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OBJECTIVES: We sought to evaluate the utility of partner notification for control of human immunodeficiency virus (HIV) infection and to identify subgroups in which it may be most effective. METHODS: All persons reported to be HIV-positive during a 2-year period were interviewed. Outcome measures included proportion of index patients cooperating; number of partners named, located, counseled, and tested; number of persons newly testing positive; and costs. RESULTS: Of 308 index patients, 244 (79%) cooperated. They named 890 partners; 499 (70%) of in-state partners were located. Of these, 154 (34%) had previously tested HIV-positive. Of 279 partners tested for the first time, 39 (14%) were HIV-positive. Injecting drug users were significantly more likely to cooperate than persons in other risk groups (93% vs 76%) and named more partners (median 4 vs 1). Women and persons choosing confidential testing were more likely to cooperate and named more partners. The estimated cost of the program was $62,500 per year. CONCLUSIONS: Partner notification identified a group with a high seroprevalence of HIV. It was not successful among populations that may be difficult to reach with other interventions.
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In animal production systems (poultry, beef, and swine), current production, storage, and disposal techniques present a challenge to manage wastes to minimize the emissions of trace gases within relatively small geographical areas. Physical and chemical parameters were measured on primary and secondary lagoons on three different swine farming systems, three replicates each, in the Central Great Basin of the United States to determine ammonia (NH3) emissions. Nutrient concentrations, lagoon water temperature, and micrometeorological data from these measurements were used with a published process model to calculate emissions. Annual cycling of emissions was determined in relation to climatic factors and wind speed was found the predominating factor when the lagoon temperatures were above about 3 degrees C. Total NH3 emissions increased in the order of smallest to largest: nursery, sow, and finisher farms. However, emissions on an animal basis increased from nursery animals being lowest to sow animals being highest. When emissions were compared to the amount of nitrogen (N) fed to the animals, NH3 emissions from sows were lowest with emissions from finisher animals highest. Ammonia emissions were compared to similar farm production systems in the humid East of the United States and found to be similar for finisher animals but had much lower emissions than comparable humid East sow production. Published estimates of NH3 emissions from lagoons ranged from 36 to 70% of feed input (no error range) compared to our emissions determined from a process model of 9.8% with an estimated range of +/-4%.
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Although non-insulin-dependent diabetes mellitus (NIDDM) is well recognized to be an inherited disease, the genetic lesion responsible remains to be determined. Several pedigrees have been reported in which defects of the insulin gene result in glucose intolerance or diabetes in affected members, but the role of insulin gene mutations in NIDDM is unknown. To evaluate this role, we ascertained 23 Caucasian pedigrees for a diabetic individual with at least one diabetic family member, sampled the unaffected individuals by a 75-g glucose tolerance test, and prepared leukocyte DNA on all family members. Included in the pedigrees ascertained were those with both predominantly lean and predominantly obese diabetic members and four pedigrees included as insulin-dependent diabetic individual. Insulin gene involvement was evaluated via previously described restriction-fragment-length polymorphisms (RFLPs) for the insulin gene and the nearby c-Ha-Ras oncogene (HRAS). Combination of these RFLPs resulted in the ability to trace the insulin alleles in all pedigrees studied. Analysis of individual pedigrees for sharing of insulin alleles was possible in 12 pedigrees, and lack of linkage was demonstrated in 6 of them. Neither linkage nor lack of linkage could be proved in the remaining pedigrees. Analysis of the pooled pedigree data failed to demonstrate linkage under several models, including autosomal-dominant and -recessive inheritance with different sporadic frequencies of diabetes and different prevalence figures. These results show that mutations of the insulin gene and the immediately surrounding area, including regulatory regions of the insulin gene, are unlikely to account for a significant subset of NIDDM in Caucasian individuals.
Considerable evidence supports a major inherited component of type 2 diabetes. We initially conducted a genome-wide scan with 440 microsatellite markers at 10-cM intervals in 19 multigenerational families of Northern European ancestry with at least two diabetic siblings. Initial two-point analyses of these families directed marker typing of 23 additional families. Subsequently, all available marker data on the total of 42 families were analyzed using both parametric and nonparametric multipoint methods to test for linkage to type 2 diabetes. One locus on chromosome 1q21-1q23 met genome-wide criteria for significant linkage under a model of recessive inheritance with a common diabetes allele (logarithm of odds [LOD] = 4.295). Both pedigree-based nonparametric linkage (NPL) analysis and affected sib pair (MAPMAKER/SIBS) nonparametric methods also showed the highest genome-wide scores at this region, near markers CRP and APOA2, but failed to meet levels of genome-wide significance. The risk of type 2 diabetes to siblings of a diabetic person when compared with the population (lambdaS) was estimated from MAPMAKER/SIBS to be 2.8 in these 42 families. Simulation studies using study data confirmed a genome-wide significance level of P<0.05 (95% CI 0.005-0.0466). However, analysis of 20 similarly ascertained but smaller families failed to confirm this linkage. The LOD score with 50% heterogeneity for all 62 families considered together was only 2.25, with an estimated lambdaS of 1.87. Our data suggest a novel diabetes susceptibility locus near APOA2 on chromosome 1 in a region with many transcribed genes.
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Cattle's grazing of the locoweed Wahweap milkvetch (Astragalus lentiginosus var. wahweapensis) was evaluated on desert and foothill winter range during the winter of 1986 to 1987. Dry, dead stalks of Wahweap milkvetch that had grown in 1985 and 1986 made up 15% of cattle diets overall, and 24% of diets when cattle grazed gravelly benches where it was abundant. Nutritional quality of Wahweap milkvetch was higher than of most associated forage, but its alkaloid concentration varied among the senescent stages. One cow aborted and two cows developed clinical signs of locoweed poisoning, including water belly (hydrops amnii). Microscopic lesions consisting of cytoplasmic foamy vacuolation were evident in both the dam and fetus. Because senescent stalks of Wahweap milkvetch are palatable and readily grazed by cattle, ranchers should not permit cattle to graze infested sites until other green forage is available in the spring.
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