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The number of reported cases of gonorrhea in Colorado increased 19.9% from 1991 to 1992 after declining steadily during the 1980s. In comparison, in the United States, reported cases of gonorrhea in 1992 continued an overall decreasing trend (1). This report summarizes an analysis of the increase in gonorrhea in Colorado in 1992 and characterizes trends in the occurrence of this disease from 1985 through 1992.
Non-insulin-dependent diabetes mellitus is between two and five times more prevalent among Hispanic Americans than among non-Hispanic whites (NHW). Incidence data for Hispanic populations will help to determine whether this excess prevalence is due to increased incidence, survivorship, or other factors. Incident cases were identified through concurrent surveillance of all local medical practices from 1983 to 1988 in two southern Colorado counties in which the population was 46% Hispanic. All identified subjects were invited for an oral glucose tolerance test. Among the subjects who attended clinic, 83% were confirmed as having diabetes, using WHO criteria. The standardized average annual incidence rates per 1000 for confirmed non-insulin-dependent diabetes, accounting for nonresponse, were 3.7 and 1.6 for Hispanic and NHW males, and 4.5 and 1.2 for Hispanic and NHW females, respectively. The age and nonresponse adjusted rate ratio comparing Hispanics to NHWs was 3.1 (95% CI: 2.3-4.2), indicating a significant excess risk of diabetes incidence for the Hispanic population in southern Colorado. Peak age-specific incidence among Hispanics occurred in persons 50 to 59 years old, a decade earlier than among NHWs. These results are consistent with data from the Mexican-American population in Texas and suggest that the previously observed excess in diabetes prevalence is due to higher incidence rates. The earlier age-specific peak in incidence has also been observed in Mexican-American and American Indian populations, suggesting that risk factors may operate at earlier ages.
This study was undertaken to investigate the authors' clinical impression that there are significant differences between the male and female insanity acquittees in Colorado, and that these differences result in significantly different treatment needs. The study sample included 149 patients: 112 men and 37 women committed to the Colorado Mental Health Institute at Pueblo as not guilty by reason of insanity (NGRI). Data were collected from a computerized data system and from chart reviews. The study provides descriptive data regarding demographic, legal, and mental health parameters of these acquittees. Demographic items included prior history of incarceration, age at first arrest, type of NGRI crime committed, and severity of NGRI crime. Mental health variables included prior psychiatric hospitalization history of suicide attempts, substance abuse history, inpatient substance abuse treatment history, diagnoses, escape history and length of stay. Percentages of male and female subjects were calculated for those variables with discrete categories. Means and medians were calculated for continuous variables. Results indicate that women are significantly more likely to be given a diagnosis of mood disorder or borderline personality disorder, are significantly older than men at the time of commitment, and are statistically more likely to have committed a single violent crime than men. Men were found to have a significantly higher rate of prior and current substance abuse, a significantly higher rate of antisocial personality disorder, a significantly greater history of violent crime prior to the NGRI offense, and arrests beginning at a significantly younger age than women. Despite the higher severity of crime rating for women, their length of stay was significantly shorter than for men. The implications of the findings with regard to different treatment needs are discussed, and the findings are compared to four other studies addressing female versus male insanity acquittees in other states.
During March-april 1996, a physician in the Denver area administered intramuscular injections of a preparation labeled "adrenal cortex injection" to 69 patients in Colorado as part of a weight-loss regimen. As of August 7, a total of 47 (68%) of these persons were reported to have developed abscesses (diameters ranging from 0.5 cm to 4.0 cm) at the site of injection (either gluteal or deltoid muscle). An investigation of these episodes by the physician and the Colorado Department of Public Health and Environment identified Mycobacterium abscessus as the cause of the infections. This report summarizes preliminary findings of the ongoing investigation, which indicate that injection-site abscesses were associated with contaminated injectable preparations.
Late in 1991, Colorado's Medicaid program approved coverage for the hormonal contraceptive implant among Medicaid recipients. Subsequently, the Colorado Department of Public Health and Environment undertook an analysis of data supplied by the state's Medicaid program of the probability of repeat births among Medicaid recipients. According to life-table analysis of two cohorts of women in the database who had their first Medicaid-eligible birth in 1991 and 1992, the rate of repeat delivery within 24 months of the preceding birth fell from 14.1% among 11,554 women who first delivered in 1991 to 10.6% among 13,624 women who first delivered in 1992. The 25% decline in the rate of repeat births between the two cohorts was statistically significant. These rates were higher among Medicaid-eligible mothers who first gave birth as teenagers-22.3% in the 1991 cohort and 15.9% in the 1992 cohort. Among the 2,739 Medicaid-eligible women who delivered in 1992 and chose to use the implant within six months of delivery, the repeat delivery rate was just 2.5% within 24 months; this proportion was virtually the same among implant users in the 1992 cohort who first gave birth as teenagers (2.3%).
The prevalence of diagnosed diabetes in the United States is 3%; however, diabetes accounts for approximately 15% of total U.S. health-care expenditures. Preventive-care practices (e.g., glycemic control and regular foot and ophthalmic examinations) can reduce the occurrence and progression of diabetic complications. Although managed-care organizations (MCOs) have assessed the use of such practices through chart reviews, telephone surveys of MCO patients with diabetes are a less expensive method for collecting accurate data. The ongoing, state-based Behavioral Risk Factor Surveillance System (BRFSS) telephone survey can be used to assess levels of care provided by MCOs and self-care practices among persons with diabetes in MCO populations. In 1995, a Colorado-based MCO collaborated with the Colorado Diabetes Control Program (CDCP) to use the state-based BRFSS to assess care practices among MCO enrollees. This report presents findings from the CDCP analysis of data on MCO enrollees aged > or = 30 years who had diabetes; the findings indicate that, although approximately three fourths of enrollees reported most preventive-care practices, two thirds had never heard the term hemoglobin "A-one-C," one fourth had not had their feet examined during the preceding year, and nearly one fifth did not receive an annual dilated-eye examination.
The life and work of Dr. Frederick S. McKay in solving the mystery of the Colorado Brown Stain changed the objectives of restorative and preventive dentistry. McKay was an intellectually diversified man whose personal interests ranged from economics to opera. Professionally his strong commitment to research led to dedicate thirty years of his life to the search for the mysterious agent that caused the Colorado Brown Stain which mottled but also produced caries-free teeth. His discovery of fluoride in drinking water and its effect on enamel was a critical breakthrough in understanding the etiology and prevention of dental caries. This discovery is the foundation for water fluoridation which is the single most effective public health measure to inhibit tooth decay.
PURPOSE: The purpose of this pilot study was to gather demographic data about six Colorado dental hygienists who were practicing independently and their practices as well as assess productivity and service mix, evaluate structure and process, and compare the findings in these practices to those of a study of California Health Manpower Pilot Project #139. METHODS: A convenience sample of six dental hygiene independent practices was studied. A 21-item survey was distributed by mail to obtain demographic and practice information. Weekly surveys tracking patient visits and services provided were completed for three months. A general office audit to evaluate structure and a record audit of 22 patient records to evaluate process were conducted during visits at each practice site. The overall responses for each phase of this study were tabulated and frequencies were calculated using the SPSS/PC+ statistical package. RESULTS: The dental hygienists had practiced for an average of 13 years prior to establishing their practices. Four of the six practices were office-based, one was institution-based, and one was office- and institution-based. Health history, extraoral/intraoral examination, periodontal probing, adult prophylaxis, and oral hygiene instruction were provided during a majority of patient visits. The general office audit revealed compliance with infection control, office protocols for emergency situations, and practice management protocols. The patient record audit indicated a high standard for process of care for the practice sites. CONCLUSION: The six practices revealed a variety of backgrounds among the dental hygienists and diverse practice characteristics regarding both the populations served and practice settings. The services provided were consistent with allowable services for unsupervised practice. Compliance with specific guidelines was verified during the general office and patient record audits. Consistent with the findings of California Health Manpower Pilot Project #139, the care provided by the Colorado dental hygiene independent practitioners in this study and the environment in which the care was provided do not exhibit any undue risk to the health and safety of the public.
Forty-nine Colorado birds of 6 galliform species were positive for Plasmodium (Giovannolaia) pedioecetii which we feel to be the same parasite described by Wetmore (1939) from a shaptailed grouse from North Dakota. Except for its presence in Darwin's tinamou (Nothura darwinii) from Colorado, it has been reported only from gallinaceous birds. Most stages were predominantly subpolar to polar. There were a daily 8 am to noon peak of merozoite production, but no synchronicity. Merozoite number ranged from 8 to 22, with a mean of 10.9. Gametocytes were long and slender, some curving around one end of the host nucleus.
We reported earlier the importance of digestive cathepsin D-like activity for initiating dietary protein hydrolysis in Colorado potato beetle, Leptinotarsa decemlineata Say [Brunelle et al. (1999) Arch. Insect Biochem. Physiol. 42:88-98]. We assessed here whether transgenic lines of potato (Solanum tuberosum L.) expressing a cathepsin D inhibitor (CDI) from tomato would show resistance to the beetle, or if the insect would compensate for the loss of cathepsin D activity after ingesting the recombinant inhibitor. Transgenic potato lines expressing tomato CDI were developed by Agrobacterium tumefaciens genetic transformation, and selected based on their relative amount of CDI. After confirming the absence of detectable visible effects of CDI on the plant's phenotype, diet assays with control and transgenic lines were carried out to assess the impact of the inhibitor on growth and development of the insect. Leaf consumption, relative growth rate, molting incidence, and digestive protease activity were monitored at 12-h intervals over 132 h for 3rd-instar larvae provided with transgenic potato foliage. Leaf consumption and relative growth rate were slightly reduced during the first 12 h for larvae fed CDI, but no significant differences were observed thereafter. In contrast, time for molting to the 4th larval stage was significantly longer for larvae fed modified plants, with developmental delays of approximately 10 h (0.5 day) compared to control larvae. Recombinant CDI also had an impact on the insect's digestive physiology, readily inducing overproduction of digestive proteases (rubiscases), followed by a gradual decrease of total and pepstatin-sensitive activity. Overall, these observations show the ability of Colorado potato beetle to compensate for the loss of cathepsin D activity by modulating its digestive protease complement in response to aspartate-type inhibitors in the diet. From a practical viewpoint, these data stress the importance of devising improved strategies for the effective inhibition of insect digestive proteinases in vivo, based on the use of hybrid inhibitors active against different protease classes.
The Colorado potato beetle, Leptinotarsa decemlineata (Say), has developed resistance to many insecticides used for its control, recently including imidacloprid, a neonicotinoid compound. Other neonicotinoids are now being deployed to control this pest. A key point in the strategies of resistance management is the monitoring of resistance and cross-resistance. In the summer of 2003, imidacloprid-resistant adult Colorado potato beetles collected from Long Island, New York, USA were bioassayed using topical applications of imidacloprid and nine other neonicotinoids. Compared to a standard susceptible strain, the Long Island beetles showed 309-fold resistance to imidacloprid, and lower levels of cross-resistance to all other neonicotinoids, despite these never having been used in the field, i.e., 59-fold to dinotefuran, 33-fold to clothianidin, 29-fold to acetamiprid, 28-fold to N-methylimidacloprid, 25-fold to thiacloprid, 15-fold to thiamethoxam, 10-fold to nitenpyram, but less than 2-fold to nicotine. In injection bioassays, high resistance to imidacloprid was also found (116-fold). Piperonyl butoxide partially suppressed resistance to imidacloprid, but the resistance level was still over 100-fold, indicating that other mechanisms were primarily responsible for resistance. Low levels of resistance (8- to 10-fold) were found to the nicotinic activator, spinosad, in an imidacloprid-resistant strain collected from the same field in 2004. The cross-resistance seen with all the neonicotinoids tested suggests that the rotation of imidacloprid with other neonicotinoids may not be an effective long-term resistance management strategy. Rotation with spinosad also carries some risk, but it is unlikely that spinosad resistance in this case is mechanistically related to that for the neonicotinoids.
One of the major challenges in managing the Colorado potato beetle, Leptinotarsa decemlineata (Say) is its remarkable ability to develop resistance to virtually every insecticide that has ever been used against it. Resistance is particularly common throughout northeastern USA as far north as Maine. The first instances of resistance to imidacloprid have already been reported from several locations in New York, Delaware and southern Maine. Rotating insecticides with different modes of action may delay insecticide resistance, but successful implementation of this technique depends on a good understanding of resistance and cross-resistance patterns in populations of target pests. LC(50) values were measured for imidacloprid and thiamethoxam in Colorado potato beetle populations from a variety of locations in the USA and Canada using diet incorporation bioassays. The field performance of imidacloprid, thiamethoxam and clothianidin against imidacloprid-resistant beetles on a commercial potato farm in southern Maine was also evaluated. Correlation between LC(50) values for imidacloprid and thiamethoxam was highly significant, even when populations previously exposed to thiamethoxam were excluded from the analysis. There was no statistically detectable difference in the LC(50) values between populations exposed to both insecticides and to imidacloprid alone. Applications of neonicotinoid insecticides at planting delayed build-up of imidacloprid-resistant beetle populations on field plots by 1-2 weeks but failed to provide adequate crop protection. Consistently with bioassay results, there was also substantial cross-resistance among the three tested neonicotinoid insecticides. Results of the present study support the recommendation to avoid rotating imidacloprid with thiamethoxam as a part of a resistance management plan.
Acute or chronic sublethal exposure of Colorado potato beetle larvae to the CryIIIA delta-endotoxin of Bacillus thuringiensis Berliner did not significantly (P > 0.05) alter their subsequent susceptibility to Beauveria bassiana (Balsamo) Vuillemin. During the period of exposure to B. bassiana there was continued mortality from previous exposure to delta-endotoxin, and B. bassiana also caused significant mortality. Acute and chronic exposure to delta-endotoxin significantly prolonged larval development. The weights of prepupae and adults were significantly reduced by exposure to delta-endotoxin, with the greatest effect being from chronic exposure. Separation of the manifestations of stress in time (feeding vs soil stages) and space (toxin damage to the insect gut vs fungal penetration of the cuticle and activity in the hemocoel) may have precluded alteration of insect susceptibility to infection by B. bassiana. Endemic populations of B. bassiana are not expected to influence the development of resistance in the Colorado potato beetle to the delta-endotoxin of B. thuringiensis.
Antisera against vasopressin, vasotocin, oxytocin, neurophysin-1 and neurophysin-2 were used to investigate immunocytochemically the presence of neurons containing substances antigenically related to these peptides in the nervous system of the Colorado potato beetle. Ten different antisera were used, four against vasopressin, three against oxytocin and one against vasotocin, neurophysin-1, and neurophysin-2. Immunoreactivity was shown by all antisera except those against the neurophysins. The vasopressin antisera all gave different results. One antiserum revealed only a single neuron pair, whereas others revealed in addition one or two other different cell groups. The oxytocin antisera likewise revealed different neurons. The fixation procedure influenced the outcome of the immunocytochemical reaction. Immunoreactivity as revealed by vasopressin, vasotocin and oxytocin antisera is often co-localized in the same neurons; solid phase adsorptions showed that this is due to cross-reactivity of the antisera. Some of the immunoreactive neurons are identical to those recently described to contain a bovine pancreatic polypeptide/FMRFamide-like peptide. This co-localization is probably not due to a cross-reaction. These findings indicate the presence of several vasopressin-like and oxytocin-like substances which in the Colorado potato beetle all have a different degree of immunocytochemical resemblance to vasopressin and oxytocin.
A Colorado (CO) strain of Helisoma trivolvis resistant to miracidial infection, but susceptible to Echinostoma trivolvis cercarial penetration, was used to study encystment of cercariae released from naturally infected H.trivolvis (Pennsylvania strain). All 12 snails, 8-10 mm in shell diameter, each exposed to 25 cercariae and necropsied 1-4 days post-exposure were infected with between 9 and 19 cysts per snail (average 14). In all infectivity experiments, regardless of the size (age) of the Colorado strain snails used, encysted metacercariae were recovered from the kidney-pericardial region of experimentally infected snails within 24 h post-exposure. Snails exposed individually with 500 cercariae averaged 230 cysts per snail at 24 h p.i. Cercariae encysted at 6-8 h p.i., but not at 2 and 4 h p.i. Light microscopical observations of the cysts suggested that greater than 99% were viable. Metacercariae subjected to in vitro excystation in an alkaline trypsin-bile salts medium showed excystation rates of 60-85%. In conclusion, H. trivolvis (CO strain) is an excellent experimental second intermediate host for cercarial encystment of E. trivolvis.
A total of 2,909 bulls was cultured for the presence of Trichomonas fetus at slaughter at 4 abattoirs in Colorado and Nebraska. Samples were collected using the dry pipette preputial scraping technique and were transported to diagnostic laboratories within 24 h. Of the bulls cultured, 5 were positive. The state of the last origin for each animal was Kansas, 1 bull, Montana, 1 bull, Nebraska, 1 bull, and Utah, 2 bulls. These results indicate and incidence of less than 1% (0.172%) of trichomoniasis in the populations tested, even in the states of Colorado and Nebraska where the larger numbers of bulls were cultured.
A cDNA encoding acetylcholinesterase (AChE, EC 1.1.1.7) was cloned from a cDNA library constructed from an insecticide-susceptible strain of Colorado potato beetle, Leptinotarsa decemlineata (Say). The complete amino acid sequence of AChE deduced from the cDNA consisted of 29 residues for the putative signal peptide and 600 residues for the mature protein with a predicted molecular weight of 67,994. Northern blot analysis of poly(A) RNA showed an approx 13.1-kb transcript. The mature protein sequence had 57 and 61% of amino acid residues identical to those of Drosophila melanogaster and Anopheles stephensi, respectively, and produced a remarkably similar hydropathy profile when compared to those of the two dipterous species. The three residues (Ser, Glu and His) that putatively form the catalytic triad and the six Cys that form intra-subunit disulfide bonds were completely conserved when compared to the other seven AChEs from a broad range of animal species reported to date. Other properties of the deduced protein of AChE, including molecular weight and amino acid composition, agreed well with those of a previously reported study on the purified AChE from the same insect species. All these features firmly established that the cloned cDNA encodes AChE in Colorado potato beetle.
An extract of head ganglia and retrocerebral complexes of nondiapausing and diapausing Leptinotarsa decemlineata was prepared to characterize regulatory neuropeptides involved in adult diapause by using a differential peptidomics approach. To reduce sample complexity, both extracts were roughly separated by means of an identical chromatographic step. MALDI-TOF MS led to the identification of proctolin, an adipokinetic hormone, and short neuropeptide F I and II in the extract of nondiapausing beetles. In combination with nano-ESI-Q-TOF MS(2) evidence was found for the presence of three pyrokinins, the first to be identified in a coleopteran species. Pyrokinins, involved in the induction of embryonic diapause in Bombyx mori, were present in both physiological conditions suggesting that they are of minor importance in the regulation of adult diapause in the Colorado potato beetle. A striking difference, detected by the differential peptidomics approach, between both neuropeptide profiles was the absence of ions corresponding to the short neuropeptide F (sNPF) related peptides, also known as Led-NPF-I and -II, in the extract of diapausing animals. Therefore, we postulate that "short NPFs" are involved in the regulation of adult diapause, displayed by the Colorado potato beetle.