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Diabetic ketoacidosis at the Children's Hospital of Oklahoma: a review on presentation and management.

Examination of 394 cases of diabetic ketoacidosis presenting at the Children's Hospital of Oklahoma from 1975 to 1987 has indicated a higher frequency of very young patients with low insulin requirements and frequent presentation in the winter months. The severity of the preceding hyperglycemia varies widely as indicated by the range of glycosylated hemoglobin values at the time of diagnosis. In addition we have identified measures to prevent the main hazards occurring during therapy which are related to potassium replacement and correction of dehydration without causing cerebral edema. The general principles of management are reviewed and we have selected certain aspects for emphasis and discussion based on past experience.

Child↗

An epidemiological study of the ocular and visual profiles of Oklahoma Cherokees and Minnesota Chippewas.

Over the last three decades some American Indian tribes in North America have received attention in the literature as a minority group with unique visual characteristics. Studies on the refractive status of Indians have shown an increase of refractive errors and particularly an abnormally high prevalence, and amount of, with-the-rule astigmatism. These changes appear to have taken place over the last 40 years. Eskimos, on the other hand, have recently showed an astoundingly high incidence of myopia. Other Native American tribes do not show dramatic changes in myopia or astigmatism. The Public Health Service-Indian Health Service, as an ongoing aspect of their responsibilities to Native Americans, perform screenings on children. This study reports the results of visual screenings primarily of Oklahoma Cherokee and Minnesota Chippewa children.

Astigmatism↗

Cocaine babies in Oklahoma.

Recreational use of cocaine has resulted in a dramatic increase in the incidence of fetal exposure to cocaine. Increased awareness by health professionals is needed to determine the extent of the problem in Oklahoma.

Breast Feeding↗

Occupational medicine and worker's compensation in Oklahoma.

The worker's compensation system in Oklahoma is the product of a long history of evolution involving influences from social, legal, political, cultural, and economic realms. This process of adaptation continues today. Most recently the system was amended effective November 1986. The basic principles of a worker's compensation program are important, as well as the new changes resulting from recent reforms.

Accidents, Occupational↗

Clinical experience with HIV-infected patients at the University of Oklahoma Health Sciences Center.

Two hundred seventy-two patients infected with human immunodeficiency virus (HIV) have received care from the members of the adult infectious disease section at the University of Oklahoma Health Sciences Center. The majority of these patients met the diagnostic criteria for acquired immunodeficiency syndrome. This group of patients was characterized by relatively few parenteral drug abusers, a high incidence of disseminated histoplasmosis, and an unexpectedly low frequency of toxoplasmosis. The prevalence of risk behaviors and endemic disease may be responsible for these particular case distributions.

Acquired Immunodeficiency Syndrome↗

The prevalence and risk of diabetic retinopathy among Indians of southwest Oklahoma.

The overall prevalence of diabetic retinopathy was 49.3% among 142 diabetic Indians examined at the Indian Health Service at Clinton, Oklahoma. Univariate analysis suggested a positive relationship between duration of diabetes and prevalence of retinopathy. This Indian diabetic population should be examined yearly for diabetic retinopathy.

Adult↗

Trypanosoma cruzi from wild raccoons in Oklahoma.

Trypomastigotes of Trypanosoma cruzi were detected in the blood of 5 of 8 wild adult raccoons which were live-trapped in Tulsa, Okla. Organisms were isolated in diphasic blood agar medium and maintained in Vero cell cultures. Inoculated mice exhibited transient parasitemias without tissue involvement. Amastigote forms occurred within Vero cells. This is the first report of naturally occurring T cruzi infection of wild mammals in Oklahoma.

Animals↗

Trypanosoma cruzi infection in a dog from Oklahoma.

A dog with signs of weakness, labored breathing, and generalized edema was examined. It was heavily infested with fleas and had wounds resulting from a recent fight. Hematologic findings were not remarkable, except for parasites in the blood. The dog was treated for fleas and given antibiotics, but was euthanatized when it failed to respond. Blood and tissue specimens were found to contain Trypanosoma cruzi, and the serum contained antibodies to the organism. We believe this is the first confirmed case of T cruzi infection in dogs from Oklahoma. The public health implications of this finding are underscored by a report on the detection of T cruzi in raccoons in the same season and geographic area.

Animals↗

Developing competency tests for Oklahoma's dietetic support personnel program.

Competency tests were developed for Oklahoma's Dietetic Support Personnel Training Program to assure the professional quality of its graduates. The tests' content validity was assured through an elaborate committee validation process. The tests' reliability was investigated using split-halves methods, and their criterion-related validity was investigated using non-parametric methods to correlate workers' test scores with employers' on-the-job performance ratings. The tests' reliability indexes varied between 0.88 and 0.97, indicating their consistency. Their validity indexes varied between 0.13 and 0.78, indicating the need for further work in some test areas.

Dietetics↗

Nursing home glaucoma and visual acuity screening results in western Oklahoma.

Six hundred and four patients from 19 nursing homes in rural western Oklahoma underwent visual acuity and glaucoma screening. Thirty-seven percent (221/604) had corrected near visual acuity less than or equal to 20/200 in one or both eyes. Fourty-nine percent (298/604) had best distance visual acuity less than or equal to 20/200 in one or both eyes. Improvement of distance visual acuity of two or more lines of vision by the use of pinhole viewing (indicating a possible need for glasses lens change) was helpful in only 12% (36/298) of patients with distance visual acuity less than or equal to 20/200. Fifteen percent (50/316) had intraocular pressure (Schiotz tonometry) greater than or equal to 24 mm hg. The incidence of significant visual acuity impairments and borderline-elevated glaucoma testing in the nursing home population is significantly higher than for a comparable general community vision and glaucoma screening of a more mobile and youthful population (Table 7). Eleven percent (66/604) were determined to have had an eye examination (ophthalmological or optometric) within the previous two years. Because potentially severe visual loss caused by cataracts, glaucoma, some forms of macular degeneration, and diabetic retinopathy may be reduced by timely medical or surgical eye treatment, the study suggests that many nursing home patients who might benefit from ophthalmologic care are currently not receiving it. Consideration, therefore, should be given for similar future screenings at other nursing home populations.

Adolescent↗

Prevalence of gastrointestinal parasitism in Oklahoma swine.

The prevalence of swine gastrointestinal parasites was determined from all listed large swine operations (28) and a geographically representative sample (70) of the population of small hog farm operations in Oklahoma. Fecal samples (n = 975) were collected from 98 farms. From the 98 farms, parasites were recovered in pig feces as follows: Ascaris, 53.0%, strongyles, 53.1%, Trichuris, 35.7%, spirurids, 6.1%, Strongyloides, 19.4%, coccidia, 57.1%, and Balantidium, 55.1%. A higher percentage (16.5%) of hogs maintained on cement floors were positive for Ascaris than were those on either dirt lots (11.9%) or slatted floors (9.9%), but pigs on dirt lots were more often positive with a higher percentage of coccidia (21.0%) than those on either cement or slatted floors (8.5% and 6.0%, respectively). Prevalence of Trichuris was essentially the same (6.8% to 11.3%) in hogs from all 3 management practices.

Animals↗

Cytauxzoonosis in domestic cats: report of two cases in Oklahoma, with a review and discussion of the disease.

In 2 cases of cytauxzoonosis in domestic cats in Oklahoma, the clinical features, gross lesions, and microscopic findings were of similar nature and degree to those previously reported by others, both in the naturally occurring and experimentally induced disease. Intraerythrocytic forms of Cytauxzoon felis organisms were demonstrated in stained blood smears from one cat. Blood from the other cat was not examined. The diagnosis was established by the finding of schizonts in endothelial-associated macrophages within vascular channels in tissues from both cats.

Animals↗

Weather patterns and ragweed pollen production in Tulsa, Oklahoma.

Levels of atmospheric Ambrosia (ragweed) pollen in the urban environment of Tulsa, Oklahoma, were determined using a Rotorod sampler. The data, representing the distinctly different growing seasons of 1980 and 1981, suggest it may be possible to predict pollen season levels based upon early summer weather patterns.

Oklahoma↗

Hay fever plants in Oklahoma.

More than 181 species of Oklahoma hay fever plants were identified. These are listed with their relative allergenicity and distribution within six major botanical zones of the state.

Oklahoma↗

Knowledge, attitudes, and practices of physicians regarding urinary incontinence in persons aged > or = 65 years--Massachusetts and Oklahoma, 1993.

Urinary incontinence (UI)--the involuntary loss of urine sufficient to be a problem for the patient or caregivers--affects an estimated 15%-30% of persons aged > or = 60 years in the United States and is a major cause of admittance to nursing homes. UI may be associated with a variety of medical (e.g., rashes, skin infections, pressure sores, urinary tract infections, and falls) and psychosocial problems (e.g., depression, embarrassment, restricted social interaction, reduced activities outside the home, reduced sexual activity, and sleep disturbances). Despite the dissemination of clinical practice guidelines for UI by the Agency for Health Care Policy and Research (AHCPR), many physicians do not know how to diagnose or treat UI. Beginning in 1992, CDC and AHCPR funded demonstration projects in Massachusetts and Oklahoma to educate the public, patients, and health-care professionals about UI. In both projects, physicians were assessed regarding baseline attitudes toward UI, knowledge of the causes and treatment of UI, preparedness to evaluate and treat UI, and current practices regarding UI. This report summarizes findings from the two projects during 1993.

Aged↗

Disaster nursing in the Oklahoma City bombing.

The Oklahoma City Federal Building disaster quickly changed a routine day of eye surgical procedures into a chaotic trauma center for the victims with not only eye injuries, but multiple deep lacerations and other injuries. The devastating and disruptive effect of the bombing was stressful for the nursing staff who became disaster survivors of the emotional trauma involved.

Blast Injuries↗

Foodborne botulism--Oklahoma, 1994.

On July 2, 1994, the Arkansas Department of Health and the Oklahoma State Department of Health were notified about a possible case of foodborne botulism. This report summarizes the investigation, which implicated consumption of improperly stored beef stew.

Botulism↗