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PubMed1992

Firearm-related deaths--Louisiana and Texas, 1970-1990.

In 1990, firearm-related injuries surpassed motor-vehicle crashes as the leading cause of death from injuries in both Louisiana and Texas, and from 1979 through 1987, these states ranked third and fifth, respectively, for age-adjusted firearm-related death rates. Because firearm-related injuries are a major cause of death in Louisiana and Texas, the Louisiana Disability Prevention Program, Louisiana Office of Public Health, and the Injury Control Program, Epidemiology Division, Texas Department of Health, used death certificates to examine patterns in firearm-related mortality. This report summarizes the analysis of death certificate data for firearm-related mortality in these two states.

Adult↗
PubMed2004

Melatonin exposures reported to Texas poison centers in 1998-2003.

Melatonin regulates circadian rhythms, and although widely used in the US, information on the public use of melatonin and patterns of reported adverse effects associated with the substance is limited. To describe the patterns of melatonin calls to poison centers in Texas during 1998-2003, data on all melatonin calls reported to the Texas Poison Center Network were analyzed. During 1998-2003, there were 779 identified human exposures to melatonin identified. Of those patients with a known age, 59.1% were < 6 y. Males accounted for 54.1% of preschool-age patients while more of the older patients were female. Melatonin exposures were unintentional in 99.3% of the cases among children less than 6y and unintentional in < 41% among the older age groups. While 92.4% of exposures involving theyoungest age group were managed outside of a health care facility, 42% or less of the exposures occurring to patients > age 6 years were managed outside of a health care facility. Of those cases with a known outcome, the proportion of cases with at least minor effects rose with increasing age. The majority of melatonin exposures reported to Texas poison centers involved children < 6 y. Younger patients were more likely to be male, have unintentional exposures, have no clinical effect, and to not require management at health care facilities. The observed clinical effects and treatment methods were consistent with the literature.

Adolescent↗
PubMed1992

Neonatal transport in Texas.

The critically ill newborn requires specialized care, which is generally provided in neonatal intensive care units (NICUs). We surveyed all identifiable NICUs in the state of Texas to study deficiencies in the current system. Despite the existence of many neonatal transport teams, little or nothing has been done to coordinate similar efforts at different programs or to organize programs into sharing the responsibility of transport among the less served areas of Texas. The lack of adequate reimbursement may be a limiting factor in the organization and regionalization of neonatal transport. We urge further efforts toward coordination and regionalization of transport with an examination of reimbursement policies to allow teams to share equally the responsibility of neonatal transport in Texas.

Catchment Area, Health↗
PubMed2005

Predictors of self-rated health status among Texas residents.

INTRODUCTION: The purpose of this study was to investigate the predictors of self-rated health status for Texas adults using the current 2003 Behavioral Risk Factor Surveillance System data. Self-rated health is generally accepted as a valid measure of health status in population studies, and understanding its correlates may help public health professionals prioritize health-promotion and disease-prevention interventions. METHODS: The two research questions addressed by this study involved the predictors of self-rated health: 1) "Do demographic characteristics, health care coverage, leisure-time physical activity, and body mass index predict self-rated health status for Texas residents aged 18 to 64 years?" and 2) "Does choice of interview language (English vs Spanish) predict self-rated health status for Texas residents of Hispanic ethnicity aged 18 to 64 years?" Key analysis variables were identified, and descriptive statistics were used to describe the major variables and determine whether the number of respondents for each variable was sufficient for analysis. Multivariate regression analysis was used to assess the variables. RESULTS: Multiple logistic regression analysis (controlling for diabetes and arthritis) of the self-rated health predictors indicated that older age, lack of health care coverage, lack of a college education, being Hispanic, having a lower income, obesity, and not exercising explained 19.4% of the variance of fair and poor self-rated health. The interview language (English or Spanish), age, sex, education, income, obesity, health insurance coverage, and physical activity (controlling for chronic illness) explained 22.8% of the variance in fair and poor self-rated health for Hispanic respondents. CONCLUSION: The results of this study suggest that a college education, a lower body mass index, non-Hispanic ethnicity, and participation in physical activity are associated with good, very good, or excellent self-rated health status. The finding that the interview language significantly predicted fair and poor self-rated health substantiates previous research and emphasizes the importance of culturally sensitive approaches to health care services.

Adolescent↗
PubMed2006

Association between tuberculosis and diabetes in the Mexican border and non-border regions of Texas.

The association between tuberculosis and underlying risk factors was evaluated in Texas patients hospitalized in the 15 counties along the Mexico border within the remaining non-border counties. A case control analysis of the hospital discharge dataset from the Texas Health Care Information Council was performed for the years 1999-2001. A discharge diagnosis of tuberculosis identified cases (N = 4,915). Deep venous thrombosis, pulmonary embolism, and acute appendicitis conditions identified controls (N = 70,808). Risk factors associated with tuberculosis were identified by logistic regression. Diabetes patients were almost twice as likely to have tuberculosis after adjusting by sex, age, and race/ethnicity. The association was strong for the population in the Texas border region, where there are higher incidence rates of tuberculosis (odds ratio [OR](adj) = 1.82; 95% CI = 1.57-2.12) compared with non-border counties (OR(adj) = 1.51; 95% CI = 1.36-1.67).

Adolescent↗
PubMedDate not supplied

Rural radiology services in Texas: an assessment in quality.

Health professionals share a common interest in improving the quality of healthcare provided to the notion's underserved citizens, many who live in rural areas. This article examines the quality of radiology services found in rural Texas hospitals as reported by radiology managers through online survey research in terms of staffing, radiologist availability, and quality control measures. A 22 question survey was developed and 72 of 106 possible responses were obtained for a 67.9% response rate representing 45% of the total population. Texas is a licensure state for radiologic technologists. Texas rural counties with fewer than 50 thousand citizens have only 9% of MRTs, 10% of LMRTs, and 12% of NCTs licensed to practice radiology imaging. Licensing all three levels of technologists through the some administrative body could result in more standard educational and training requirements, thereby increasing the quality of care given by these individuals. Patients seen at lower-volume rural facilities benefit from convenient scheduling and lower prices and are beginning to see faster reporting with the prevalence of teleradiology and voice recognition dictation.

Education, Continuing↗
PubMed2005

Environmental health: a survey of Texas primary care physicians.

Although the role of environmental health hazards in cancer and other diseases is increasingly appreciated, most physicians have had little or no training in environmental health or in integrating exposure histories into their clinical practice. As part of the Texas Medical Association Physician Oncology Education Program, we mailed a questionnaire to 350 Texas primary care physicians (PCPs) to evaluate their attitudes, practice, training, and preferred sources for information regarding environmental health issues. Of the respondents, 86.1% reported that they had never received specific training in environmental health history-taking and 91.7% indicated a desire to learn more about environmental health hazards. The data also revealed that patients regularly raise questions about environmental topics that PCPs do not routinely discuss. Our findings identify a need for more environmental health education for Texas PCPs, and we suggest several possible mechanisms by which this might be accomplished.

Attitude of Health Personnel↗
PubMed2006

Spillover effects of restrictive drug formularies in the statin class: a descriptive study of the Medicaid preferred drug list in Texas.

This study examines whether the implementation of Texas' Medicaid preferred drug list (PDL) influenced, or had a spillover effect, on the prescribing of statin products for non-Medicaid patients. Simvastatin and pravastatin were on the PDL, but atorvastatin was not. Physicians in Texas were categorized into four groups with increasing Medicaid exposure. Compared with physicians with very low, low, or medium Medicaid exposure, the non-Medicaid marketshare of atorvastatin dropped approximately two percentage points and the non-Medicaid marketshare of simvastatin and pravastatin increased by approximately one percentage point among physicians with high Medicaid exposure after six months. Therefore, the restrictive Medicaid PDL in Texas spilled over to non-Medicaid patients.

Formularies as Topic↗
PubMed1991

The University of Texas Medical Branch: a century of service.

The current centennial celebration of The University of Texas Medical Branch (UTMB) at Galveston spotlights not only a history of medicine, but a history of Texas as well. As fellow travelers across the rugged terrain of the past century, UTMB and Texas have shared times of prosperity and times of hardship; both have been gifted with growth and suffered sorrow and loss. Since its first day of class, on October 5, 1981, UTMB has grown from 23 students, one school, and one hospital to 2,360 students, four schools, seven hospitals, and two institutes. Since its first commencement class of three in 1892, UTMB has graduated more than 17,000 health science professionals during the past 100 years, and it is estimated that one in four doctors practicing in the state has trained at UTMB. Today, as UTMB stands on the threshold of its second hundred years, the health science center's first century of service is a history worthy of celebration.

Education, Medical↗
PubMed1990

A study of medical costs associated with selected genetic disorders in Texas.

We estimated that the payments associated with the 11 selected diseases during 1987 in Texas included $88.2 million from Medicaid and $10.6 million from CIDC for a total of $98.8 million. Patients with these diseases represented 0.83% of Medicaid claims, but 4.68% of Medicaid payments. Medicaid payments for genetic services for patients with these 11 selected disorders in Texas during a nine-month period in 1987 were $10,122, or 0.02% of the total Medicaid payments for these claimants. We conclude that our estimate of the Medicaid payments for these disorders in 1987 of nearly $100 million represents a low estimate of the true medical costs for the care of these patients. This study also indicates that these 11 disorders represent a disproportionate share of Medicaid payments; i.e., these patients show a high ratio of payment per claim. We also conclude from these data that CIDC is a significant source of support for the medical care of these patients in Texas. And, finally, this study suggests that referral for genetic services represents a significant barrier for individuals in need of these services.

Child↗
PubMed1990

Firearm-related deaths among children in Texas: 1984-1988.

Although firearms are significant contributors to intentional and unintentional injuries among children in Texas, little information has been published on this topic. We reviewed all firearm-related deaths occurring among persons younger than 15 years of age in Texas from 1984-1988. There were 337 firearm-related deaths among Texas children 0-14 years of age in this 5-year period. Unintentional deaths and firearm homicides were approximately equal for this age group. Black males ages 10-14 years were at highest risk of firearm-related death. The death rate for males was three times that of females. Death rates from unintentional shootings were highest in rural areas, while firearm homicides and suicides were highest in the largest cities.

Adolescent↗
PubMed1990

Neonatal extracorporeal membrane oxygenation in Texas.

Extracorporeal membrane oxygenation (ECMO) has been a successful treatment (80% survival) in over 3,000 neonates with severe respiratory failure (80% predicted mortality without ECMO). ECMO is prolonged extracorporeal cardiopulmonary bypass achieved by extrathoracic vascular cannulation using a modified heart-lung machine. ECMO as treatment for severe respiratory failure in neonates is currently available in Texas in San Antonio, Galveston, Lubbock, and Dallas. Of 116 Texas neonates treated with ECMO, 74% survived. Because of the distances between ECMO programs in Texas, early communication with the nearest center is highly recommended.

Extracorporeal Membrane Oxygenation↗
PubMed1989

71st legislature produces bills that improve health care in Texas.

The 71st Texas Legislature adjourned May 29, ending what was an extremely successful session for the Texas Medical Association. During the 140-day session, TMA tracked more than 600 individual bills and secured passage of major legislation addressing rural health care, Medicaid enhancement, medical liability reform, and other measures to improve the quality of health care and the practice of medicine. TMA also was successful in blocking passage of legislation that might have lowered the quality of care. As this issue of Texas Medicine was going to press, Gov Bill Clements was threatening to veto the rural health care bill, House Bill 18. That issue was a possible agenda item for the special session Clements called for June 20. The special session was called specifically to deal with workers compensation reform, an issue the lawmakers failed to resolve during the regular session. This article, prepared by Ken Ortolon, public relations assistant, and the TMA Public Affairs staff, lists some of the issues TMA was involved in during the 71st session and their outcomes.

Legislation, Medical↗
PubMed1989

Epidemiology of anencephaly in Texas, 1981-1986.

The incidence of anencephalic births among Texas residents for the period 1981 through 1986 is described. The annual incidence of this birth defect varied from 3.8 to 4.3 cases per 10,000 total births (live births and stillbirths). The highest mean annual incidence was found in East Texas and South Texas. Within all ethnic and racial groups studied, females had higher rates of anencephaly than males, and Spanish-surnamed residents had the highest incidence of this defect, with 5.0 cases per 10,000 live births. Mothers with three or more previous live births or a history of stillbirths were more likely to have anencephalic offspring than were those without these documented histories. Differences in the incidence of anencephalic births between Spanish-surnamed and non-Spanish-surnamed whites were not explained by differences in parity.

Anencephaly↗
PubMed1989

Eye banking in Texas.

Texas is providing corneal tissue in the 1980s that is quite adequate to meet the needs of all Texas patients. Infrequent maldistribution is corrected by tissue-sharing between eye banks, facilitated by a toll-free number in Dallas (800-433-6667) for Texas eye banks to call when they cannot meet a local need. With distribution of tissue through eye banks, no patient need wait when tissue is abundantly available. The most important law aiding corneal tissue procurement has been the 1977 Medical Examiners/Justice of the Peace Act, that permits removal of corneas under controlled conditions. This has been implemented in almost all jurisdictions where medical examiners are active, although only a few counties have the services of a medical examiner. The implementation of this law, particularly in Austin, Dallas, El Paso, Fort Worth, Houston, and San Antonio, has increased previous donations by more than double.

Eye Banks↗
PubMed1986

Epidemiology of murine typhus in Texas. 1980 through 1984.

From 1980 through 1984, a total of 200 cases of murine typhus were reported in Texas. All cases were confirmed by the indirect fluorescent antibody assay or latex agglutination test. Patients ranged in age from 1 to 90 years (median, 35 years). Fifty-one percent were female. Seventy-four percent of the patients resided in south Texas. Illness occurred in all months of the year, but 40% of the cases had onset in April, May, or June. Annual incidence increased with age and was higher in Hispanics. Murine typhus continues to be an important public health problem in Texas.

Adolescent↗
PubMedDate not supplied

Videotaped interviews in child sexual abuse cases: the Texas example.

Suchrara writes [1977: 296] that "a child's right to humane treatment must be considered not an option on the part of adults, but an obligation." The use of videotaped interviews as admissible judicial evidence is an important step toward Suchrara's goal; videotaped testimony attempts to balance the emotional, psychological, and developmental needs of the child with the civil liberties afforded to alleged perpetrators. The Texas State Legislature, with the passage of Senate Bill 836, broadened the civil rights of children to include the notion of humane treatment in civil and criminal investigations and proceedings. The Texas law establishes explicit guidelines to enhance the child's dignity in a traumatic and personal experience. Furthermore, the law protects the civil rights of the accused guaranteed by the sixth and fourteenth amendments to the U.S. Constitution. The successful implementation of the videotape law, however, depends on the skills and expertise of the social worker. The practitioner must possess specialized training in the dynamics of child sexual abuse and an extensive understanding of related law and legal processes. This expertise is built on a foundation of knowledge and skills required for effective interviewing, counseling, and an exhaustive understanding of human behavior theory. Given the complexity and interplay of law, rights, and human behavior, the social worker requires ongoing training in these areas in order that the interests of all concerned parties be protected. The Texas State Legislature provides an opportunity for the social welfare and legal communities to determine jointly how and to what extent the rights of a victim and an alleged perpetrator may be protected. The law is in hand; the success of its implementation now rests with the practitioners.

Child↗
PubMed1983

Leprosy in wild armadillos (Dasypus novemcinctus) of the Texas Gulf Coast: epidemiology and mycobacteriology.

A significant prevalence of leprosy has been demonstrated in wild Louisiana armadillos. The Texas Gulf Coast still has endemic human leprosy, and recent mores in Texas have markedly increased armadillo-human contact. Armadillos were screened by physical examination, and by ear-snip and slit-scrape technique. Animals that screened "positive" were sacrificed and necropsied under aseptic conditions. Liver, spleen, gross lesions, and four groups of lymph nodes were cultured for mycobacteria and were studied histologically. Base ratios and DNA homology with Mycobacterium leprae were determined on mycobacteria from two armadillos (and two tissues from one of these); these studies indicate that the organism found in Texas armadillos is M leprae. Twenty-one of the armadillos were leprous--4.66%. The local prevalence varied from 1.0% to 15.4%. Epidemiologic implications of these findings and the occurrence of other concomitant mycobacterial infections are discussed.

Animal Diseases↗