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PubMed1989

Identification and determination of tert-alkylphenols in carp from the Trenton Channel of the Detroit River, Michigan, USA.

Whole carp from the Detroit River were analyzed by gas chromatographic mass spectrometry. Seven tertiary alkyl phenols (tert-pentylphenols, tert-butyl-tert-pentylphenols, a di-tert-pentylphenol and a tri-tert-pentylphenol) and eight chlorinated derivatives of these compounds were identified from their mass spectra and confirmed with synthesized authentic standards. 2,4-Di-tert-pentylphenol was the most abundant of these compounds; in one fish sample, its concentration was about 140 ppm. The same alkyl phenols were also found in technical-grade 2,4-di-tert-pentylphenol, which is manufactured at a chemical plant located near the Detroit River. Comparison of the alkyl phenol levels in carp with those in nearby sediments showed that many of these compounds are taken up by carp and that carp can be used to roughly track local sediment contamination.

Animals↗
PubMed2002

Complications from treatment for prostate carcinoma among men in the Detroit area.

BACKGROUND: Aggressive treatment of early stage prostate carcinoma (PC) is limited primarily to two modalities: radical prostatectomy (RP) and external beam radiation therapy (RT). The authors conducted a population-based study of Detroit area men with localized PC to determine the outcome of bowel, urinary, and sexual function after aggressive treatment. METHODS: Men with PC were identified through the Metropolitan Detroit Cancer Surveillance System, a member of the National Cancer Institute Surveillance, Epidemiology, and End Results Program. Patients participated in interviews about their pretreatment bowel, urinary, and sexual function approximately 9 months after treatment. The same men were asked identical questions about their function an average of 2 years after treatment. Treatment outcomes were compared for men who underwent RP and men who received RT. RESULTS: Of 501 men, 398 (79.4%) participated in both interviews, 304 of whom (76.4%) had localized PC and had been treated at least 1 year previously (median, 688 days). One hundred thirty men underwent RP, and 115 men received RT. The proportion of men in the RP group who reported an increase in incontinence symptoms was significant (53.8% compared with 19.2% in the RT group; P < 0.001). Men in the RT group reported increased loose stools between the pretreatment and post-treatment interviews (5.2% vs. 29.6%; P < 0.001). Men in both the RT group and the RP group reported increases in impotence from 40% to > 75% (P < 0.001 for both). Men in the RT group were 3.6 times more likely to have bowel incontinence compared with men in the RP group (odds ratio [OR], 3.61; 95% confidence interval [95% CI], 1.54-8.47). Urinary incontinence (OR, 2.87; 95% CI, 1.52-5.44) and erection difficulty (OR, 3.98; 95% CI, 1.35-11.70) were more likely among men in the RP group. CONCLUSIONS: Although patients may have recalled their baseline function as better than it was, the current results are consistent with other population-based studies of treatment outcomes among men with localized PC. They indicate that the side effects associated with treatment are greater than those based on case series. Physicians and patients should be aware of these population-based outcomes and should use them as part of the decision-making process regarding the treatment options for men with PC.

Aged↗
PubMed1992

Racial differences in cancer of the male breast--15 year experience in the Detroit metropolitan area.

Characteristics of cancer of the male breast were evaluated in a population based review of 244 cases identified retrospectively through the Metropolitan Detroit Cancer Surveillance System (MDCSS) between 1973 and 1987. The mean age at diagnosis was 65 years and median survival time, 44 months. There were no apparent time trends in incidence for either white or black men from 1973 through 1987. Modified radical mastectomy was the most common surgical procedure, while simple and radical mastectomy declined in popularity over time. Cox's proportional hazards regression model was used to test the simultaneous effects of age, race, stage, and treatment on survival. Men older than 65 at diagnosis had a greater risk of dying than men under 65 (RR 1.52, 95% confidence interval, 1.01-2.28). Survival was significantly worse for men who presented at a more advanced stage; regional versus localized (RR 2.19, 95% confidence interval, 1.39-3.45) and remote versus localized (RR 4.31, 95% confidence interval 2.26-8.23). Race had no significant effect on survival in men with breast cancer in the Detroit Metropolitan Area.

Adult↗
PubMed2005

Asthma prevalence and severity in Arab American communities in the Detroit area, Michigan.

Immigrant populations provide a unique intersection of cultural and environmental risk factors implicated in asthma etiology. This study focuses on asthma prevalence and severity in 600 Arab American households in metro Detroit, the largest immigrant reception zone for Arab Americans in North America. The survey method introduced a number of novel features: (a) a ranking scheme for the key environmental risk factors for asthma was used to derive an aggregated environmental risk index (ERI) for each household, and (b) an aggregate measure of asthma severity based on symptom frequency and intensity. Environmental risk factors and surrogates for socioeconomic status (SES) were found to be stronger predictors of asthma prevalence than asthma severity, while demographic variables such as English fluency and birth in the United States were better predictors of asthma severity than asthma prevalence. These results suggest that SES variables may be more reflective of environmental exposures in communities involved in this study, while English fluency and birth in the United States may be linked to health care access and utilization behavior that can influence the asthma management. We also found a significant relationship between asthma prevalence and degree of acculturation. Asthma prevalence was highest among moderately acculturated immigrants compared with new immigrants and those who were well acculturated, suggesting that among Arab Americans in the Detroit area, risk factors associated with new immigrant status are replaced by "western" risk factors as the population becomes more acculturated.

Acculturation↗
PubMed1978

Hemoglobin Detroit: beta95 (FG2) lysine leads to asparagine.

Hb Detroit is a mutant which migrates between Hb A and Hb J Baltimore on cellulose acetate (pH 8.5), and with Hb A on citrate agar (pH 6.0). Globin chain analyses in alkaline and acid buffers reveal an abnormal beta chain with a mobility between the betaA and betaJ Baltimore chains. Structural characterization of this abnormal chain shows that lysine at position 95 is replaced by asparagine. No hematological abnormalities could be attributed to the presence of the mutant, and the oxygen affinity properties of the stripped hemoglobin are similar to those of Hb A. The beta95 residue which is substituted in Hb Detroit and also in Hb N Baltimore ((beta95 Lys leads to Glu) does not appear to be in a critical functional area of the molecule.

Adult↗
PubMed2004

Clinical characterization of idiopathic intracranial hypertension at the Detroit Medical Center.

BACKGROUND: Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri (PTC), is a condition characterized by increased intracranial pressure without clinical, laboratory or radiologic evidence of an intracranial space-occupying lesion, meningeal inflammation or venous outflow obstruction. Previous population-based studies evaluated the presenting clinical features of IIH in North-Eastern Libya, Iowa, Louisiana, Minnesota, Northern Ireland, Israel and Western Turkey. However, we report the demographic patterns of a metropolitan North American city. METHODS: We performed a retrospective study of all patients with an initial IIH diagnosis and follow-up at the Detroit Medical Center (DMC), Michigan from 1985 to 2002. Medical records of 174 patients were reviewed, with 77 patients fitting the diagnostic criteria. RESULTS: Seventy-seven patients, 71 females (92.2%) and 6 males (7.8%) were identified. Age ranged from 10 to 50 years, with a mean of 34 years. Fifty patients (65%) were African-American and 24 patients (31%) were Caucasian. The most common presentation was isolated headache (28.6%). Nineteen patients (24.7%) were asymptomatic. Obesity was described in 65 of 74 patients (87.8%) evaluated for body dimensions. CONCLUSIONS: We report an increased number of asymptomatic patients after routine ophthalmic examination. Obese females in metropolitan Detroit would benefit from routine eye evaluations to avoid potential visual loss related to papilledema.

Adolescent↗
PubMed2002

Substance use for insomnia in Metropolitan Detroit.

OBJECTIVE: People with insomnia are not typically treated medically for their insomnia. Studies have reported approximately 30% of insomniacs self-medicate with alcohol or over-the-counter (OTC) medications. This study was done to identify determinants and risks of different insomnia therapeutics. METHODS: A random-digit-dial, computer-assisted survey of a representative sample of adults in Metropolitan Detroit, aged 18-65 years, is being conducted. A sample of all respondents over an 18-month period was collected (n=1324) with a 68% response rate. Exclusive past-year use of alcohol for sleep was reported by 10% (n=132), prescription medications by 8% (n=108), and OTC medications by 10% (n=135). Five percent used both alcohol and sleep medications. The three exclusive-use groups formed the comparison groups of the study. RESULTS: The prescription drug group used medications for more consecutive nights and for more total nights than the alcohol and OTC users. Alcohol users were predominantly male, while OTC and prescription drug users were predominantly female. Alcohol users were more likely to be single than the others, and prescription drug users were older than the others. Prescription drug users had more severe insomnia and had greater disability, neuroticism, and daytime fatigue than the others. In contrast, the alcohol users had greater daytime sleepiness than the others. CONCLUSIONS: In Metropolitan Detroit, insomniacs receiving medical treatment have more severe insomnia and greater disability than those who self-treat. However, while the insomnia of those self-treating is less severe, it is still associated with some risks.

Adolescent↗
PubMed2002

Persistent organic pollutants in Detroit River suspended sediments: polychlorinated dibenzo-p-dioxins and dibenzofurans, dioxin-like polychlorinated biphenyls and polychlorinated naphthalenes.

Suspended sediments from the Detroit River were collected in 1999 and 2000 using sediment traps at sites ranging from western Lake Erie to southern Lake St. Clair and analyzed to determine the spatial distributions of contaminants including polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDDs/PCDFs), dioxin-like PCBs (DLPCBs) and polychlorinated naphthalenes (PCNs). Concentrations of all three contaminant classes were clearly elevated at sites in the lower reaches of the river in the Trenton Channel. The potential influence of the Trenton Channel as a source of contamination to western Lake Erie was further evidenced by PCDD/PCDF homologue profiles, which indicated a contribution from chemical manufacturing in addition to the normal background combustion profile. Toxic equivalents (TEQs) for PCDDs/PCDFs generally exceeded those for DLPCBs; combined total TEQs in July 2000 for these two compound classes ranged from 2.30 pg/g in southern Lake St. Clair to 306 pg/g at a station just downstream of the outflow of Monguagon Creek in the Trenton Channel. The spatial distribution of PCN contamination was similar to that of PCDDs/PCDFs and DLPCBs, with the highest level of total PCNs (8200 ng/g) detected at a site in the Trenton Channel near Elizabeth Park; TEQs for PCNs in the Trenton Channel ranged from 73 to 3300 pg/g. The data indicate that PCNs represent a significant contribution to dioxin-like biological activity in Detroit River suspended sediments.

Benzofurans↗
PubMed1999

Prostate cancer histologic trends in the metropolitan Detroit area, 1982 to 1996.

OBJECTIVES: One of the concerns regarding the widespread use of serum prostate-specific antigen (PSA) as a screening tool for prostate cancer is the possibility that it may detect latent or clinically insignificant cancers. One indicator of clinical importance is thought to be histologic grade, with clinically unimportant cancers more likely to be well differentiated and clinically important tumors more likely to be moderately or poorly differentiated. METHODS: Data from the metropolitan Detroit population-based Surveillance, Epidemiology, and End Results Program were examined to determine trends in prostate cancer histologic grading before and after the introduction of PSA screening. RESULTS: From 1989 through 1996, the most recent year for which data are available, a dramatic increase in the incidence of prostate cancer occurred in the Detroit area, corresponding to the routine use of PSA as a screening test for prostate cancer. Local stage cancer demonstrated the largest increase in incidence. The incidence of moderately differentiated cancers also rose substantially during the same period; the incidence of poorly differentiated tumors remained about the same, and the incidence of well differentiated tumors decreased. Coincident with the increasing proportion of moderately differentiated cancers was a significant increase in the proportion of prostate biopsies performed (P = 0.001). CONCLUSIONS: These population-based data add important evidence that prostate cancers identified with PSA are more likely to be moderately than well differentiated. Additionally, if the definition of clinical significance depends on histopathologic grade, this finding could further be interpreted as evidence that PSA is more likely to detect clinically significant prostate cancer.

Adult↗
PubMed1999

Evaluation of air and dust sampling schemes for Fel d 1, Der f 1, and Der p 1 allergens in homes in the Detroit area.

BACKGROUND: Studies often use a point estimate of allergen exposure without fully justifying the accuracy of this single measure as an estimate of total exposure. Many studies have reported relationships between indoor allergen concentrations and manifestations of allergic disease on the basis of single samples. OBJECTIVES: The purposes of this study were to (1) characterize the variability in dust and air concentrations of allergens, (2) assess the relationships between dust and air concentrations of allergens, and (3) determine the minimum number and timing of samples to characterize annual indoor allergen exposure. METHODS: As part of a prospective cohort study of asthma in children, air and dust samples were repeatedly obtained from the homes of children residing in suburban Detroit, Michigan. Concentrations of Fel d 1, Der f 1, and Der p 1 were measured in the samples. The results of various patterns of sampling were compared with yearly averages. RESULTS: The concentrations of all 3 allergens in both air and dust varied widely both within and between homes. The allergen concentrations had peak concentrations in the fall. There was little correlation between air and dust concentrations. Our results indicate that as few as 2 or 3 samples taken late in the year provide good estimates of the annual average concentrations. CONCLUSIONS: Two or 3 samples, obtained 1 month apart and taken late in the year, represent the best balance between sampling effort and accuracy of the yearly exposure estimates of Fel d 1, Der f 1, and Der p 1 in temperate climates similar to those of Detroit, Michigan.

Air Pollution↗
PubMed1997

Trends in primary surgical and radiation therapy for localized breast cancer in the Detroit Metropolitan area 1973-1992.

PURPOSE: The purpose of this report is to describe trends in primary surgical and radiation therapy for localized breast cancer from 1973 through 1992 among residents of the Detroit Metropolitan area. METHODS AND MATERIALS: Data on surgical and radiation therapy procedures for women with local stage breast cancer were obtained from the population-based Metropolitan Detroit Cancer Surveillance System (MDCSS). RESULTS: Women age 75 years and older were treated less aggressively than younger women (< age 75) as evidenced by higher rates of simple mastectomy or no treatment among older women. Younger women (< age 75) were more likely to have had optimal breast conservation therapy which consisted of partial mastectomy, axillary lymph node dissection (ALND), and radiation therapy, than were women who were older than 75. Partial mastectomy has increased proportionally from 4% of all breast cancer surgeries in the time period 1973 to 1977, to 39% of all surgeries from 1988 through 1992. CONCLUSION: A marked difference in surgical treatment of breast cancer exists for younger vs. older women. Despite changes in surgical treatment trends for breast cancer, a large proportion of women who are candidates for conservative therapy continue to undergo mastectomy.

Age Factors↗
PubMed2005

Polybrominated diphenyl ethers and hydroxylated and methoxylated brominated and chlorinated analogues in the plasma of fish from the Detroit River.

Novel classes and congeners of contaminant residues that are structurally analogous to polybrominated diphenyl ether (PBDE) flame retardants were assessed in the plasma of seven benthic- and six pelagic-feeding fish species from the highly contaminated Detroit River corridor, namely, hydroxylated-PBDEs (OH-PBDEs), methoxylated-PBDEs (MeO-PBDEs), and the antimicrobial OH-trichlorodiphenyl ether, triclosan, and its methylated (MeO) triclosan analogue. In all samples sigmaPBDE concentrations were comprised mainly of BDE47, BDE99, and BDE100 (>85%) and ranged from 155 pg/g wet weight (ww) to 21 069 pg/g ww. Of the 14 OH-PBDE congeners assessed, as many as 10 congeners were identified, although profiles were generally dominated by 6-OH-BDE47 with lesser amounts of 2'-OH-BDE68, 4'-OH-BDE49, and 4-OH-BDE42. sigmaOH-PBDE concentrations ranged from 2.7 to 198 pg/g ww, with sigmaPBDE to sigmaOH-PBDE concentration ratios ranging from 0.0005 to 0.02. OH-PBDEs are likely derived in these freshwater species as metabolites of precursor PBDEs and are subsequently retained in the blood, for example, 6-OH-BDE47, 4'-OH-BDE49, and 4-OH-BDE42 could be derived from BDE47. Portions of concentrations of the OH-PBDEs may also be of alternate origins and are accumulated and retained in these fish. In all samples, the 14 MeO-PBDEs monitored were below detection (<0.01 pg/g ww). Anthropogenic triclosan concentrations ranged from 750 to >10 000 pg/g ww and is clearly a bioaccumulative halogenated phenolic compound in these fish. MeO-triclosan concentrations were considerably lower. In addition to emerging classes of brominated contaminant such as PBDEs, whether of metabolic or anthropogenic origin, fish collected from the Detroit River are exposed to a complex profile of PBDE-like organohalogens.

Animals↗
PubMed2003

Religious involvement, social support, and health among African-American women on the east side of Detroit.

BACKGROUND: A significant body of research suggests that religious involvement is related to better mental and physical health. Religion or spirituality was identified as an important health protective factor by women participating in the East Side Village Health Worker Partnership (ESVHWP), a community-based participatory research initiative on Detroit's east side. However, relatively little research to date has examined the mechanisms through which religion may exert a positive effect on health. OBJECTIVE: The research presented here examines the direct effects of different forms of religious involvement on health, and the mediating effects of social support received in the church as a potential mechanism that may account for observed relationships between church attendance and health. DESIGN: This study involved a random sample household survey of 679 African-American women living on the east side of Detroit, conducted as part of the ESVHWP. MAIN RESULTS: Results of multivariate analyses show that respondents who pray less often report a greater number of depressive symptoms, and that faith, as an important source of strength in one's daily life, is positively associated with chronic conditions such as asthma or arthritis. Tests of the mediating effect of social support in the church indicated that social support received from church members mediates the positive relationship between church attendance and specific indicators of health. CONCLUSIONS: These findings are consistent with the hypothesis that one of the major ways religious involvement benefits health is through expanding an individual's social connections. The implications of these findings for research and practice are discussed.

Adolescent↗
PubMed1997

Urban vegetational change as an indicator of demographic trends in cities: the case of Detroit.

"In this study the author seeks to find whether changes in urban vegetation can be linked to urban social changes by using Detroit [Michigan] as a case study. Demographic trends in Detroit are analyzed in light of the increasing greenness in the city detected by recent satellite images. Robust relationships between greenness change and demographic factors associated with urban decay (population decline, an increase in poverty level, and an increase in vacant units) are found.... It is concluded that vegetation trends could be used as indicators of urban socioeconomic changes. A vegetation-based urban environmental quality index could therefore be developed to monitor physical and social changes in the cities."

Americas↗
PubMed2004

Characterization of ultrafine particle number concentration and size distribution during a summer campaign in southwest Detroit.

This paper presents results from a study conducted in southwest Detroit from July 20 to July 30, 2002, to characterize ambient ultrafine particles (dP < 0.1 microm), and to examine the effect of local sources and meteorological parameters on the ultrafine number concentration and size distribution. The number concentrations of ambient particles in the size range of 0.01-0.43 microm were obtained from a scanning mobility particle sizer (SMPS). Meteorological parameters including ambient temperature, relative humidity, wind speed, wind direction, rainfall, and solar radiation flux were also monitored concurrently atop a 10-m tower. On average, ultrafine particles ranged from 1.4 x 10(4) to 2.5 x 10(4) cm(-3), with significant diurnal and daily variations, and accounted for approximately 89% of the total number concentration (0.01 < dP < 0.43 microm). Time-series plots of the 5-min number concentrations revealed that peak concentrations often occurred during morning rush hour and/or around solar noon when photochemical activity was at a maximum. The morning traffic-related peak coincided with the NOx peak, whereas the photochemical-related peak correlated with solar radiation flux. On some days, the noon peak concentration was many times higher than the morning peak concentration. Although the number size distribution varied considerably over the course of the study, it typically exhibited one to three modes, with diameters around 0.01, 0.05, and 0.09 microm. Analysis of the influence of wind direction indicated that stationary sources could be one of the contributors to elevated ultrafine particle concentration. Overall, the data indicated that fossil fuel combustion and atmospheric gas-to-particle conversion of precursor gases are the major sources of ultrafine particles in the southwest Detroit area during the summer.

Air Pollutants↗
PubMedDate not supplied

Bacteremia in narcotic addicts at the Detroit Medical Center. I. Microbiology, epidemiology, risk factors, and empiric therapy.

The changing microbiology of bacteremia among narcotic addicts in Detroit raised concerns about current presumptive antimicrobial therapy. In a one-year study of incidence, microbiology, sites, and risk factors, 180 bacteremic addicts (15% of addict-related admissions) were followed prospectively. Cases of bacteremia were caused by methicillin-sensitive Staphylococcus aureus (33%), methicillin-resistant S. aureus (MRSA, 24%), streptococci (20%), mixed organisms (11%), Pseudomonas aeruginosa (9%), and miscellaneous other single organisms (3%). Endocarditis (41%) and abscess or cellulitis (34%) were usually found. Multivariate analysis of host factors and addiction habits yielded results predictive of bacterial species but not of infection sites. Previous hospitalization, long-term addiction, and nonprescribed antibiotic use were associated with MRSA acquisition (odds ratio, 8.6:1). All addicts with polymicrobial or P. aeruginosa bacteremia abused pentazocine and tripelennamine (P = .05). Many of the addicts with streptococcal bacteremia were women who did not abuse antibiotics (odds ratio, 20.7:1). Physicians inappropriately prescribed empiric antibiotics for 67 of 72 addicts with MRSA, P. aeruginosa, or polymicrobial infection. The results of regression analysis suggest that, guided by the patient's history, the physician can prescribe appropriate empiric antimicrobial therapy for bacteremia in the febrile addict in Detroit.

Adolescent↗
PubMed1997

Outcome of African American men screened for prostate cancer: the Detroit Education and Early Detection Study.

PURPOSE: Will early detection impact on stage of disease and recurrence of prostate cancer in a high risk population? We initiated a community based study to educate and recruit African American men for early diagnosis of prostate cancer, that is the Detroit Education and Early Detection (DEED) study. Our objective was to evaluate our recruitment process for this target population, examine the percentage of organ confined prostate cancer in men undergoing radical prostatectomy and measure recurrence biochemically. MATERIALS AND METHODS: A community based study from February 1993 to February 1995 through the African American churches in metropolitan Detroit was initiated. We compared the early detection group treated with radical prostatectomy to the population presenting to our urological clinic during the same period. We tested and followed 1,105 African American men using the prostate specific antigen blood test. RESULTS: Pathologically organ confined prostate cancer was diagnosed in 11 of 17 men (65%) who underwent radical prostatectomy in the DEED project. Within the clinic population 35% of the African American men were diagnosed with pathologically organ confined prostate cancer. The difference between the 2 populations was statistically significant (p = 0.033). Disease recurred in 1 of 15 (7%) and 39 of 157 (25%) men in the DEED and clinic populations, respectively (p = 0.97). CONCLUSIONS: We demonstrated our ability to recruit African American men into a prostate cancer early detection program. We diagnosed early but clinically significant prostate cancers among African American men with characteristics similar to prostate cancers diagnosed in other early detection studies in which the overwhelming majority of men were white.

Aged↗
PubMedDate not supplied

Eating patterns and cardiovascular disease risk in a Detroit Mexican American population.

The purpose of this study was to examine dietary patterns and cardiovascular risk factors in Hispanic adults living in Southwest Detroit. A descriptive design was used. Self-report baseline data were collected using The Rate Your Plate and Personal Health Risk Assessment questionnaires. A nonrandom sample of 32 Mexican American adults was recruited from a large Roman Catholic Church in Southwest Detroit. Participants were selected if they were enrolled in the larger parent research study to test the effects of a lay health educator intervention and planned to participate in the nutrition education portion of the intervention. Unhealthy eating patterns outnumbered heart healthy eating practices. The majority used higher fat salad dressings; ate fried foods, sweets, and high fat snacks; consumed greater than the desired amounts of regular cheese; drank whole milk; and ate few fruits and vegetables. Lack of physical activity, being overweight, and exposure to second-hand smoke were the most prevalent cardiovascular risk factors. The data suggest that effective community-based heart disease prevention programs that emphasize risk factor screening and cardiovascular risk reduction through heart healthy eating are needed.

Adult↗