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PubMed1973

California arbovirus (La Crosse) infections. II. Precipitin antibody tests for the diagnosis of California encephalitis.

Precipitin antibodies to California group arboviruses were studied by double agar gel immunodiffusion (ID) and counterimmunoelectrophoresis (CEP). Forty children with California encephalitis (CE), 12 patients with other forms of meningoencephalitis, and 120 residents of endemic CE areas were tested. Precipitin antibodies were detected only in the 40 patients with CE, whereas hemagglutination-inhibiting, neutralizing, and complement-fixing antibodies were also found in persons without a history of CE. Precipitin antibodies did not persist for more than a year, in contrast to the other three antibodies which may be detected for 2 or more years. Of the children with CE, 36% had precipitin antibodies in their acute sera by CEP and 44% by ID. Precipitin responses were subtype-specific, and the patients reacted most strongly with La Crosse virus. The results indicated that precipitin techniques would be useful for the early detection of CE in some patients and that the presence of precipitin antibodies in a patient with acute central nervous system infection is strongly suggestive of CE. In addition, precipitin tests can be used to distinguish the California subtype responsible for CE in a given area.

Antibodies, Viral↗
PubMed1999

Antibodies against Leptospira interrogans in California sea lion pups from Gulf of California.

One hundred and twenty-five serum samples from California sea lion (Zalophus californianus californianus) pups, and one from an adult female from eight reproductive rookeries located in seven islands in the Gulf of California (Mexico), were collected during the 1994-96 reproductive seasons. These were tested for antibodies to 19 serovars of Leptospira interrogans using a Microscopic Agglutination Test (MAT). Forty-one samples (32%) had antibody levels from 1:20 to 1:320 to one or more serovars. The most frequently detected serotypes were Leptospira interrogans hardjo (n = 13), cynopteri (8), ballum (6), and szwajizak (5). Serovars with the highest prevalence were Leptospira interrogans hardjo and serjoe (1:320), ballum (1:160), and cynopteri, girppotyphosa, and tarassovi (1:80). Based on these results, exposure of sea lions to L. interrogans serovar hardjo seems to be relatively common among colonies located in the islands of the Gulf of California in contrast with those located on the Pacific coast, where the most frequently detected serovar is L. interrogans serovar pomona.

Agglutination Tests↗
PubMed1999

Hepatic carcinoma with spleen metastasis in a California sea lion from the Gulf of California.

A primary hepatic carcinoma with a neuroendocrine pattern was detected in an adult female California sea lion (Zalophus californianus) found dead on Granito Island in the Gulf of California (Mexico) in January 1996. At necropsy, several light yellow nodules of different sizes were observed on the entire surface of the liver and spleen. Microscopic examination of these nodules using routine haematoxylin-eosin stain, revealed cubic, polyhedral and pleomorphic cells with three to four bizarre mitotic figures per field (40X). An immunohistochemistry test revealed a positive reaction of indirect immunoperoxide to cytokeratin (CK2). This is the first known case of a primary hepatic carcinoma in free-ranging California sea lions from Mexican waters.

Animals↗
PubMed2005

Cryptic vicariance in Gulf of California fishes parallels vicariant patterns found in Baja California mammals and reptiles.

Comparisons across multiple taxa can often clarify the histories of biogeographic regions. In particular, historic barriers to movement should have affected multiple species and, thus, result in a pattern of concordant intraspecific genetic divisions among species. A striking example of such comparative phylogeography is the recent observation that populations of many small mammals and reptiles living on the Baja California peninsula have a large genetic break between northern and southern peninsular populations. In the present study, I demonstrate that five species of near-shore fishes living on the Baja coastline of the Gulf of California share this genetic pattern. The simplest explanation for this concordant genetic division within both terrestrial and marine vertebrates is that the Baja Peninsula was fragmented by a Plio-Pleistocene marine seaway and that this seaway posed a substantial barrier to movement for near-shore fishes. For some fish species, the signal of this vicariance in mtDNA has been eroded by gene flow and is not evident with classic, equilibrium measures of population structure. Yet, significant divisions are apparent in coalescent analyses that jointly estimate divergence with gene flow. The genetic divisions within Gulf of California fishes also coincide with recognized biogeographic regions based on fish community composition and several environmental factors. It is likely that adaptation to regional environments and present-day oceanographic circulation limit gene exchange between biogeographic regions and help maintain evidence of past vicariance.

Animals↗
PubMed2005

Seasonal prevalence and intensity of hookworms (Uncinaria spp.) in California sea lion (Zalophus californianus) pups born in 2002 on San Miguel Island, California.

Intestines of California sea lion (Zalophus californianus) pups (n= 204), born in 2002 on San Miguel Island, California, were examined for hookworms (Uncinaria spp.) as part of a seasonal mortality study from June through December 2002 and January 2003. The investigation was planned to coincide with most of the previously established hookworm infection period of the pups. Prevalence of hookworms in dead pups was 100% for each month of the study. The geometric mean intensity of infections per month was: 94.03 (n=30) for June, 629.09 (n=50) for July, 319.90 (n=31) for August, 159.90 (n=30) for October, 109.03 (n=30) for November, 37.84 (n=24) for December 2002 and 11.05 (n=9) for January 2003. In addition to the temporal pattern, the infection intensity was higher for pups in good condition and for male pups. An inter-year comparison of hookworm counts from dead pups collected in July of 1996, 2000, and 2002 also demonstrated higher intensity in pups in better condition but sex-differences in intensity were inconsistent across years. The inter-year comparison also demonstrated higher intensities in dead pups collected from portions of the rookery with sandy substrate versus rocky substrate. No annual differences in intensity were found after adjusting for substrate and condition.

Ancylostomatoidea↗
PubMed2006

Tissue heavy metal concentrations of stranded California sea lions (Zalophus californianus) in Southern California.

Concentrations of nine heavy metals (As, Cd, Cu, Fe, Hg, Pb, Mn, Mo and Zn) were determined in the hepatic and renal tissues of 80 stranded California sea lions (Zalophus californianus). Significant age-dependant increases were observed in liver and kidney concentrations of cadmium and mercury, and renal zinc concentrations. Hepatic iron concentrations were significantly higher in females than males. Animals with suspected domoic acid associated pathological findings had significantly higher concentrations of liver and kidney cadmium; and significantly higher liver mercury concentrations when compared to animals classified with infectious disease or traumatic mortality. Significantly higher hepatic burdens of molybdenum and zinc were found in animals that died from infectious diseases. This is the largest study of tissue heavy metal concentrations in California sea lions to date. These data demonstrate how passive monitoring of stranded animals can provide insight into environmental impacts on marine mammals.

Aging↗
PubMed2004

Incidence and prevalence of uveitis in Northern California; the Northern California Epidemiology of Uveitis Study.

PURPOSE: To determine the incidence and prevalence of uveitis in a large, well-defined population in Northern California. DESIGN: Cross-sectional study using retrospective database and medical record review. PARTICIPANTS: A group of 2070 people within 6 Northern California medical center communities (N = 731 898) who had a potential diagnosis of uveitis. METHODS: The patient database of a large health maintenance organization (2 805 443 members at time of the study) was searched for all patients who, during a 12-month period, had the potential diagnosis of uveitis. Detailed quarterly gender- and age-stratified population data were available. Medical records of patients who potentially had uveitis and who were members of the 6 target communities were reviewed by 2 uveitis subspecialists to confirm the diagnosis of uveitis and to establish time of onset. Demographic and clinical data were gathered for patients meeting the clinical definition of uveitis. Incidence rates were calculated by using a dynamic population model. Prevalence rates were based on the mid-study period population. MAIN OUTCOME MEASURES: Presence and date of onset of uveitis. RESULTS: At midstudy, the population for the 6 communities was 731 898. During the target period, 382 new cases of uveitis were diagnosed; 462 cases of uveitis were diagnosed before the target period. These data yielded an incidence of 52.4/100 000 person-years and a period prevalence of 115.3/100 000 persons. The incidence and prevalence of disease were lowest in pediatric age groups and were highest in patients 65 years or older (P<0.0001). The prevalence of uveitis was higher in women than in men (P<0.001), but the difference in incidence between men and women was not statistically significant. Comparison between the group of patients who had onset of uveitis before the target period (ongoing uveitis) and the entire cohort of uveitis patients showed that women had a higher prevalence of ongoing uveitis than men and that this difference was largest in the older age groups (P<0.001). CONCLUSION: In this largest population-based uveitis study in the United States to date, the incidence of uveitis was approximately 3 times that of previous U.S. estimates and increased with the increasing age of patients. Women had a higher prevalence of uveitis than men, and the largest differences were in older age groups.

Adolescent↗
PubMed1991

The HIV-1 seroprevalence rate of injured patients admitted through California emergency departments. California HIV-1 Emergency Department Seroprevalence Study Group.

STUDY OBJECTIVES: To measure the HIV seroprevalence of injured emergency department patients in a number of California hospitals and to examine the relationship between ED seroprevalence and local AIDS incidence. DESIGN: Prospective blinded testing for HIV-1 antibody was performed on routinely collected blood samples. SETTING: Ten California hospitals; group 1 included three hospitals from counties of high AIDS incidence (more than 40 cases per 100,000 population), group 2 included three hospitals from counties of intermediate AIDS incidence (20 to 40 cases per 100,000 population); and group 3 included four hospitals from counties of low AIDS incidence (less than 20 cases per 100,000 population). TYPE OF PARTICIPANTS: Eligible patients were all adult trauma victims admitted to a participating hospital through the ED during a consecutive three-month period occurring between June and November 1989. MEASUREMENTS: HIV-1 antibody testing was done using enzyme immunoassay confirmed by immunofluorescence assay. Equivocal results were confirmed by Western blot. Mann-Whitney U test, chi 2 test, and multiple logistic regression were used where appropriate. RESULTS: There were 2,264 patients with adequate blood samples for serologic testing. The seroprevalence rates for hospitals in groups 1, 2, and 3 were significantly different (chi 2 = 8.44, P = .02): Group 1, 2.5% (19 of 756: 95% confidence interval [CI], 1.5% to 3.9%); group 2, 0.9% (10 of 1,078; CI, 0.5% to 1.7%); and group 3, 0.5% (two of 430; CI, 0.06% to 1.7%). CONCLUSION: This study suggests that local AIDS incidence rates do not necessarily predict the seroprevalence rates of injured patients who are admitted through local EDs.

Acquired Immunodeficiency Syndrome↗
PubMed1998

The California Hospital Outcomes Project: how useful is California's report card for quality improvement?

BACKGROUND: Hospital report cards have proliferated in the 1990s but remain controversial because risk-adjusted outcomes measures are complex and have uncertain validity. Despite this controversy, little is known about their value and impact. METHODS: A two-stage survey of hospital leaders in California was undertaken in September 1996 and July 1997 to explore how the 1996 reports and data from the California Hospital Outcomes Project (CHOP) were used to improve organizations' performance. In the first stage, a questionnaire was mailed to the chief executive officer of each hospital in the report. In the second stage, a stratified random sample of the respondents who indicated a willingness to provide further information was interviewed. RESULTS: Thirty-nine interviews were completed, representing 87% yield after replacing informants who failed to return six messages. About three-quarters of the interviewees found some aspect of the CHOP report to be useful, especially for benchmarking performance, improving ICD-9-CM (International Classification of Diseases, 9th Revision, Clinical Modification) coding, and educating physicians about documentation and clinical pathways. The most common criticisms were that the reports were not timely and described death rates without providing practical information about the process of care. DISCUSSION: Although the 1996 CHOP reports and data were widely disseminated within hospitals, most reported uses did not directly affect the process of care for patients with acute myocardial infarction. This finding reflects two critical weaknesses of the project--nontimely data and lack of information about the process of care. Nevertheless, hospital quality managers recognize that public report cards are here to stay, and some carefully studied their outcomes data to identify areas for improvement.

California↗
PubMed1995

Determination and comparative analysis of the small RNA genomic sequences of California encephalitis, Jamestown Canyon, Jerry Slough, Melao, Keystone and Trivittatus viruses (Bunyaviridae, genus Bunyavirus, California serogroup).

The nucleotide sequences of the small (S) genomic RNAs of six California (CAL) serogroup bunyaviruses (Bunyaviridae: genus Bunyavirus) were determined. The S RNAs of two California encephalitis virus strains, two Jamestown Canyon virus strains, Jerry Slough virus, Melao virus, Keystone virus and Trivittatus virus contained the overlapping nucleocapsid (N) and non-structural (NSs) protein open reading frames (ORFs) as described previously for the S RNAs of other CAL serogroup viruses. All N protein ORFs were 708 nucleotides in length and encoded a putative 235 amino acid gene product. The NSs ORFs were found to be of two lengths, 279 and 294 nucleotides, which potentially encode 92 and 97 amino acid proteins, respectively. The complementary termini and a purine-rich sequence in the 3' non-coding region (genome-complementary sense) were highly conserved amongst CAL serogroup bunyavirus S RNAs. Phylogenetic analyses of N ORF sequences indicate that the CAL serogroup bunyaviruses can be divided into three monophyletic lineages corresponding to three of the complexes previously derived by serological classification. The truncated version of the NSs protein, which is found in five CAL serogroup bunyaviruses, appears to have arisen twice during virus evolution.

Amino Acid Sequence↗
PubMed2000

The Harvard Southern California Chronic Ozone Exposure Study: assessing ozone exposure of grade-school-age children in two Southern California communities.

The Harvard Southern California Chronic Ozone Exposure Study measured personal exposure to, and indoor and outdoor ozone concentrations of, approximately 200 elementary school children 6-12 years of age for 12 months (June 1995-May 1996). We selected two Southern California communities, Upland and several towns located in the San Bernardino mountains, because certain characteristics of those communities were believed to affect personal exposures. On 6 consecutive days during each study month, participant homes were monitored for indoor and outdoor ozone concentrations, and participating children wore a small passive ozone sampler to measure personal exposure. During each sampling period, the children recorded time-location-activity information in a diary. Ambient ozone concentration data were obtained from air quality monitoring stations in the study areas. We present ozone concentration data for the ozone season (June-September 1995 and May 1996) and the nonozone season (October 1995-April 1996). During the ozone season, outdoor and indoor concentrations and personal exposure averaged 48.2, 11.8, and 18.8 ppb in Upland and 60.1, 21.4, and 25.4 ppb in the mountain towns, respectively. During the nonozone season, outdoor and indoor concentrations and personal exposure averaged 21.1, 3.2, and 6.2 ppb in Upland, and 35.7, 2.8, and 5.7 ppb in the mountain towns, respectively. Personal exposure differed by community and sex, but not by age group.

Age Distribution↗
PubMed1993

Development of neurosurgery in southern California and the Los Angeles county/University of Southern California Medical Center.

The Los Angeles County General Hospital has played an integral role in the development of medicine and neurosurgery in Southern California. From its fledgling beginnings, the University of Southern California School of Medicine has been closely affiliated with the hospital, providing the predominant source of clinicians to care for and to utilize as a teaching resource the immense and varied patient population it serves.

Academic Medical Centers↗
PubMed2002

California's Cushing connection: Harvey Cushing trained California's first neurosurgeons.

On September 9, 2000, California celebrated its sesquicentennial anniversary of its admission to the United States. One hundred years ago, in September of 1901, Harvey Cushing began his surgical practice in Baltimore, Maryland. The proximity of these dates presents an auspicious moment for a review of the careers of three neurosurgeons trained by Dr. Cushing--Howard Naffziger, Carl Rand, and Edward Towne--who played defining roles in establishing modern neurosurgery in the Golden State. In promulgating Cushing's surgical principles and philosophy, these physicians achieved a distinguished place in the history of medicine in California.

California↗
PubMed1996

Leptospirosis in California sea lions (Zalophus californianus) stranded along the central California coast, 1981-1994.

Prevalence of leptospirosis was determined in California sea lions (Zalophus californianus) stranded live along the central California (USA) coast between January 1981 and December 1994. Clinical signs of renal disease were seen in 764 (33%) of 2338 animals examined; 545 (71%) of these 764 animals died, with similar gross lesions of nephritis. In silver impregnation stains of sections of formalin-fixed kidney, numerous loosely coiled spiral organisms were observed. Leptospira pomona kenniwicki was cultured from four kidney samples in 1991. Epizootics of leptospirosis occurred in 1984, 1988, 1991, and 1994, and were more common in the autumn, typically affecting juvenile males. In 1991 and 1994, 47 animals sampled had antibody titers to L. pomona greater than 1:3200. In 1992, 20 animals sampled were seronegative, and in 1993 three of 20 animals sampled had low titers to L. pomona.

Animals↗
PubMed1967

North American blastomycosis in California. Diagnosis of a case and a survey with 28 California observed cases.

North American blastomycosis is not seen often in California. An exhaustive survey uncovered records of only 28 cases. It is believed that this disease does not occur naturally in California and that a careful study of the history will reveal that a residence or visit to a known endemic area can be found.A chart summarizing the results of complement fixation and skin tests for coccidioidomycosis, North American blastomycosis, and histoplasmosis in the 28 cases is included. Use of all three antigens is recommended in cases where there is a difficult diagnostic pulmonary problem, even though there is occasional occurrence of cross-reactions between the three antigens. Finally, an appeal is made to be aware of other mycotic diseases non-edemic to this state.

Adult↗
PubMedDate not supplied

Raw shellfish consumption in California: the 1992 California Behavioral Risk Factor Survey.

We used the 1992 California Behavioral Risk Factor Surveillance System to study the prevalence of raw shellfish consumption in California and the demographic and behavioral characteristics of raw shellfish consumers. We used the logistic regression analysis of the weighted survey data with PC SAS and SUDAAN to adjust for the effects of age and gender. Twenty-three percent of the respondents in the survey reported that they ate raw shellfish; one third of these reported eating raw shellfish once a month. Higher prevalences of raw shellfish consumption were reported by men, persons 18-49 years old, those with income above $25,000 and education beyond high school than by women, individuals older than 49 years, and those with an income of $25,000 or less per year and 12 or fewer years of school. A higher percentage of persons with liver disease, stomach surgery, and a history of chronic alcohol drinking reported consumption of raw shellfish than did individuals without liver disease, previous stomach surgery, or a history of alcohol abuse. After adjustment for gender and age, those who reported acute (P < .01) and chronic (P < .01) drinking and driving while intoxicated (P < .01) were more likely to report consumption of raw shellfish. Two variables (lack of seat belt usage [P = 2] and cigarette smoking [P = .13]) were not significantly associated statistically with raw shellfish consumption.

Adult↗
PubMed1993

HIV-1 seroprevalence among women attending sexually transmitted disease clinics in California. California Family of Surveys and Sentinel Surveillance Consortia.

To evaluate the distribution of the human immunodeficiency virus type 1 (HIV-1) epidemic among California women, we analyzed HIV-1 seroprevalence and risk factors among women attending sexually transmitted disease (STD) clinics in 21 local health jurisdictions. Using standardized protocols developed by the Centers for Disease Control, we tested unlinked serum specimens from women attending participating STD clinics in 1989. We analyzed demographic characteristics, HIV risk exposure groups, and results of HIV-1 antibody testing on 17,210 specimens with an overall HIV-1 seroprevalence of 0.57%. Seroprevalence rates were highest for African-American women, women 25 to 29 years of age, injection drug users, and women attending STD clinics in San Francisco. After multiple logistic regression analysis, HIV-1 seropositivity remained highest for these four groups. The rate of HIV-1 infection among women attending STD clinics in California underscores the continued need to make HIV counseling and testing an integral component of routine services for women being evaluated for, or presenting with, sexually transmitted diseases.

Adolescent↗
PubMed1998

Bacterial isolates from California sea lions (Zalophus californianus), harbor seals (Phoca vitulina), and northern elephant seals (Mirounga angustirostris) admitted to a rehabilitation center along the central California coast, 1994-1995.

In 2 yr of bacteriologic culturing of 297 California sea lions (Zalophus californianus), 154 harbor seals (Phoca vitulina), and 89 northern elephant seals (Mirounga angustirostris) stranded alive along the California coast, the most frequent isolates from inflammatory lesions in live animals were Escherichia coli, Streptococcus viridans, Listeria ivanovii, beta-hemolytic Streptococcus spp., and Enterococcus spp. This is the first report of L. ivanovii isolation from a marine mammal. The common isolates from lung and liver in animals dying during rehabilitation were E. coli, Salmonella spp., Klebsiella spp., Pseudomonas spp., Aeromonas spp., Proteus spp., and Staphylococcus aureus. The most common isolates from brain were Enterococcus spp., E. coli, Klebsiella spp., and Pseudomonas spp. Ocular lesions were seen most often in harbor seals and elephant seals, from which the isolates cultured included Pseudomonas spp., Enterococcus spp., Streptococcus viridans, E. coli, Staphylococcus aureus, Proteus spp., Morganella morganii, Moraxella spp., beta-hemolytic Streptococcus spp., and L. ivanovii. Nine different Salmonella serotypes were isolated from 49 animals; S. newport was the most common. These results should enable those working clinically with these species to make logical decisions in choosing initial antimicrobial therapy.

Abscess↗