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PubMed1979

Intraerythrocytic parasites in rodent populations of Connecticut: Babesia and Grahamella species.

A total of 612 Peromyscus leucopus, 11 Microtus pennsylvanicus, 21 Clethrionomys gapperi, and 4 Tamias striatus was collected in Connecticut and examined for Babesia and Grahamella during 1976 and 1977. Babesia antibodies were detected in sera of 9 P. leucopus collected from 4 sites. Babesia parasites were not detected in the blood smears of captured rodents. Subsequent splenectomy and subinoculation of blood from these rodents into susceptible animals failed to induce disease and no Babesia was isolated. Six of 10 P. leucopus inoculated with a Shelter Island, New York strain of B. microti remained infected for 3 1/2 months. Indirect fluorescent antibody titers of experimentally infected P. leucopus ranged from 1:8 to 1:256. Prevalence of Grahamella peromysci infection, as determined from examinations of blood smears of P. leucopus, was 13%. This infection rate is a conservative estimate because parasitemia is difficult to detect in intact animals. Twenty of 58 P. leucopus, taken at 2 sites and with negative blood smears for G. peromysci, developed parasitemia after splenectomy.

Animals↗
PubMed1984

Applying for a certificate of need for unit dose and i.v. admixture services in a Connecticut hospital.

The process of obtaining regulatory-agency review of a proposal for unit dose and i.v. admixture services is described. In a 901-bed community hospital in Connecticut, a pharmacy department proposal for instituting unit dose distribution and expanding the i.v. admixture service was supported by the hospital administration and included in hospital budget projections. A state body that regulates hospital revenues, the Commission on Hospitals and Health Care (CHHC), rejected the proposal for these changes in pharmaceutical services. The pharmacy and hospital administration subsequently petitioned the Health Systems Agency in that jurisdiction for a certificate of need (CON); the procedure required that the application also be simultaneously submitted to CHHC. Implementation of the program over a three-year period was proposed. The CON application was submitted in July 1981; it required detailed information from pharmacy, nursing services, and hospital administration. During the nine months following application for the CON, further questions were asked and five hearings were held. In April 1982, CHHC approved the program and the capital expenditures but did not approve the proposed 10% increase in drug revenue needed to support the services. The hospital ultimately committed funding for implementation of the program over three years. The net result of the application procedure was a delay in implementation of expanded pharmaceutical services.

Certificate of Need↗
PubMedDate not supplied

Avian and mammalian hosts for spirochete-infected ticks and insects in a Lyme disease focus in Connecticut.

Spirochetes and their vectors and reservoirs were studied in a Lyme disease focus in East Haddam, Connecticut, from mid-May through September 1983. Ixodes dammini subadults were comparable in number on white-footed mice (Peromyscus leucopus) (means = 2.9 +/- 3.6 SD) to those on 27 different species of birds (means = 2.3 +/- 4.2 SD) representing 11 families within the order Passeriformes. Less commonly found ticks on birds (means less than or equal to 0.1) were immature Ixodes dentatus and Haemaphysalis leporispalustris. Although spirochete-infected I. dammini larvae and nymphs were taken off eight and nine different species of birds, respectively, significantly fewer positive larvae were removed from birds than from white-footed mice. Spirochetes were detected in the midguts of I. dammini, Dermacentor variabilis, and H. leporispalustris and two species of insects (Cuterebra fontinella and Orchopeas leucopus). Possibly, arthropods other than I. dammini vector these spirochetes in northeastern United States. Spirochetes grew in a cell-free medium inoculated with bloods from four white-footed mice, one woodland jumping mouse (Napaeozapus insignis), one northern mockingbird (Mimus polyglottos), one gray catbird (Dumetella carolinensis), two prairie warblers (Dendroica discolor), one orchard oriole (Icterus spurius), one common yellowthroat (Geothlypis trichas), and one American robin (Turdus migratorius). We suggest that avian hosts, like mammals, develop spirochetemias of the causative agent of Lyme disease. Erythematous tissues from a white-footed mouse were infected with spirochetes.

Animals↗
PubMed1981

Raccoon babesiosis in Connecticut, USA: Babesia lotori sp. n.

A species of Babesia which infects raccoons, Procyon lotor, is described and named Babesia lotori. Twelve of 14 raccoons captured from five counties in Connecticut developed parasitemia after splenectomy. Preoperative levels were subpatent or less than 1%. Parasitemia peaked anywhere from less than 5% to 36.6% in splenectomized raccoons, and all but one survived and possessed low infection rates (less than or equal to 3%) at the end of the experiment. An indirect fluorescent antibody test is described and shown to be useful in detecting antibodies to B. lotori. Seropositive raccoons were obtained from six counties. Two, Babesia-free, splenectomized raccoons developed parasitemia with corresponding increases in antibody titers after they were inoculated with infected blood. Antibody titers of naturally infected raccoons following splenectomy either remained stable or increased fourfold. Babesia was observed in three of four young raccoons which had been naturally confined to chimneys. Two of these four young raccoons were infested with a nest-dwelling tick, Ixodes texanus.

Animals↗
PubMed1980

Pemphigus in Hartford County, Connecticut, from 1972 to 1977.

An investigation of a possible cluster of pemphigus cases that were diagnosed in Hartford County, Connecticut, in 1977 provided data for estimating the incidence of this disease in a defined population for the years 1972 to 1977. The average annual incidence (new cases per population per year) estimated for the overall adult population (over the age of 20 years) was 0.42 cases per 100,000 people, whereas that for Jewish adults was 3.2 cases per 100,000. Thus, the results of this report both support the hypothesis that Jewish people are at higher risk than others for the development of pemphigus and provide a basis for comparison with the results of other studies of this disease.

Adult↗
PubMed1995

Readmission rates, 30 days and 365 days postdischarge, among the 20 most frequent DRG groups, Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.

This report presents readmission rates following inpatient admissions for the 20 most frequent DRG categories among Medicare inpatients age > or = 65 years, at Connecticut acute-care hospitals during the three-year period FY 1991 to FY 1993. We provide frequency distributions of the 30-day and 365-day readmission rates within these 20 DRG categories. Among the 184,490 discharges of elderly Medicare beneficiaries, discharged alive, who were included in the 20 most frequent DRG categories in the three-year study period, the crude 30-day readmission rate was 15.6%; the crude 365-day readmission rate was 46.9%. By gender, the crude 30-day readmission rate for women was 15.1%; the corresponding rate for men was 17.8%. This gender readmission difference occurred in the context of a significant age differential; on average, the females were 2.5 years older than the males. By age group, the crude readmission rates were: age 65 to 74 years, 16.5%; age 75 to 84 years, 16.8%; age > or = 85 years, 14.6%. With the exception of the DRG category representing cancer (all types), within which there was a significant decrease in readmission rates over the three years examined, the crude readmission rates for the DRG categories were found to be stable over the three-year study period.

Aged↗
PubMed1995

Mortality experience, 30-days and 365-days after admission, for the 20 most frequent DRG groups among Medicare inpatients aged 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.

This report presents mortality rates following inpatient admissions for the 20 most frequent DRG categories among Medicare inpatients aged > or = 65 years at Connecticut acute-care hospitals during the three-year period from fiscal year 1991 to fiscal year 1993. We provide frequency distributions of the 30-day and 365-day mortality rates among these 20 DRG categories. Among the 199,680 discharges of elderly Medicare beneficiaries within the 20 most frequent DRG categories in the three-year study period, the crude 30-day mortality rate was 9.51%; the crude 365-day mortality rate was 28.40%. By gender, the crude 30-day mortality rate for women was 8.78%; the corresponding rate for men was 10.48%. This gender mortality differential occurred despite a significant age differential; on average, the females were 2.5 years older than the males. By age group, the crude mortality rates were: age 65-74 years, 6.66%; age 75-84 years, 9.80%; age > or = 85 years, 15.25%. The crude mortality rates for the DRG categories were found to be stable over the three-year study period.

Age Distribution↗
PubMed1995

Twenty most frequent DRG groups among Medicare inpatients age 65 or older in Connecticut hospitals, fiscal years 1991, 1992, and 1993.

This report provides data on the frequency of inpatient admissions for the 20 most frequent DRG categories among Medicare inpatients age > or = 65 years at Connecticut acute care hospitals during the three-year period FY1991 to FY1993. Frequency distributions of the numbers of discharges within these 20 DRG categories are provided, in aggregate and by gender and age subgroups. There were 199,680 discharges of elderly Medicare beneficiaries within the 20 most frequent DRG categories in the three-year study period, 55.7% of all Medicare discharges. Within this total, there was year-to-year stability in total numbers of discharges and in the distribution of DRGs. By gender, 43% of elderly Medicare patients discharged in the three year period were men; 57%, women. Forty-one percent, 41%, and 18% of the discharges occurred among beneficiary age groups 65 to 74 years, 75 to 84 years, and > or = 85 years, respectively.

Aged↗
PubMed1994

Arenavirus infection--Connecticut, 1994.

On August 20, 1994, the Connecticut Department of Public Health and Addiction Services received a report of a case of acute illness in a virologist suspected to be associated with Sabiá virus, a newly described arenavirus. This report preliminary findings from the case investigation.

Adult↗
PubMed1994

Late-stage breast cancer in Connecticut's three largest cities.

Among 1,559 breast cancer patients diagnosed in 1984-89 in residents of Connecticut's three largest cities (Bridgeport, Hartford, and New Haven), the proportion of late- (ie, regional or distant) stage cancers increased with increasing poverty level in the census tract of residence. Many census tracts with the highest proportions of late-stage breast cancers were located near a federally-qualified community health center or a hospital. Changing the stage distribution of breast cancer through increased screening by mammography and clinical breast examination may require greater collaboration among community health centers, local hospitals, mammography facilities, and mobile mammography vans, along with continuing medical education programs for primary care physicians in these cities.

Adult↗
PubMedDate not supplied

Characteristics of Connecticut patients receiving services for end-stage uremia.

Data are presented on the characteristics of all patients with end-stage uremia who were treated in Connecticut hemodialysis programs over a 7-year period. Of the total of 353 patients, 103 patients died, 37 had successful transplants and discontinued dialysis, no information was available for one patient, and the remaining 212 patients continued to receive treatment in 1 of the 12 hemodialysis programs. The mean age of active chronic hemodialysis patients was 43.6 years; about 83 percent of all active patients were under age 55. Twenty-two percent were nonwhite; the nonwhite caseload appeared high in relation to the percent of nonwhite population. Of the 212 active patients, 78 percent were dialyzed at in-center programs and 22 percent at home; one patient obtained dialysis from a new limited-care program. The largest group (28 percent) of active patients had been in dialysis less than 7 months, about one-fourth had been dialyzing for 7-12 months, and about 13 percent of the total active population had been in dialysis between 19 and 24 months. The average period for active patients to be in dialysis was 17 months. The advent of Federal reimbursement for hemodialysis, as well as changes in the criteria for the selection of patients and increased physician awareness, can result in significant increases in the future population of patients receiving dialysis. To prevent overburdening of existing in center programs, expansion of training facilities statewide for home care dialysis is suggested.

Adolescent↗
PubMed1994

Maternal hepatitis B screening practices--California, Connecticut, Kansas, and United States, 1992-1993.

Each year in the United States, an estimated 22,000 infants are born to women with chronic hepatitis B virus (HBV) infection. These infants are at high risk for perinatal HBV infection and chronic liver disease as adults. The American College of Obstetrics and Gynecology, the American Academy of Pediatrics, the American Academy of Family Practice, and the Advisory Committee on Immunization Practices each have recommended that all pregnant women be routinely tested for hepatitis B surface antigen (HBsAg) during an early prenatal visit in each pregnancy to identify newborns who require immunoprophylaxis for the prevention of perinatal HBV infection (1-4). To evaluate progress in implementing this recommendation, surveys were conducted to assess the effectiveness of maternal HBsAg screening in three states--California, Connecticut, and Kansas--and a sample of hospitals in the United States.

California↗
PubMed1993

Public awareness of Lyme disease in obstetric, pediatric, and student settings in northwestern Connecticut.

The purpose of this study has been to survey the attitudes and understandings of Lyme disease by pregnant women, mothers, and ninth-grade students in Northwestern Connecticut. A sample of 100 obstetrical patients from two private obstetric offices, 100 mothers from four private pediatric offices, and 200 students from four secondary schools was asked to complete a 15 question survey about Lyme disease. In all groups, the responses indicated some misconceptions or a lack of knowledge about the manifestations, diagnosis, and treatment of Lyme disease, as well as about the transmission of Borrelia burgdorferi. This information indicates that better public education about Lyme disease is important.

Adolescent↗
PubMed1993

Trends in breast cancer treatment in Connecticut.

Data from the population-based Connecticut Tumor Registry showed an increase in partial mastectomy (PM) from 18.9% for local-stage breast cancers diagnosed in 1983 to 47.3% for those diagnosed in 1990, with no change in axillary dissection. For local-stage cancers 4 cm or smaller in size that received PM, axillary dissection increased from 39.2% in 1983 to 60.8% in 1990, with larger increases for cases < 50 and 50-59 years old, while radiotherapy increased mainly for cases 70-79 and > 80 years old. Among regional-stage cases with positive nodes (but no extension to skin or beyond the breast tissue) and 4 cm or smaller in size, PM increased from 9.4% to 29.1%, but remained lower than that among local-stage cancers. Continued monitoring is needed to assess the full impact of the 1990 NIH Consensus Conference Panel's recommendations for the treatment of early-stage breast cancer.

Adult↗
PubMed1996

Progress toward integrating hepatitis B vaccine into routine infant immunization schedules in the United States, 1991 through 1994. Connecticut Hepatitis B Project Group.

OBJECTIVE: We assessed progress toward universal infant immunization against hepatitis B, which was first recommended in November 1991. METHODS: Multiple data sources were used to describe vaccination policies and trends in infant hepatitis B vaccine coverage. RESULTS: As of June 1993, 51% of the 63 local, state, and territorial immunization programs recommended hepatitis B vaccination of all newborns shortly after birth. The number of first dosages of hepatitis B vaccine administered to infants in public sector clinics increased rapidly from late 1992 to 1993, and at the end of 1993 was approximately two thirds the number of first dosages of other infant antigens. In a nationwide survey of hospital nurseries 47% offered hepatitis B vaccine to all newborns. Of 3982 sampled newborns in these hospitals, 36.2% had been vaccinated before discharge. In San Francisco and Connecticut, where public health officials encouraged hospitals to offer hepatitis B vaccination, first-dose coverage at discharge was 82.3% in 1994 and 69.1% in 1993, respectively. Coverage was higher in healthier infants and lower in infants of older or better-educated mothers. Results from the National Health Interview Survey demonstrate that three-dose completion at 12 months of age increased form less than 1% of children born in 1989 to 40% of children born in the fourth quarter of 1992. Vaccination at birth increased from less than 1% of infants born in 1989 to 32% of infants born in the second half of 1993. CONCLUSIONS: Infant hepatitis B vaccination has expanded rapidly since national recommendations were made; however, universal coverage has not been achieved.

Connecticut↗
PubMed1977

Medical laboratory personnel: clinical education and employment in Connecticut.

This paper presents the results of a survey of CLA, MLT, and MT graduates of clinical programs in Connecticut. It reports on characteristics such as educational background and employment history. Differences among the three professional categories are examined with respect to method of locating first job, setting, activities and tasks, job titles, and applicability of education to employment.

Allied Health Personnel↗