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At least 289 records · Page 16Linked to original sources
PubMed1998

Mycobacterium bovis in coyotes from Michigan.

During a survey for tuberculosis in wild carnivores and omnivores, Mycobacterium bovis was cultured from pooled lymph nodes of three adult female coyotes (Canis latrans) harvested by hunters in Michigan (USA). No gross or histologic lesions suggestive of tuberculosis were seen in these animals. One coyote was taken from Montmorency county and two coyotes from Alcona county located in the north-eastern portion of Michigan's Lower Peninsula where free-ranging white-tailed deer (Odocoileus virginianus) have been found infected with bovine tuberculosis. It is thought that these coyotes became infected with M. bovis through the consumption of tuberculous deer. Other species included in the survey were the opossum (Didelphis virginiana), raccoon (Procyon lotor), red fox (Vulpes vulpes), bobcat (Felis rufus), and badger (Taxidea taxus).

Animal Feed↗
PubMed1984

The elimination of selected drug products from the Michigan Medicaid formulary: a case study.

The purpose of this study was to evaluate the prescribing behavior, recipient response, and economic impact of the removal of selected prescription drug products from the Michigan Medicaid formulary. The frequency with which alternate legend drugs were prescribed and the frequency of continuous therapy via out-of-pocket cash were determined. From 17 independent Michigan pharmacies, a total of 137 patients with prescriptions for at least one eliminated drug product was identified. Of the Medicaid recipients on continuous therapy, 46% discontinued therapy. Over 23% had an alternate legend drug prescribed still covered under the Medicaid drug benefit. The alternate drug resulted in significantly higher acquisition costs. Over 30% of the recipients continued therapy at their own expense, representing a cost savings to the Medicaid program.

Drug Utilization↗
PubMed1999

Distribution and environmental risk factors for paratuberculosis in dairy cattle herds in Michigan.

OBJECTIVE: To determine prevalence of paratuberculosis among dairy cattle herds and to identify associated soil-related risk factors. SAMPLE POPULATION: Serum and soil samples for 121 Michigan dairy herds. PROCEDURE: Blood samples were collected from cows at each farm and tested for Mycobacterium paratuberculosis, using an antibody ELISA. Soil samples were collected from pastures and exercise lots; pH and available iron content were determined. A questionnaire was administered to collect data regarding farm management practices and productivity. RESULTS: 55% of the herds tested had > or = 2 M paratuberculosis-positive cattle. Adjusting sample prevalence for distribution of herd size strata yielded a statewide herd prevalence of 54%. Of 3,886 cattle tested, 267 had positive results. Prevalence of test-positive cattle was 6.9%. For every part per million (ppm) increase in soil iron content, there was a 1.4% increase in the risk of a herd being test-positive. An increase in soil pH of 0.1 was associated with a 5% decrease and an increase in soil iron content of 10 ppm was associated with a 4% increase in the number of test-positive cattle. Application of lime to pasture areas was associated with a herd being only 10% as likely to be paratuberculosis positive and with a 72% reduction in number of test-positive cattle. CONCLUSIONS AND CLINICAL RELEVANCE: Prevalence of paratuberculosis-positive dairy herds in Michigan (54%) was greater than expected, but prevalence of paratuberculosis-positive cattle (6.9%) was within anticipated values. These prevalences were associated positively with acidic soil and increased soil iron content. Application of lime to pasture areas was associated with reduced risk of paratuberculosis.

Animals↗
PubMed2000

Extracorporeal life support: the University of Michigan experience.

The University of Michigan experience with extracorporeal life support (ECLS) in 1000 consecutive patients between 1980 and 1998 is the largest series at one institution in the world. Among this patient population, survival to hospital discharge in moribund patients with respiratory failure was 88% in 586 neonates, 70% in 132 children, and 56% in 146 adults. Survival in moribund patients with cardiac failure was 48% in 105 children and 33% in 31 adults. This article describes the University of Michigan's overall ECLS patient experience, the progression of ECLS from laboratory experiments to clinical application at the bedside, the expansion of the technology to other centers, and current ECLS technology and outcomes. Despite the challenges faced in clinical research in this field, our experience and that of others has shown that ECLS saves lives of patients with acute cardiac or pulmonary failure in a variety of clinical settings.

Adult↗
PubMed2000

Thoracic surgery training at the University of Michigan.

The process of thoracic surgery resident education is and always has been taken very seriously at the University of Michigan, where it is regarded as a key mission of the faculty. More attention is paid to the details of providing a supportive educational environment using established principles of education, curriculum planning, evaluation, and feedback. Resident education is the order of business today and, although challenged by the demands of managed care and cost containment, it remains among the most important priorities at the University of Michigan.

History, 20th Century↗
PubMed1999

Evaluation of certification in the Milk and Dairy Beef Quality Assurance Program and associated factors on the risk of having violative antibiotic residues in milk from dairy farms in Michigan.

OBJECTIVE: To determine whether certification in a Milk and Dairy Beef Quality Assurance Program (MDBQAP) was associated with a reduced risk of having antibiotic residues in milk and to define specific management factors that may have predisposed dairy farms to having violative antibiotic residues in milk. SAMPLE POPULATION: 124 dairy farms in Michigan that had > 1 violative residue in milk during 1993 and 248 randomly selected control farms in Michigan that did not have violative residues in milk during 1993. PROCEDURE: A pretested structured questionnaire was mailed to case and control farms. A conditional multivariate logistic regression model was developed to determine risk factors associated with having a violative antibiotic residue in milk. RESULTS: Certification in the MDBQAP did not significantly reduce the risk of having a violative antibiotic residue. Annual treatment of > 10% of a herd for metritis was associated with a reduced risk of having a violative residue. Evidence suggested that a routine request for a milk processor to perform residue testing was associated with a decreased risk of having had a violative antibiotic residue, but routine on-farm residue testing was associated with an increased risk of having had a residue. CONCLUSIONS AND CLINICAL RELEVANCE: MDBQAP certification was associated, although not significantly, with a reduced risk of having violative antibiotic residues in milk. Risk factors significantly associated with violative antibiotic residues are addressed by various critical control points in the MDBQAP and may be indicators for strengths and weaknesses of MDBQAP.

Animals↗
PubMed2001

Time trends in sport-caught Great Lakes fish consumption and serum polychlorinated biphenyl levels among Michigan Anglers, 1973-1993.

Polychlorinated biphenyls (PCBs) remain public health concerns because of their persistence in the environment and their potential health impact. We linked data from three mixed cross-sectional/longitudinal surveys of Michigan anglers conducted by the Michigan Department of Public Health in 1973-1974, 1979-1982, and 1989-1993 to examine the association between sport-caught fish consumption and serum PCBs. The reported weight of fish consumed declined over the three surveys (median 40, 38, and 31 lb/yr). Serum Aroclor 1260 levels were 2-3 times higher in fish-eaters than in nonfish-eaters in all three surveys in both men and women. In nonfish-eaters, serum PCB levels rose between 1973-1974 and 1979-1982 [adjusted change = 0.30 log(ppb), p = 0.01] and then declined between 1979-1982 and 1989-1993 [adjusted change = -0.16 log(ppb), p = 0.002]. Among fish-eaters, serum PCB levels also rose between 1973-1974 and 1979-1982 [adjusted change = 0.45 log(ppb), p < 0.001] but were unchanged between 1979-1982 and 1989-1993 [adjusted change = -0.09 log(ppb), p = 0.14]. Predictors of serum PCB levels included annual fish consumption, gender, and age. We conclude that background human serum levels of Aroclor 1260 had declined by 1989-1993 from earlier peak levels. Among consumers of sport-caught Great Lake fish, serum PCB levels did not significantly decrease, probably due to continued exposure and the long half-life of PCB.

Adolescent↗
PubMed2001

Polychlorinated naphthalenes, biphenyls, dibenzo-p-dioxins, and dibenzofurans as well as polycyclic aromatic hydrocarbons and alkylphenols in sediment from the Detroit and Rouge Rivers, Michigan, USA.

Sediment from the upper Detroit and lower Rouge Rivers in southeastern Michigan, USA, were analyzed to examine the distribution of polychlorinated naphthalenes (PCNs), biphenyls (PCBs), dibenzo-p-dioxins (PCDDs), and dibenzofurans (PCDFs) as well as polycyclic aromatic hydrocarbons (PAHs) and alkylphenolic compounds such as butylphenol, octylphenol, and nonylphenol (NP). Sediments from a non-point source location in Lake Michigan were also analyzed for target compounds. Concentrations of target compounds in the upper Detroit and lower Rouge Rivers varied considerably among locations, and notable spatial variation existed. Concentrations of PCNs and PCDDs/PCDFs in sediments from the upper Detroit and lower Rouge Rivers ranged from 0.08 to 187 ng/g and 69 to 1420 pg/g dry weight, respectively. Total PCBs, PAHs, and NP concentrations ranged from 8 to 25,000, 17 to 44,000, and < 10 to 60,000 ng/g dry weight, respectively. Concentrations of all target compounds except PCNs were significantly correlated with total organic carbon content of sediments. Similarly, concentrations of PCBs, PCDDs, and PCDFs were significantly correlated with each other. The distribution of organic contaminants in the upper reaches of the Detroit River and lower Rouge River suggested the presence of localized, but multiple, sources of contamination for each compound class. Conners Creek combined sewer overflow has been identified as one of the potential sources for the upper Detroit River, where the highest concentrations PCBs and PCDDs/PCDFs were found. Polycyclic aromatic hydrocarbon and NP concentrations were consistently high in sediment from the lower Rouge River. Analysis of data from selected locations suggested that PCNs contributed a greater proportion of the dioxin-like activity than PCBs and PCDDs/PCDFs contributed.

Benzofurans↗
PubMedDate not supplied

Michigan Harvest Gathering creates a sense of family.

In 1998, the MHA became the primary sponsor of the Michigan Harvest Gathering food- and fund-raising drive to help the Food Bank Council of Michigan (FBCM) and its 12 regional food banks.

Community Health Planning↗
PubMed1994

Federal court rules on Hyde Amendment in Michigan case.

In a ruling issued on July 18 (1994), the US District Court for the Western District of Michigan found that the state's near ban on abortion coverage under Medicaid violates federal law because it is more restrictive than the current version of the federal Hyde Amendment. Chief Judge Benjamin F. Gibson ordered Michigan to cover abortions in cases of rape and incest, even though a 1988 law adopted by a voter initiative and upheld in 1992 by the state Supreme Court prohibits public funding except in cases of life endangerment. Last October, Congress approved the fiscal year 1994 Medicaid budget and slightly expanded abortion coverage to include funding for abortions in cases of rape and incest, as well as life endangerment. Summit Medical Center v. Smith, a CRLP lawsuit that was consolidated with Planned Parenthood v. Engler, was the second case this year in which a federal court ruled on state obligations under current Medicaid law. In early May, in a similar CRLP case, US District Court Judge Edward Nottingham enjoined enforcement of an amendment to the Colorado Constitution on the same grounds (see RFN III/9). On June 1, a trial court judge ordered Montana to comply with the Hyde Amendment in an CRLP suit; a federal district court in Montana came to the same conclusion on June 20 in a case filed by Planned Parenthood. CRLP suits in federal court against states for non-compliance are still pending in Arkansas, Louisiana, North Dakota, Oklahoma, and Pennsylvania.

Abortion, Induced↗
PubMedDate not supplied

Characterization and statistical modeling of bacterial (Escherichia coli) outflows from watersheds that discharge into southern Lake Michigan.

Two watersheds in northwestern Indiana were selected for detailed monitoring of bacterially contaminated discharges (Escherichia coli) into Lake Michigan. A large watershed that drains an urbanized area with treatment plants that release raw sewage during storms discharges into Lake Michigan at the outlet of Burns Ditch. A small watershed drains part of the Great Marsh, a wetland complex that has been disrupted by ditching and limited residential development, at the outlet of Derby Ditch. Monitoring at the outlet of Burns Ditch in 1999 and 2000 indicated that E. coli concentrations vary over two orders of magnitude during storms. During one storm, sewage overflows caused concentrations to increase to more than 10,000 cfu/100 mL for several hours. Monitoring at Derby Ditch from 1997 to 2000 also indicated that E. coli concentrations increase during storms with the highest concentrations generally occurring during rising streamflow. Multiple regression analysis indicated that 60% of the variability in measured outflows of E. coli from Derby Ditch (n = 88) could be accounted for by a model that utilizes continuously measured rainfall, stream discharge, soil temperature and depth to water table in the Great Marsh. A similar analysis indicated that 90% of the variability in measured E. coli concentrations at the outlet of Burns Ditch (n = 43) during storms could be accounted for by a combination of continuously measured water-quality variables including nitrate and ammonium. These models, which utilize data that can be collected on a real-time basis, could form part of an Early Warning System for predicting beach closures.

Ammonia↗
PubMed2003

Severe morbidity and mortality associated with influenza in children and young adults--Michigan, 2003.

During late January 2003, the Michigan Department of Community Health (MDCH) received reports of severe unexplained illnesses and deaths in children and young adults aged <21 years residing in Michigan. Subsequently, two of the deaths were found to be associated with influenza, including one with neurologic complications. To identify cases of severe influenza in otherwise healthy children and young adults aged <21 years, MDCH conducted enhanced surveillance for influenza-associated illness. This report summarizes the findings of this ongoing investigation, which indicate the need to better define the frequency of serious complications from influenza in healthy children and to incorporate such findings into evaluations of current vaccine recommendations for children.

Adolescent↗
PubMedDate not supplied

Caries prevalence in northwest Michigan migrant children.

PURPOSE: The purpose of this study was to describe the prevalence of dental caries in a sample of Hispanic-American migrant workers' children and compare the results with an earlier Northwest Michigan migrant study to assess if migrant children have benefited from the global caries decline. METHODS: A non-probability convenience sample of migrant farm worker children was obtained from migrant schools in Northwest Michigan during the summer of 1999. Field dental equipment was used to examine caries, fluorosis, and urgent dental needs by 1 examiner. Statistical analysis was performed using SAS software with the student t-test used to test for differences between the samples. Intra-examiner reliability was high for caries at the surface level (kappa = 0.94). RESULTS: The sample consisted of 211 children with 95% ranging in ages from 5 to 13. Mean caries levels were as follows: DMFT = 1.1 (SD 1.6); DMFS = 1.6 (SD 2.5); dft = 3.0 (SD 2.9); dfs = 6.3 (SD 6.7) Fifty percent of children with at least 1 permanent tooth (189) were caries free, with 17% (34) having DMFT values greater than or equal to 3. The large number of caries-free children displayed a skewed distribution of caries where a small proportion of the population harbored the majority of the disease. A statistically significant decrease in caries was evident in permanent teeth (P = .0001) between 1999 and 1982 samples, but no change was realized in primary teeth (P = .7). CONCLUSIONS: Results indicated that the caries decline has extended to this long-neglected migrant group, but only in the permanent dentition. Caries remained moderate to high in the primary dentition and the caries burden was carried by a relatively small segment of the population. Dental treatment programs should be expanded to include preschool children who appear to be at the highest risk for caries.

Adolescent↗
PubMed2004

Voluntary HIV counseling and testing of pregnant women--an assessment of compliance with Michigan public health statutes.

OBJECTIVES: First, to evaluate compliance with Michigan's laws mandating universal, voluntary HIV counseling and testing (VCT) of all pregnant women who provide informed consent (ie, the "opt-out strategy"). Second, to assess the acceptability of and agreement to VCT. METHODS: Women who delivered a live infant at a large, urban academic medical center were interviewed before hospital discharge. Obstetric and prenatal medical records were abstracted to document that VCT was offered, accepted, or declined and that pre- and posttest counseling were provided and test results noted. RESULTS: Our survey of 491 postpartum women interviewed from February 1998 through January 1999 revealed that 83% reported that they were offered VCT; of those, 95% reported that they had agreed to testing. Uninsured women were least likely to undergo VCT; no other demographic, social, or behavioral characteristics were associated with VCT. Nor was VCT more likely to occur according to providers' different practice settings (ie, "private" vs publicly funded). Most women reported that they did not find VCT offensive or threatening, although only 49% reported that they felt "very comfortable," refusing testing. CONCLUSION: These results suggest the opt-out strategy for VCT, as currently practiced in Michigan, can effectively promote the US Public Health Service testing goals. Offering VCT with the understanding that it may be refused without risk is essential. Additional educational interventions about HIV infection during pregnancy and perinatal HIV-transmission interruption were requested by women in our study and should be widely promoted. Given that 95% of women agreed to VCT, mandatory testing without consent is not needed to achieve federal testing benchmarks and seems ethically problematic.

AIDS Serodiagnosis↗
PubMedDate not supplied

The Michigan leadership model: developing a management infrastructure.

University of Michigan Health System underwent a number of reduction strategies in the early 1990s to address the rising costs of healthcare. By 2001, an analysis revealed that these strategies negatively impacted employee satisfaction and patient care. A team of nurse managers was charged with redesigning the current support structure for nurse managers. The team conducted an analysis of the current situation and designed a new model called the Michigan Leadership Model comprising both administrative and leadership support positions.

Humans↗
PubMed2005

Pregnancy and other factors associated with higher CD4+ T-cell counts at HIV diagnosis in Southeast Michigan, 1992-2002.

BACKGROUND: Early diagnosis of HIV infection provides the opportunity for treatment to prevent progression to AIDS and for intervention to prevent further transmission. The impact of routine screening of pregnant women and other factors on the stage of HIV disease at diagnosis were evaluated. METHODS: Data were collected in 1992-2002 from the medical records of persons presenting for HIV-related care at 2 major medical centers in Detroit, Michigan. Patients were included in the analysis if they had a CD4+ T-cell count recorded within 6 months of their first positive HIV test (N = 1858). RESULTS: Half of the patients (49%) had a first CD4+ T-cell count of < 200 cells/mm3 and 19% had an AIDS-defining illness at the time of HIV diagnosis. In the multivariate model, pregnant women were less likely than nonpregnant women to enter care with a CD4+ T-cell count of < 200 cells/mm3 (odds ratio, .24; 95% confidence interval, .14-.41). Even after adjusting for pregnancy, female sex was protective, as was age < 30 years. HIV-transmission risk factors, race, and time period of HIV diagnosis were not significantly associated with first CD4+ T-cell counts of < 200 cells/mm3. CONCLUSION: Routinely offering HIV testing in prenatal care, as required by Michigan law, resulted in earlier diagnoses of HIV in pregnant women, as indicated by their higher CD4+ T-cell counts. Increasing routine HIV testing of all persons seeking medical care may increase the overall proportion of HIV diagnoses that are made early in the disease process.

Adult↗
PubMedDate not supplied

HIV infection treatment costs under Medicaid in Michigan.

The Michigan Medicaid Program payment records generated in the period 1985-89 by 783 persons were analyzed for services related to human immunodeficiency virus (HIV) infection. Other data from death records and the Michigan AIDS Surveillance Registry were available for a subset of those persons. The average monthly payment in 1989 dollars for HIV-related services was $1,302.57. Services determined to be unrelated to HIV infection accounted for 12.5 percent of the total amount for health care received and another 2.5 percent was questionable. The average monthly expenditure for men was roughly twice that for women. The discrepancy did not exist among persons identified in the AIDS Surveillance Registry. Sex differences ceased to exist when Medicaid eligibility (disability versus Aid to Families with Dependent Children) was controlled for by analysis of variance. There were no significant differences between payments to those infected through male-to-male sexual contact and those infected through intravenous drug use. Payments for HIV treatments rose with age to about 40 years, and declined slightly among older adults. The sharpest rise was for those ages 19-25 years and 26-35 years. Large sex differences existed among those who received zidovudine (AZT), 61.4 percent of the men and 19.1 percent of the women. Controlling for Medicaid eligibility moderated those differences, but they remained statistically significant. Differences in zidovudine usage were not found between men and women in the subset identified in the AIDS Surveillance Registry nor among persons infected through male-to-male sexual contact and intravenous drug use.

Adult↗
PubMed2006

Drinking water in Michigan: source, quality, and contaminants.

The Michigan Safe Drinking Water Act (Act 399) was enacted in 1976 and enables the Michigan Department of Environmental Quality (DEQ) to maintain the state's authority over drinking water in the state. The DEQ also contracts with local health departments to maintain non-community programs in each county. Private water wells throughout the state are clearly the most troublesome for users and regulators. An abundant array of contaminants (e.g., pesticides, metals, etc.) may impact wells without the user's knowledge. Most private wells are only inspected when they are installed and have no further regulatory requirements. With regards to contaminants in public systems, lead is problematic. Irregardless of the source or treatment, the piping infrastructure leading to and inside the home can be a source affecting the quality. Thus, the problem of lead in drinking water can be from the service lines, the pipes inside the home, the solder connecting the pipes, or in some case the treatment chemicals used for disinfection.

Humans↗