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PubMed2005

Work-related asthma in teachers in Connecticut: association with chronic water damage and fungal growth in schools.

PURPOSE: To review a series of 55 teachers from schools in Connecticut who presented consecutively to our clinic, and to summarize our clinical experience with work-related disease in this population, which could lead to a more formal study. METHODS: Retrospective chart review; data were abstracted concerning clinical and environmental factors and entered into a statistical spreadsheet program (JMP for Windows). RESULTS: Of the 55 educators, 22 were diagnosed with upper respiratory syndromes (rhinitis or sinusitis), three with bronchitis, and 23 with asthma. Of the 23 with asthma, 20 presented with active or symptomatic asthma, and seven of these were incident cases of occupational asthma. In addition, four cases (7%) of granulomatous lung disease (two hypersensitivity pneumonitis and two sarcoidosis) were diagnosed. Finally, three patients (5%) received only nonrespiratory diagnoses (panic disorder, sicca syndrome, and vertigo). In 33 work-places, the exposures of concern were predominantly related to ongoing "dampness" or visible mold growth. The remaining 22 work-places were "dry." Symptoms varied according to the work-place environment, with more patients from water damaged (vs dry) work-places having upper respiratory symptoms (76% vs 45%) and asthma (45% vs 23%). All seven patients with incident asthma and all four patients with interstitial lung disease worked in schools with documented water incursion. CONCLUSIONS: Work-place exposures in water damaged school buildings are risk factors for development of work-related lower respiratory disease in schoolteachers and staff. Identification of such high-risk environments can be done by a simple but thorough qualitative evaluation during a walk-through inspection, and it should not require air sampling or surface sampling protocols for microbial contaminants.

Adult↗
PubMed2005

Vaccination coverage among callers to a state influenza hotline--Connecticut, 2004-05 influenza season.

In response to the influenza vaccine shortage in the United States, the Connecticut Department of Public Health (DPH) operated a telephone hotline during October 22, 2004-January 15, 2005. The purpose of the hotline was to address questions from the public regarding the availability of influenza vaccine, reduce the number of telephone inquiries to physicians and local health departments (LHDs), and advise callers regarding which groups were most at risk and in need of influenza vaccination. Caller information was collected and shared daily with LHDs, which were encouraged to follow up with callers as their resources allowed. This report summarizes results of a retrospective survey of callers to the DPH influenza vaccine hotline during November 2004. The results indicated that vaccination coverage varied by age group and that persons receiving follow-up calls from LHDs were more likely to receive vaccination. State health departments might consider a hotline as a method for educating the public regarding influenza vaccination and a follow-up system as a means to improve vaccination coverage, especially among those at greatest risk.

Connecticut↗
PubMed1992

Analysis of lawsuits against general surgeons in Connecticut during the years 1985 to 1990.

This study examines 42 lawsuits brought against general surgeons in Connecticut to discern which complications most often result in litigation, and what other activity prompts litigation. Analysis reveals that most cases involve injury to surrounding tissues: nerves, blood vessels, or adjacent organs. Retained foreign bodies occurred in four cases. The remaining complications concern singular complaints or iatrogenic injuries such as a Bovie burn, incorrect incisions, biopsy of incorrect tissue, etc. In addition to acute complications, four cases alleged failure to diagnose cancer and four cases alleged failure to provide informed consent. In five cases, the patient died, allegedly from the incident at issue in the suit. The study concludes that most surgical injuries are identifiable and preventible, and that many suits could be avoided.

Connecticut↗
PubMed2005

Hospital admissions syndromic surveillance--Connecticut, October 2001-June 2004.

INTRODUCTION: The Connecticut Department of Public Health (CDPH) has continuously monitored daily nonelective hospital admissions through a syndromic surveillance reporting system (HASS) since September 2001. Admission diagnoses are categorized into 11 syndromes including one possible indicator of smallpox, fever with rash, and one possible indicator of influenza and pneumonia. OBJECTIVES: The objectives are to describe findings from systematic investigation of individual admissions attributed to fever and rash and to determine the utility of monitoring pneumonia admissions as an indicator of severe influenza activity during the 2003-04 influenza season. METHODS: The incidence of admissions for fever and rash illness was determined for a 12-month period, and results of clinical discharge diagnoses were tabulated. Excess admissions for pneumonia by week during the influenza seasons beginning 2001-03 were determined and compared. Trends in admissions from the 2003-04 season were compared with trends from laboratory and sentinel physician surveillance. RESULTS: A total of 57 admissions for fever and rash illness were reported from 32 acute-care hospitals and verified for an incidence of 1.7 per 100,000 population. Specific clinical diagnoses were made for 29. Many were compatible with the initial clinical presentation of smallpox. Excess admissions for pneumonia during the 2003-04 season occurred concurrently with sharp increases in positive laboratory reports and percentages of visits to physician's offices attributed to influenza-like illness. The 2003-04 influenza season had many more excess admissions than the 2001-02 and 2002-03 seasons. CONCLUSION: HASS is a useful surveillance tool for rapid detection of sentinel cases of smallpox. Monitoring excess pneumonia admissions during the influenza season appears to be an effective and specific method for determining levels of influenza activity and for quantification of influenza-related morbidity and impact on the hospital system.

Connecticut↗
PubMed2006

A New England bonesetter dynasty: the Porters of Farmington, Connecticut--Part I of II.

Daniel Porter (d. 1690), a bonesetter/ chirurgeon, one of the early settlers of the Connecticut Colony, was the first and only doctor serving the Farmington valley during much of the second half of the 17th century. More than 40 of his descendants, spanning eight generations and almost three centuries, practiced medicine and surgery, moving with the migration of the expanding population to towns throughout New England, New York State, and ultimately the midwest and west coast. Their notable accomplishments, apart from their consistent reputation for exceptional skill and endurance, include the training and independent practice as bonesetters of two of their wives. In 1796, Samuel Lee, Jr., (1773-1814), a fifth-generation descendant, received the first U.S. patent for a medication, "Samuel Lee's Genuine Windham Bilious Pills." The last Porter doctor to be identified, Charles Allen Porter (1866-1931), a pioneer Professor of Surgery at Harvard Medical School, was among the first to recognize the carcinogenic effects of radiation. In the absence of a comprehensive published genealogy of the Daniel Porter family, this essay identifies the relationships among his many descendants.

Connecticut↗
PubMedDate not supplied

A New England bonesetter dynasty: the Porters of Farmington, Connecticut--Part II of II.

Daniel Porter (d. 1690), a bonesetter/ chirurgeon, one of the early settlers of the Connecticut Colony, was the first and only doctor serving the Farmington valley during much of the second half of the 17th century. More than forty of his descendants, spanning eight generations and almost three centuries, practiced medicine and surgery, moving with the migration of the expanding population to towns throughout New England, New York State, and ultimately the midwest and west coast. Their notable accomplishments, apart from their consistent reputation for exceptional skill and endurance, include the training and independent practice as bonesetters of two of their wives. In 1796, Samuel Lee, Jr., (1773-1814), a fifth-generation descendant, received the first U.S. patent for a medication, "Samuel Lee's Genuine Windham Bilious Pills." The last Porter doctor to be identified, Charles Allen Porter (1866-1931), a pioneer Professor of Surgery at Harvard Medical School, was among the first to recognize the carcinogenic effects of radiation. In the absence of a comprehensive published genealogy of the Daniel Porter family, this essay identifies the relationships among his many descendants.

Connecticut↗
PubMedDate not supplied

Infectious tenosynovitis (viral arthritis): characterization of a Connecticut viral isolant as a reovirus and evidence of viral egg transmission by reovirus-infected broiler breeders.

Connecticut isolant S1133 of tenosynovitis was characterized as a reovirus by physicochemical, biological, and morphologic studies. After inoculation of 35-week-old broiler breeders with tenosynovitis virus by subcutaneous route, virus was found in embryos of eggs laid by the breeders during a period of 8 to 12 days after inoculation.

Animals↗
PubMed1991

The emergence of methicillin resistant Staphylococcus aureus in extended care facilities in northern Connecticut between 1986 and 1990.

Methicillin resistant Staphylococcus aureus (MRSA) is recognized as a pathogen of significant morbidity in hospital facilities. The microorganism can also be recovered from clinical specimens taken from patients who are residents of extended care facilities (ECFs). This report is a five-year retrospective review of the emergence and spread of MRSA isolates within ECFs located in north central Connecticut and their susceptibility profile over that time span.

Connecticut↗
PubMed1991

Pathologic stage I and II Hodgkin's disease. Long-term results at three Connecticut hospitals.

Three radiation therapy departments in Connecticut (Uncas on Thames Hospital, Norwich; Yale-New Haven Hospital, New Haven; and the Hospital of Saint Raphael, New Haven) have consistently used the strategy of staging laparotomy with splenectomy for clinical stage I and II Hodgkin's disease patients with primary radiation therapy as initial therapy for most pathologic stage (PS) I and II patients. From 1971 through 1986, 239 PS I and II patients were treated at these three institutions and 94% received radiation therapy alone as initial treatment. With a minimum follow-up time of one year and a maximum follow-up time of 18 years (mean: 7.3 years), only 19 (8%) of the 239 patients have ultimately died of Hodgkin's disease. Two factors were responsible for the low death rate due to Hodgkin's disease: 1) 176 patients (74%) went into complete remission following initial therapy and did not experience a relapse; and 2) 63 patients relapsed following initial therapy; however, subsequent salvage therapy was successful in 44 (70%) of these 63 patients. The overall 10-year and 18-year survival rates were 81% and 78%, respectively. Staging laparotomy with initial radiation therapy for most PS I and II patients remains an important and highly successful strategy for Hodgkin's disease.

Adolescent↗
PubMed1990

Changes in Connecticut hospital use rates: have small-area variations been affected?

This paper examines the extent to which changes (prospective payment, alternative delivery systems, etc.) in the hospital environment and the general decline in hospital days affect small-area variations in hospital use rates for 18 selected diagnoses in nine hospital service areas in Connecticut. After adjusting for coding changes between DRGs, we found that variation across the service areas did not, in general, differ for any one of the years 1981-86. In one instance (cardiac catheterization), however, we found that a DRG-specific change in knowledge and technology decreased the extent of small-area variation for that diagnosis.

Analysis of Variance↗
PubMed1990

Incidence of listeriosis in Connecticut.

In Connecticut, 92 cases of human listeriosis were reported to the Department of Health Services from 1984 to 1988. The annual incidence per million population ranged from 7.3 in 1984 to 4.2 in 1988. The average annual incidence was 5.6 per million population. Case rates were highest in those aged 70 years and older (15.8 per million). Cases included 12 pregnant women and 11 newborns. Bacterial meningitis was the primary diagnosis in 23 cases. Of the 49 isolates of Listeria monocytogenes that were serotyped, 21 (43%) were type 4, 24 (49%) were type 1, and 4 (8%) were nontypable.

Adolescent↗
PubMed1990

Conducting a third-party reimbursement survey: experience of the Connecticut Nutrition Services Payment Systems Committee.

Third-party reimbursement (TPR) has emerged as a crucial issue for dietetics in the past decade. To investigate the level of TPR being obtained by individuals receiving nutrition services from registered dietitians in ambulatory settings, the Connecticut Nutrition Services Payment Systems (NSPS) Committee conducted an audit. Sixty survey packets were distributed to consulting dietitians in private practice and to dietitians in outpatient nutrition clinics. Twenty dietitians participated in the audit process, providing 99 client responses to the survey. Sixty-seven percent of clients submitted the charges for nutrition services to their insurance companies, but only 17% received reimbursement for the claims submitted. This audit process raised the level of awareness of the state membership regarding the need to aggressively pursue TPR for nutrition services at all levels, and it provided a model for dietitians to use to conduct periodic audits and assess TPR being received by their clients.

Connecticut↗
PubMed1990

Persistence of antibodies to Borrelia burgdorferi in dogs of New York and Connecticut.

Multiple blood samples were obtained from privately owned dogs living in tick-infested areas of New York (Westchester County) and Connecticut, where Lyme disease in human beings has been reported. Of the 175 dogs examined, 127 (72.6%) had limb/joint disorder, whereas the remaining 48 dogs were considered healthy. Results of analysis of 419 serum samples revealed IgM antibody to Borrelia burgdorferi in healthy and lame dogs during all seasons. Prevalence of seropositivity was significantly (P less than 0.01) greater, using a polyvalent ELISA (89.5%) than using a class-specific ELISA for IGM antibody (57.8%). Mean antibody titers obtained by use of polyvalent ELISA were likewise higher than IgM titers. Analysis of paired serum samples from dogs with limb/joint disorder indicated that 118 (92.9%) remained positive for IgM or IgG antibodies when retested weeks or months after initial testing. In 48 dogs without history of joint involvement or other signs of disease, 43 (89.6%) had antibody to B burgdorferi 2 or more times. Serotest results also revealed little or no change in antibody titer for lame dogs given antibiotics or for healthy dogs 2 or more months after initial sample collection.

Animals↗
PubMed1990

Part I: The NGRI Registry: initial analyses of data collected on Connecticut insanity acquittees.

The NGRI Registry is a comprehensive census database collected by the Law and Psychiatry Division of the Department of Psychiatry at the Yale University School of Medicine. This longitudinal database was compiled following a systematic search of all available docket books from the superior courts and mental health records from the state hospitals in Connecticut beginning in January 1970. Detailed life span information is available for 364 insanity acquittees identified during the search. Comparative analyses with four other locales suggested that there were regional differences in diagnoses of and crimes committed by the acquittees. These initial analyses demonstrate the promise of this registry becoming one tool for collaborative research on issues relevant to law and mental health.

Connecticut↗
PubMed1990

Part II: Sex differences in persons found not guilty by reason of insanity: analysis of data from the Connecticut NGRI Registry.

Thirty-one female insanity acquittess from Connecticut were matched to a group of 31 male NGRIs. The samples were compared with regard to demographic, criminal, and clinical characteristics. Logistic regression analyses were used to determine predictors of criminal recidivism for the sample. Results indicated that women NGRIs were older, more likely to be married, less likely to be substance abusers, had less extensive criminal records, and were released from hospitals sooner than the men. A significant racial difference was noted: white women had less extensive criminal records and were hospitalized for shorter periods than minority women. Results of the logistic regression analyses showed that the strongest independent predictors of criminal recidivism were race and having a diagnosis other than psychosis (schizophrenia, affective or organic disorders). Findings support recent APA policy guidelines on the insanity defense.

Adult↗
PubMed1990

Encouraging screening mammograms. Results of the 1988 Connecticut Breast Cancer Detection Awareness Campaign.

Connecticut's first Breast Cancer Detection Awareness Campaign during April 1988 offered low-cost screening mammograms ($50) to women over age 34 who had not been previously examined. Following a brief mass media campaign, some 2,500 inquiries about the program were received over a seven-day period, resulting in 1,243 examinations of the detection of eight breast cancers. Program participants cited an enhanced awareness that a baseline examination was due, and knowledge about the availability of low-cost services as reasons for obtaining a screening mammogram. Their reasons for not having been previously screened included not having been advised by physicians to have such an examination (28%); high cost (37%); and failure to recognize the importance of periodic screening (21%). By contrast, relatively few women expressed concern about the test procedure (12%), or fear of finding cancer (9%) as reasons for not being screened previously. These findings underscore the benefit of cancer control efforts to reduce access and information barriers to regular use of mammography by women.

Adult↗
PubMed1975

Biochemically aberrant Salmonella enteritidis ser. newington from human sources in Connecticut.

Three isolates of a lactose-fermenting, xylose-negative variety of Salmonella enteritidis ser. newington, identical in biochemical and serological reactions and in the antibiogram, were recovered from three patients in different areas of Connecticut in January 1974. Hydrogen sulfide production was not visible in Salmonella-Shigella agar, in triple sugar iron agar, and in Kligler iron agar but was noticed in lysine iron agar and on XLD agar, among others. The amount of fermentable carbohydrates present was found to correlate with failure to show hydrogen sulfide production (pH effect). In contrast to lactose-fermenting Salmonella strains reported by other authors, we could not elicit a direct transfer of the lac(+) character at frequencies above 10(-6). An epidemiological follow-up remained unsuccessful. Recommendations for the recognition of similar strains are presented.

Adult↗
PubMed1989

A three-year report of the medical helicopter transportation system of Connecticut.

Over 63% of the patients transported by the LIFE STAR crew are the victims of trauma. The system has transported 2,215 ill and/or injured patients, the majority of whom are critical, either from the scene of an injury or from a medical facility to another of greater specialization. With the audit procedure indicating a 95% positive predictive value for summoning this service, LIFE STAR has contributed to the care of critically ill or injured persons in Connecticut and surrounding areas.

Adult↗