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PubMed1996

A program on the rise: the combined (M.D./Ph.D.) Degree Program at the University of Connecticut School of Medicine.

The Combined M.D./Ph.D. Degree Program (CDP) of the University of Connecticut School of Medicine is an intensive seven-year program that allows exceptional students simultaneously to develop both clinical and research skills. Each year the program accepts up to four highly qualified students from an applicant pool that has been increasing in both size and talent. Currently, there are 25 students in the program. Each student receives a waiver of tuition and fees for both graduate and medical school as well as a fellowship stipend of $14,700 per year for all seven years. In the initial two years the combined-degree students are enrolled in medical school and participate in laboratory research. During the next three years students focus exclusively on graduate course work and the doctoral dissertation. Following the thesis defense, they enter the final two years of medical school and are graduated with the dual degree. As of May 1995 the CDP has graduated 15 students, each of whom is currently pursuing a career in academic medicine.

Animals↗
PubMed1996

Violence prevention program targeting Connecticut adolescents: description and preliminary results.

Recent statistics show that adolescents are increasingly becoming both the perpetrators and the victims of violent crime in our nation. At our institution, we have developed a violence prevention program specifically targeting adolescents. This three-hour workshop utilizes a multimedia style of presenting information that we believe is well suited to young audiences. To date, over 1,000 adolescents from all over the state have participated in our program. In addition to describing the program, we also summarize the results of program evaluations and demographic profiles completed by audience members. Most participants report that the program was successful in educating them about the causes and consequences of violent injury and offered them alternatives to violence in resolving difficult situations. It is our hope that the education we provide will translate into fewer violent injuries within the state of Connecticut.

Connecticut↗
PubMed1996

Trends in breast-conserving surgery in Connecticut: no effect of negative publicity.

Trends in breast-conserving surgery (BCS) rates among 12,745 early-stage invasive breast cancers diagnosed in 1988-94 in Connecticut residents supported the effects of dissemination (around 1990) of results of clinical trials. The lack of decline in BCS from 1993 to 1994 did not support concerns about the effect of negative publicity (in early 1994) regarding fraudulent data from a large clinical trial of BCS vs modified radical mastectomy. The BCS rate reached 75% for node-negative cancers 2 cm or less in diameter diagnosed at age < 60 years in 1994, although it was lower (and declined with age) for larger and/or node-positive cancers. Further study is needed on the decision-making process regarding BCS and its full implications for the quality of life of the large numbers of women diagnosed each year with breast cancer.

Breast Neoplasms↗
PubMed1996

A survey of sunbathing practices on three Connecticut State beaches.

In order to analyze sunbathing practices, a survey was conducted during the summer of 1995 on three Connecticut state beaches, with 1,003 interviews completed. The majority (65.8%) of respondents were women. Almost 70% of respondents were visiting the beach to get or maintain a tan. While the intended beach stay averaged four hours, only 55.7% of respondents were using sunscreen, 6.9% were sitting under shade, 12.7% were wearing hats, and 17.1% were wearing clothes other than a bathing suit. More than half (55%) of the sunscreen used had a sun protection factor of less than 15. Children were provided with greater protection than adults. The survey indicates the need for greater educational efforts to motivate protective behavior. Primary-care physicians could have an important role in these efforts.

Adolescent↗
PubMed1996

Serogroup Y meningococcal disease--Illinois, Connecticut, and selected areas, United States, 1989-1996.

Neisseria meningitidis is a leading cause of bacterial meningitis and sepsis in the United States. N. meningitidis is classified into serogroups based on the antigenic characteristics of its capsular polysaccharide. During 1989-1991 in the United States, serogroups B and C accounted for most (91%) of invasive meningococcal disease while serogroup Y caused < 5%; however, during 1992-1995, serogroup Y accounted for an increasing proportion of meningococcal disease. This report describes the epidemiology of serogroup Y meningococcal disease (SYMD) during 1991-1996 in Illinois and Connecticut, which conducted enhanced surveillance through active reviews of clinical records and in areas participating in active laboratory-based surveillance during 1989-1995. The findings indicate a substantial increase in the proportion of meningococcal disease caused by N. meningitidis serogroup Y since 1989.

Adolescent↗
PubMed1996

Estimating breast cancer treatment charges in Connecticut.

Previous studies of estimated costs for cancer treatment have been limited to elderly patients or to specific health maintenance organizations. Data from the statewide population-based Connecticut Tumor Registry on a random sample of 407 breast cancer patients diagnosed in 1991 were linked with a statewide hospital-discharge database, to estimate charges (through September 1993) for inpatient and ambulatory surgery care. For the 377 cases (92.6% of 407) successfully linked, average charges attributed to breast cancer care declined with age, increased with extent of disease (stage at diagnosis), and increased with extent of surgery; these associations persisted in multivariate analyses. Total hospital-related charges for comorbid conditions (during 1991-93) were considerable by age 45 to 64 years. The merged database should be most useful in estimating charges for: cancers treated mainly by surgery (including ambulatory surgery at hospitals); comorbid conditions; and terminal care.

Adult↗
PubMed1996

Cancer screening in primary care: strategies for your office. A program of the Connecticut Division of the American Cancer Society.

Primary-care physicians' compliance with cancer screening guidelines has been in general unsatisfactory. Mailings have not had the desired effect upon these busy physicians who are preoccupied with many other issues. The Ohio Division of the American Cancer Society developed a program of in-office cancer screening education of primary-care physicians which resulted in a significant improvement in compliance to cancer screening guidelines. The Connecticut Division of the American Cancer Society has pursued this concept with their own program of visits targeted at physicians and their office staffs. A description of this program, which is still in its initial phases, is presented. The impact will be evaluated in due time, however additional volunteers to conduct these visits are needed.

Connecticut↗
PubMed1996

Prevention of perinatal hepatitis B through enhanced case management--Connecticut, 1994-95, and the United States, 1994.

Each year, an estimated 20,000 infants are born to women in the United States who are positive for hepatitis B surface antigen (HBsAg). These infants are at high risk for perinatal hepatitis B virus (HBV) infection and for chronic liver disease as adults. To identify newborns who require immunoprophylaxis to prevent perinatal HBV infection, all vaccine advisory groups have recommended routine HBsAg screening of all pregnant women during an early prenatal visit in each pregnancy. Federal funding to support perinatal hepatitis B-prevention programs became available in 1990, and by 1992, programs had been implemented in all 50 states and the District of Columbia. Specific objectives of these programs are to ensure that 1) all pregnant women are tested for HBsAg, and 2) infants born to HBsAg-positive women receive hepatitis B immune globulin (HBIG) and hepatitis B vaccine at birth, with follow-up doses of vaccine at ages 1 and 6 months. This report describes the case-management features of successful hepatitis B-prevention programs in Connecticut during 1994-95 and in the United States during 1994.

Connecticut↗
PubMed1997

Trends in cancer incidence in Connecticut.

The population-based Connecticut Tumor Registry was used to examine recent trends (1980-84 to 1990-94) in average annual age-standardized incidence rates (ASRs) for invasive cancers. Noteworthy were the increase for lung cancer in women (but a decline in men), the sharp increase for prostate cancer (but little change in female breast cancer), increases for melanoma of skin (both sexes) and non-Hodgkin's lymphoma (especially in males), and declines for colon and rectum (both sexes). Reducing cancer incidence rates will require expanded primary prevention efforts, involving mainly behavioral or life-style changes, with an important role for primary-care physicians.

Colonic Neoplasms↗
PubMed1997

The increase of Hodgkin's disease incidence among young adults. Experience in Connecticut, 1935-1992.

BACKGROUND: Recent studies have indicated an increase in young adulthood Hodgkin's disease incidence, particularly among females, since 1970. However, no studies have examined the long term trends and period-cohort patterns of Hodgkin's disease incidence. METHODS: The current study reported time trends and age-period-cohort patterns of Hodgkin's disease incidence during the period 1935-1992, with an emphasis on incidence rate changes among young adults, using data from the Connecticut Tumor Registry. RESULTS: A total of 4997 incidences of Hodgkin's disease were included in the study. The authors found that the incidence of Hodgkin's disease had increased among young adults age 20-44 years. Incidence had increased dramatically among females since 1970 but less significantly among males. These observed trends were primarily associated with nodular sclerosis histologic type. Age-period-cohort analyses indicated that these observed increases in young adults were cohort phenomena, suggesting possible changes in exposure to risk factors. CONCLUSIONS: Currently identified major risk factors, including social status, Epstein-Barr virus infection, and human immunodeficiency virus infection, cannot adequately explain the observed trends. Analytical epidemiologic studies are urgently needed to identify risk factors that will not only elucidate the etiology of Hodgkin's disease but also explain the rapid increase in Hodgkin's disease incidence among young females.

Adult↗
PubMed1997

Stage at diagnosis of prostate cancer in Connecticut by poverty and race.

OBJECTIVE: The study sought to determine if black-white differences in distribution of stage at diagnosis of prostate cancer persisted after controlling for a socioeconomic status (SES) indicator as an ecologic variable. DESIGN: A descriptive epidemiologic study. SETTING: The dataset was from the population-based Connecticut Tumor Registry (CTR), covering patients diagnosed in 1988-92. PARTICIPANTS: All white (N = 8,155) and black (N = 521) patients diagnosed with prostate cancer and reported to the CTR. RESULTS: The proportion of prostate cancers diagnosed at the distant (metastatic) stage was significantly higher in blacks than in whites, even within census tracts with high overall or race-specific poverty rates (20% or higher). When patient age and poverty rate of census tract (deciles) were included in a logistic model, black vs. white race was still statistically significantly associated with diagnosis at the distant vs. local or regional stage. CONCLUSIONS: Further studies are needed to explore the potential roles of black-white differences in screening rates and in biological factors, independent of SES, in explaining these findings.

Black or African American↗
PubMed1998

Statewide surveillance for ehrlichiosis--Connecticut and New York, 1994-1997.

In the United States, human monocytic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE) represent two clinically indistinguishable yet epidemiologically and etiologically distinct diseases caused by Ehrlichia chaffeensis and a bacterium similar or identical to E. equi, respectively. Infection with these emerging tickborne pathogens results in acute, influenza-like illnesses with fever, headache, malaise, and frequently leukopenia and/or thrombocytopenia. Connecticut and New York have initiated statewide laboratory-based surveillance to determine the magnitude and geographic extent of ehrlichiosis. This report summarizes results from the first 3 years of surveillance, which showed that rates of ehrlichiosis were similar in counties in both states where the disease occurs, and highest age-specific rates occurred among persons aged >40 years.

Adolescent↗
PubMed1998

Childhood injury in Connecticut.

We reviewed vital statistics (1988-95) and hospital discharge data (1990-94) for Connecticut children and youth to describe the epidemiology of childhood injuries. There are approximately 175 deaths (rate = 21/100,000) and 4,230 hospitalizations (rate = 468/100,000) annually due to injury. Nonfatal injuries resulted in over 94,000 hospital days at a cost of nearly $155 million dollars. Death and hospitalization rates are highest among male children and adolescents 15 to 19 years of age. Geographic analysis of injury revealed significantly higher injury death and hospitalization rates in towns greater than 100,000 population. In addition, a majority of the homicides occurred in large urban areas, and most of the motor vehicle occupant deaths and suicides occurred in suburban and rural areas. Injury is an important cause of mortality and morbidity in youth and is largely preventable. The data presented here allow for the development, implementation, and evaluation of community based injury prevention programs.

Accidents, Traffic↗
PubMed1999

Adult lead poisoning from an Asian remedy for menstrual cramps--Connecticut, 1997.

Follow-back procedures to determine the source of elevated blood lead levels (BLLs) are integral parts of the CDC's National Institute for Occupational Safety and Health Adult Blood Lead Epidemiology and Surveillance program (ABLES) in 27 states. Although an estimated 90%-95% of cases of elevated BLLs reported to the states in the ABLES program result from occupational exposures, nonoccupational exposures also are identified by this system. This report describes a case of adult lead poisoning attributed to an Asian remedy for menstrual cramps, "Koo Sar" pills, following an investigation by the Adult Lead Registry of the Connecticut Department of Public Health (CDPH), Division of Environmental Epidemiology and Occupational Health.

Adult↗
PubMed1999

Outbreak of Vibrio parahaemolyticus infection associated with eating raw oysters and clams harvested from Long Island Sound--Connecticut, New Jersey, and New York, 1998.

During July-September 1998, an outbreak of Vibrio parahaemolyticus infections associated with consumption of oysters and clams harvested from Long Island Sound occurred among residents of Connecticut, New Jersey, and New York. This is the first reported outbreak of V. parahaemolyticus linked to consumption of shellfish harvested from New York waters. This report summarizes the investigation of this outbreak.

Animals↗
PubMed1981

Hemoglobin connecticut (beta 21 (B3) Asp leads to Gly): a hemoglobin variant with low oxygen affinity.

Electrophoretic analysis of a hemolysate from a young man undergoing a routine physical examination revealed an abnormal hemoglobin with a mobility similar to Hb S on cellulose acetate (pH, 8.4). This new variant, designated Hb Connecticut, was found in three generations of a family of Polish descent. Several individuals possessing the variant exhibited mild anemia. Structural analysis of the abnormal beta-chain indicated that the amino acid substitution was at position 21 (B3), and involved the replacement of aspartic acid with glycine. Oxygen dissociation studies revealed low oxygen affinity. The alkaline Bohr effect and the degree of cooperativity were unchanged. Analysis of the crystal structure of the variant suggested that the low oxygen affinity was due to the possible disruption of salt bridges between aspartic acid 21(B3) and lysines 61(ES) and 65(E9), changes that could lead to steric interference in oxygen binding.

Adolescent↗
PubMed1985

Population structure in the Connecticut Valley: II. A comparison of multidimensional scaling solutions of migration matrices and isonymy.

In a previous paper (Swedlund et al., 1984) we have described the population structure of the historical Connecticut River Valley of Massachusetts in terms of matrimonial migration matrices. Using procedures described by Morton (1973), Harpending and Jenkins (1974), Jorde (1980), and others the exchanges between subdivisions which make up the matrices are made column stochastic and analyzed to predict genetic kinship. Subsequently the kinship estimates within and between subdivisions can be interpreted as genetic covariance and compared to the actual geographic distances between the respective subdivisions using a principal components analysis. In the present paper we extend these results by applying nonmetric multidimensional scaling to the migration matrices, and to isonymy matrices based on the same communities. We demonstrate that the multidimensional scaling configurations of marital migration represent the actual geographic relationships between the communities quite effectively for this particular case study from historical Massachusetts. Moreover, we argue that while these migration data may provide good estimates of social and genetic exchange between the subdivisions, surname analysis may also be informative of processes not revealed in the migration matrices alone.

Demography↗