha, intraclass correlation coefficient (ICC) between raters and test-retest measurements. The prevalence of dyskinetic and parkinsonian signs at several levels of severity are reported. Total dyskinesia was strongly correlated with AIMS score, r = 0.97. Inter-rater reliability was 0.81-0.90 for total dyskinesia score. Receiver Operating Characteristic (ROC) analysis shows a total dyskinesia score of 4 or above to predict tardive dyskinesia, consistent with RDC-TD criteria. Hand dyskinesia showed a high prevalence comparable to that of oral dyskinesias. The MPRC scale is a valid, sensitive and reliable instrument for the rating of neuroleptic-induced dyskinetic and parkinsonian syndromes and may offer advantages over other scales in neurophysiologic research and brain imaging with its ease of use, uniform structure and greater discrimination of anatomic place and severity in the rating of involuntary movements.

Dyskinesia, Drug-Induced↗

PubMed2000

Prevalence of Cryptosporidium, Giardia and Eimeria infections in post-weaned and adult cattle on three Maryland farms.

The prevalence of Cryptosporidium, Giardia and Eimeria, in healthy, asymptomatic, post-weaned and mature cattle was investigated on three Maryland farms. One farm, a dairy research facility, had 150 multiparous Holstein milking cows; 24 were examined and Cryptosporidium andersoni was detected in three (12.5%) but neither Giardia nor Eimeria was detected. The second farm, a commercial dairy, had 57 multiparous Holstein milking cows and an equal number of heifers. Of 19 cows examined, C. parvum, Giardia duodenalis, and Eimeria bovis and/or E. ellipsoidalis were detected in two (10.5%), two (10.5%) and one (5.26%) cow, respectively. Of 23 heifers examined, C. parvum, Giardia, and E. bovis and E. ellipsoidalis, was detected in two (8.7%), four (17.4%), and five (21.7%), heifers, respectively. The third farm, a beef cattle breeding and genetics research facility, had 180 7- to 9-month old purebred black Angus. Of 118 examined for C. parvum and Giardia, 34 (28.8%) and 44 (37.3%) were positive, respectively, of 97 examined for E. bovis and/or E. ellipsoidalis 32 (33.0%) were positive. These findings, based on a method with a minimum detection level of 100 oocysts of C. parvum/g of feces, which underestimates the number of infected cattle, clearly demonstrate the presence of low level, asymptomatic infections in post-weaned and adult cattle in the United States and indicate the potential role of such cattle as reservoirs of infectious parasites.

Animals↗

PubMedDate not supplied

An inpatient profile of patients with a substance abuse diagnosis in Maryland.

We provide a descriptive analysis of patients with a substance abuse diagnosis in Maryland hospitals in 1991. The intent of the study was not to model relationships between substance abuse and other outcomes (e.g., length of stay), but was to obtain a better understanding of the population receiving inpatient care and to motivate future research. We found that the majority of patients with a substance abuse diagnosis were male, African-American, single, and between the ages of 15 and 44. Medicaid was overwhelmingly the primary payer for their care. These patients were diagnosed with chronic liver disease, pancreas diseases, HIV infection, a number of psychiatric disorders, and respiratory symptoms. We surprisingly found that the average length of stay was shorter for patients with a substance abuse diagnosis and that their average charges were only slightly higher than other patients. We also found that substance abuse patients enter the hospital through the emergency room and the majority leave the hospital against medical advice.

Adolescent↗

PubMed1998

Surgical repair of ruptured abdominal aortic aneurysms in the state of Maryland: factors influencing outcome among 527 recent cases.

PURPOSE: Abdominal aortic aneurysm (AAA) rupture has been historically associated with high operative mortality rates. In this community-based, cross-sectional study, we examined factors influencing outcome after operations performed for ruptured AAA (rAAA). METHODS: An analysis of a state database identified 3820 patients who underwent AAA repair between 1990 and 1995, including 527 (13.8%) who had an operation for an rAAA. Demographic variables examined included patient age, gender, race, associated comorbidity rates, operative surgeon experience with rAAA, and annual hospital rAAA and total AAA operative volumes. Outcomes measured included operative mortality rates, hospital length of stay, and charges. RESULTS: Operative mortality rates increased significantly with advancing age (P < 0.0001) but were not related to gender (P = 0.474) or race (p = 0.598) and were significantly lower among patients with hypertension (P = 0.006) or pulmonary disease (P = 0.045). There was no relationship between hospital rAAA or total AAA volume and rAAA repair mortality rate, although high-volume surgeons (i.e., performing more than 10 rAAA repairs) had decreased mortality rates and hospital charges compared with other surgeons. Hospital lengths of stay and charges increased with age among survivors, but not nonsurvivors, of rAAA repair. Despite a stable incidence of rAAA repairs during the study interval and no significant change in the mean age of patients undergoing operation or the percentage of operations performed by high-volume surgeons, the statewide mortality rate declined from 59.3% to 43.2% (P = 0.039). CONCLUSION: The incidence of rAAA does not appear to be declining. Although operative rAAA repair continues to be associated with substantial risk and remains an especially lethal condition among the elderly, the operative mortality rate has declined in recent years in Maryland. Lower operative mortality rates and hospital charges are associated with operations performed by high-volume surgeons.

Adult↗

PubMed2001

A case-control study of nonsyndromic oral clefts in Maryland.

PURPOSE: Isolated, nonsyndromic oral clefts cases (n = 171) and unaffected controls (n = 182) were used to identify both genetic and environmental risk factors. METHODS: Infants born in Maryland between 1992 to 1998 with an isolated, nonsyndromic oral cleft [cleft lip (CL), cleft lip and palate (CLP), or cleft palate (CP)] were recruited and exposure plus family history data were collected. Controls were unaffected infants. DNA was collected from all cases and their parents, plus controls. RESULTS: No statistically significant association was found between any of the following: maternal smoking, vitamin use, urinary tract infection, or recreational drug use in either univariate analysis or after adjusting for maternal age and education. More control mothers reported alcohol use during the critical time period of pregnancy (one month before conception through the first trimester) as compared to case mothers. There was a 10-fold increase in risk to siblings of cases as compared to siblings of controls. Markers at four candidate genes were examined: transforming growth factor alpha (TGF alpha), transforming growth factor beta 3 (TGF beta 3), MSX1, and BCL3. Only MSX1 showed significant differences in allele frequencies between CP cases and controls. MSX1 also showed significant evidence of linkage disequilibrium with a susceptibility gene controlling risk for CP. CONCLUSION: Most environmental risk factors examined here gave little evidence of association with risk to isolated, nonsyndromic oral clefts, although any alcohol consumption seemed protective. MSX1 showed evidence of linkage disequilibrium in both case-control and case-parent trio analysis.

Case-Control Studies↗

PubMed1993

Relating outcomes to processes of care: the Maryland Hospital Association's Quality Indicator Project (QI Project).

BACKGROUND: The Maryland Hospital Association's Quality Indicator Project (QI Project) is a program of indicator development and application that has grown from 7 hospitals in 1987 to more than 700 hospitals today. METHODOLOGY: Expert panels help to create sets of indicators that describe events involved in a specific sequence of patient care. Each hospital collects data elements for the 21 indicators on a quarterly basis using specifically designed data-collection software. Indicator data are adjusted for case complexity, risk of adverse outcomes, and patient group characteristics. A report is developed that states the rate of occurrence of each indicator and how the hospital's indicator rate compares to other hospitals in the database. Hospitals then use this information to determine if specific processes in their delivery of care yield results that deviate from those of other hospitals. The QI Project promotes regional sharing of information about specific hospital initiatives that might benefit other participants. It also provides a model to use in interpreting what the indicator data reveal about hospital performance. OPERATIONAL ISSUES: QI Project is testing process indicators for patient-level and service-level data to supplement current aggregate-level trend and profile analysis. Indicator data are shared solely with participating systems, but changes in the confidentiality policy are being studied. Reliability assessment surveys are periodically conducted. EXAMPLES: Case studies portray improvement of processes prompted by indicator data for unscheduled admission following ambulatory surgery, for surgical wound infections, and for reducing emergency room waiting times. CONCLUSIONS: The chief contribution of the QI Project and similar projects may not be that they identify all issues of quality, but rather that they may help develop a generation of hospital professionals who will be better able to quantify, evaluate, and improve health care quality.

Confidentiality↗

PubMedDate not supplied

The relationship between selected educational outcomes of senior RN-to-BSN students and their choice of advanced placement options available in the Maryland nursing articulation model.

If national standards for entry into practice are to be changed, viable routes to achievement of the BSN must be established in each state. Maryland has implemented a statewide articulation model that allows the registered nurse to obtain credit for work completed at lower division schools through one of three advanced placement options. This study sought to answer the question of whether there is a difference in selected academic outcomes of senior RN-to-BSN students who choose different pathways available in the model. Data were collected from all students (n = 113) completing clinical concepts courses at a large university school of nursing. The independent variables were mode of entry and pattern of study. The dependent variables were scores obtained on the National League for Nursing (NLN) Comprehensive Nursing Achievement Test for Baccalaureate Nursing Students and the grades obtained in the spring and fall nine-credit clinical concepts courses (examinations, formal papers, clinical evaluations). The entry pathway did not make a significant difference in terms of scores on the spring NLN examination, course tests, or paper grades. However, differences were noted in the clinical area. Transition course students achieved the highest mean clinical performance score, and direct transfer students achieved the lowest score. The implication for nursing education is that there appears to be no significant difference in academic achievement of RN-to-BSN students admitted for advanced placement using three different validating procedures.

Adult↗

PubMed1997

Bladder cancer and drinking water: a population-based case-control study in Washington County, Maryland (United States).

A population-based case-control study was conducted in Washington County, Maryland (United States) to explore the association between incident bladder cancer and exposure to drinking water from chlorinated surface sources. Cancer cases were White residents, enumerated in a 1975 county census and reported to the Washington County Cancer Registry (n = 294) between 1975 and 1992. White controls, frequency matched by age (+/- 5 years) and gender, were selected randomly from the census (n = 2,326). Households receiving municipal water, which generally derived from chlorinated surface waters, were treated as having 'high exposure' and all others, as 'low exposure.' Duration of exposure to type of drinking water was based on length of residence in the census household prior to 1975. Odds ratios (OR) were calculated using logistic regression methods, adjusting for age, gender, tobacco use, and urbanicity. Bladder cancer risk was associated weakly in the general population with duration of exposure to municipal water. The association was limited to those who had smoked cigarettes. In ever-smokers compared with never-smokers with low exposure, the adjusted ORs for bladder cancer risk with increasing exposure were 1.3, 1.4, 1.4, 1.7, 2.2, 2.8, respectively, for 0, 1-10, 11-20, 21-30, 31-40, > 40 years' exposure duration. The ORs in smokers were not diminished after adjusting for smoking history and intensity.

Adult↗

PubMed2002

Control of Ixodes scapularis and Amblyomma americanum through use of the '4-poster' treatment device on deer in Maryland.

Deer self-treatment devices ('4-posters') were evaluated for their efficacy in reducing populations of blacklegged ticks, Ixodes scapularis, and lone star ticks, Amblyomma americanum. At each of three locations in Maryland, 25 '4-posters' were operated in study areas of approximately 5.18 km2. Populations of host-seeking ticks were monitored by flagging of treated areas and similar untreated control areas without '4-posters.' From 1998 to 2002 the percent mortalities achieved were 69, 75.8 and 80 at the three study sites infested with I. scapularis nymphs, and 99.5 and 95.3 for A. americanum nymphs at the two sites where this species occurred.

Animals↗