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George Washington's infertility: why was the father of our country never a father?

George Washington was the single most important figure in the founding of the United States of America. Numerous biographies of Washington have been written and his name is honored in countless ways, including as the name of the United States' capital. Washington has become so idealized in U.S. consciousness that it is easy to lose sight of his failings and disappointments. Undoubtedly, one of his most personal sorrows was his inability to have a child with his wife Martha. As the historian W.S. Randall puts it, "He was content with Martha, but mystified why, year after year, he and Martha could produce no Washington heir." In this article, George and Martha Washington's inability to have children is discussed, and it is suggested that George was the likely source of the couple's infertility. The author also speculates as to the cause of Washington's infertility and its effect on the course of American history. Frank discussion of Washington's infertility might provide some comfort to men struggling with infertility today.

Famous Persons↗

A risk management procedure for the Washington state ferries.

The state of Washington operates the largest passenger vessel ferry system in the United States. In part due to the introduction of high-speed ferries, the state of Washington established an independent blue-ribbon panel to assess the adequacy of requirements for passenger and crew safety aboard the Washington state ferries. On July 9, 1998, the Blue Ribbon Panel on Washington State Ferry Safety engaged a consultant team from The George Washington University and Rensselaer Polytechnic Institute/Le Moyne College to assess the adequacy of passenger and crew safety in the Washington state ferry (WSF) system, to evaluate the level of risk present in the WSF system, and to develop recommendations for prioritized risk reduction measures, which, once implemented, can improve the level of safety in the WSF system. The probability of ferry collisions in the WSF system was assessed using a dynamic simulation methodology that extends the scope of available data with expert judgment. The potential consequences of collisions were modeled in order to determine the requirements for onboard and external emergency response procedures and equipment. The methodology was used to evaluate potential risk reduction measures and to make detailed risk management recommendations to the blue-ribbon panel and the Washington State Transportation Commission.

Journal Article↗

Distribution, prevalence, and relative risk of filariasis in dogs from the State of Washington (1997-1999).

Using antigen capture and filter tests, 6,078 dogs throughout the state of Washington were examined for filariasis between July 1, 1997 and October 31, 1999. In western Washington, 791 males and 901 females examined were outdoors, not on prophylaxis, and had traveled out of the state; 6/791 (0.8%) males and 7/901 (0.8%) females were infected with Dirofilaria immitis (D. immitis), and one (0.1%) male and one (0.1%) female were infected with Dipetalonema reconditum (D. reconditum). There were also 392 males and 362 females examined that were outdoors, not on prophylaxis, and had not traveled out of western Washington. One (0.1%) female was infected with D. immitis, and two (0.5%) males and one (0.2%) female were infected with D. reconditum. In eastern Washington, 707 males and 826 females examined were outdoors, not on prophylaxis, and had traveled out of the state; 9/707 (1.0%) males and 4/826 (0.5%) females were infected with D. immitis, and no D. reconditum was found. There were also 376 males and 412 females examined that were outdoors, not on prophylaxis, and had not traveled out of the state. Three (0.8%) males and three (0.7%) females had D. immitis. One (0.2%) female had D. reconditum. Distribution of D. immitis-infected, nontravel dogs in eastern Washington was only found between 120 degrees and 119 degrees west longitude in the communities of Richland, Moses Lake, Okanogan, and Omak. Enzootic transmission of D. immitis and D. reconditum is occurring in both eastern and western Washington.

Animals↗

Characterization of prostatic carcinoma among blacks: a comparison between a low-incidence area, Ibadan, Nigeria, and a high-incidence area, Washington, DC.

A comparison of carcinoma of the prostate gland in a low-incidence Nigerian (Ibadan) population and a high-incidence U.S. Afro-American (Washington, D.C.) population was the purpose for this study, initiated in 1973. The frequency of carcinoma (micro- and invasive) was determined in consecutive necropsy cases from hospitals in Ibadan, Nigeria, Accra, Ghana and Washington, D.C. The results of these clinical, epidemiologic and morphologic studies are reported. Clinically, the peak incidence of carcinoma of the prostate in Nigerian males in Ibadan and in American males in Washington, D.C. was in the 65-74 age group. The median age of patients was 66.4 years in Ibadan and 69.2 years in Washington, D.C. Seventy-five percent of Nigerian and 49% of American patients were in stages III and IV. Overall, the distribution by grade of neoplasms in surgical material from Ibadan and Washington, D.C. was similar. Plasma testosterone and estrone levels were significantly higher (p < 0.05 and p < 0.001) in U.S. patients than in U.S. controls and higher (p < 0.001 and p < 0.05) in U.S. patients than in Nigerian patients with prostatic carcinoma. Plasma testosterone levels were significantly lower (p < 0.05) in Nigerian patients than in Nigerian controls. Estrone levels were not significantly different in Nigerian patients than controls. Nigerian patients were more sexually active throughout their lives than American patients; however, they reported a higher incidence of impotence than U.S. patients in the immediate 5 years preceding the diagnosis of prostatic carcinoma. Nigerian respondents (patients and controls) arrived at puberty later than their American counterparts. Within each of the two population groups, the factor with the highest relative risk ratio was lower urinary tract symtoms occurring 10 years or longer before the onset of the present complaints which led to the diagnosis of prostatic carcinoma. Nigerian and U.S. patients were more sexually active than controls. Microcarcinoma (incidental, latent) of the prostate gland occurred with a frequency of 11.8% and at an age-adjusted incidence rate (world standard) of 40.6 per 1000 necropsies in the sampled U.S. black male population. The age-adjusted incidence rate (world standard) for microcarcinoma in the combined West African (Accra and Ibadan) series (36.7/1000) was almost equal to the rate (40.6/1000) in the Washington, D.C. series.

Aged↗

Blastomycosis in Washington Parish, Louisiana, 1976-1985.

For the period 1976-1985, the authors attempted to identify all cases of blastomycosis in Louisiana and studied in detail one county (Washington Parish) suspected by local physicians of having an unusually high incidence of the disease. The mean annual incidence rates for Louisiana and for Washington Parish were 0.23 and 6.8 cases per 100,000 population, respectively. To the authors' knowledge, the rate for Washington Parish is the highest annual incidence rate documented for a population in a nonoutbreak setting. Among the 30 cases detected in Washington Parish, the age range was 3 weeks to 81 years. Five cases died; of these, one was an infant who may have been infected in utero, and another developed clinical symptoms compatible with adult respiratory distress syndrome. There was no geographic clustering among cases the authors investigated, and a case-control study failed to identify specific activities or host factors which may have predispose to infection. Washington Parish is probably a hyperendemic area for blastomycosis because environmental conditions are especially conducive to Blastomyces dermatitidis growth. The study suggests that most cases in Washington Parish were sporadically infected, and common-source exposures to B. dermatitidis with resultant clinical illness are rare even in hyperendemic settings.

Adolescent↗

Geographic and occupational risk factors for ventricular septal defects: Washington State, 1987-2003.

OBJECTIVE: Ventricular septal defect (VSD) is currently the most common congenital cardiac malformation in the United States, but little is known about its etiology. The objective of this study was to address the hypothesis that parents' residence in eastern Washington, a region heavily dominated by the agricultural industry, and employment in agriculturally related occupations can influence the presence of a VSD in their offspring. DESIGN: Population-based case-control study. SETTING: Washington State from January 1, 1987, through December 31, 2003. PATIENTS: Children aged 0 to 2 years diagnosed as having a VSD (n = 3489), and other infants selected at random as control subjects (n = 13 290). MAIN EXPOSURES: Parental occupation and county of maternal residence were obtained from the birth certificate. The latter was categorized according to region (east vs west), rural-urban classification, and the proportion of farm and crop land. MAIN OUTCOME MEASURES: Diagnosis of VSD within the first 2 years of life. RESULTS: The risk of VSD was greater for infants whose mothers resided in eastern Washington (odds ratio, 1.30; 95% confidence interval, 1.03-1.65). The risk of VSD with other cardiac malformations (n = 1205) exhibited a stronger geographic association than did isolated VSD (n = 2284). Analyses restricted to eastern Washington did not reveal a clear relationship between the risk of VSD and an increasing proportion of agricultural land in the mother's county of residence. Parental occupation in agriculture was not associated with the presence of VSD. CONCLUSION: Although these findings suggest regional variation in Washington State in the occurrence of VSD, the basis for this variation remains to be determined.

Adult↗