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PubMedDate not supplied

Surveillance of hazardous substance releases and related health effects.

The public health consequences of hazardous substance releases have not been characterized adequately. In response, therefore, the Agency for Toxic Substances and Disease Registry implemented an active, state-based surveillance system. Information is collected with respect to the events, chemicals, victims, injuries, and evacuations. Five states reported 1,249 events during 1990 and 1991. Seventy-two percent of the events occurred at fixed facilities, and 28% of the events were transportation related. In 80% of the events, one chemical was released. The most frequently released chemicals were herbicides, acids, volatile organic compounds, and ammonias. In 204 events, 846 persons were injured and 7 died. Employees were injured more frequently than first responders or the general public. The most frequently reported injuries were respiratory irritation and eye irritation. Evacuations occurred in 14% of the events. These results provide information for preparedness planning and training of first responders and employees.

Adult↗
PubMed1969

Morphological, cultural, biochemical, and serological comparison of Japanese strains of Vibrio parahemolyticus with related cultures isolated in the United States.

Morphological, cultural, biochemical, and serological characteristics of 79 strains of Vibrio parahemolyticus isolated from patients suffering from gastroenteric disease in Japan were compared with 17 suspected V. parahemolyticus cultures isolated from wound infections and 14 nonpathogenic vibrios isolated from an estuarine environment in the United States. These groups were differentiated on the basis of several key reactions which included: the range of growth temperature and salt tolerance; the production of catalase and acetoin; the hydrolysis of starch; the fermentation and utilization as single carbon source of sucrose, cellobiose, and arabinose; and the ability to swarm on 1% agar. The separation of the groups on the basis of cultural and biochemical analyses was confirmed by means of slide agglutinations with specific anti-K antisera. The results of this study strongly suggest that the wound infection isolates are V. parahemolyticus species which are easily distinguished from the nonpathogenic estuarine vibrios.

Acids↗
PubMed1999

The use of adjuvant radiation therapy by members of the Society of Gynecologic Oncologists.

UNLABELLED: OBJECTIVES. The aim of this study was to determine the attitudes of the members of the Society of Gynecologic Oncologists with respect to the use of adjuvant radiation therapy in women with endometrial cancer. METHODS: An anonymous survey concerning the use of adjuvant radiation therapy in endometrial cancer was mailed to all members of the Society of Gynecologic Oncologists listed in the 1998 directory. RESULTS: Of the 767 listed members, 325 (42%) returned completed surveys. Less than 20% of respondents recommended adjuvant radiation therapy in stage IA grade 1 or 2 and stage IB grade 1 endometrial cancer. Adjuvant radiation is recommended by 40 to 50% of respondents in women with stage IA grade 3 and IB grade 2 tumors. Most recommend adjuvant radiation for all women with >50% myometrial invasion or grade 3 tumors with any myometrial invasion. Lymph node sampling is attempted in all cases by 48% of respondents. For those familiar with Gynecologic Oncology Group (GOG) Study No. 99, 20% stated that they were more likely to recommend adjuvant radiation and 27% stated that they were less likely to recommend adjuvant radiation based on the preliminary results. Except in stage IA grade 1 tumors, the chance of recommending further therapy in women with all stages and grades was significantly less if a complete staging procedure including lymph node dissection had been performed. CONCLUSIONS: Complete staging appears to decrease the chance that postoperative therapy will be recommended. The use of adjuvant radiation therapy seem to have declined slightly as a result of GOG Study No. 99. Future studies in women with endometrial cancer that do not require lymph node sampling should evaluate the frequency of adjuvant therapy in the absence of complete staging.

Adenocarcinoma↗
PubMed1996

Risk factors for hazardous substance releases that result in injuries and evacuations: data from 9 states.

This study was undertaken to determine risk factors associated with hazardous substance releases (at fixed facilities or during transport) that have public health consequences. Data from nine states with surveillance systems for such releases and their consequences were analyzed. Risk factors were determined for releases resulting in (1) injuries or (2) evacuations. Both outcomes were more likely to occur as a result of facility releases (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.44, 2.47, for injuries; OR = 3.29, 95% CI = 2.28, 4.74, for evacuations). Releases of ammonia, chlorine, and acids resulted in injuries and evacuations more frequently than releases of other substances.

Disaster Planning↗
PubMed2001

A randomized multicenter trial of crotalinae polyvalent immune Fab (ovine) antivenom for the treatment for crotaline snakebite in the United States.

BACKGROUND: Current therapy for crotaline snakebite includes antivenin (Crotalidae) polyvalent, an antivenom with numerous adverse effects. We compared the efficacy and safety of 2 dosing regimens with a new antivenom, Crotalinae polyvalent immune Fab (Fab AV). METHODS: A single dose of Fab AV alone (as-needed [PRN] group) was compared with an initial dose plus repeated treatments during 18 hours (scheduled group) in a multicenter randomized trial. The study included patients with minimal or moderate envenomation by a crotaline snake within the preceding 6 hours, aged 10 years or older, in whom worsening of the envenomation syndrome was observed before Fab AV treatment. After treatment with Fab AV to achieve initial control, patients were randomized to the scheduled or PRN treatment group. Scheduled group patients received additional doses of Fab AV every 6 hours for 3 doses. The PRN group received no planned additional doses of antivenom. RESULTS: The mean severity score of the 31 patients decreased from 4.35 to 2.39 points (P<.001); there was no difference between scheduled and PRN groups. No patient in the scheduled group received unplanned Fab AV doses, but 8 of 16 patients in the PRN group received unplanned doses (P =.002). Acute reactions occurred in 6 patients (19%), and serum sickness occurred in 6 (23%) of 26 patients who returned for follow-up. CONCLUSIONS: In the first randomized trial of antivenom in the United States, Fab AV effectively terminated venom effects. Since the unplanned use of Fab AV in the PRN group was common, the treatment regimen may require more than 1 initial dose.

Adolescent↗
PubMed1999

Process control procedures to augment quality control of leukocyte-reduced red cell blood products.

Quality control of leukocyte-reduced packed red cell units (LRprc) produced in blood facilities must conform to regulatory criteria, which state that units may not contain more than 1 x 10(6) to 5 x 10(6) white blood cells (WBC) per unit. The post-filtration WBC content of a total of n = 386 LRprc units was counted with a Nageotte chamber to model the probability that a unit would not meet the regulatory criteria. The distribution of the residual leukocyte counts is close to a negative binomial distribution (NBD) and is independent of the packed red cell volume filtered. The observed probability that a unit of blood has a residual WBC greater than 5 x 10(6) is 2.6 +/- 2.6 x 10(-3). A power analysis of the two-sample Kolmogorov-Smirnov (KS) test in this application shows that a sample size of 20 is sufficient for determining that the process is in control when an out of control process has a k NBD parameter greater than or equal to that of the in control process. The three out of control processes observed to date appear to have this property. A sample of size 80 may be necessary for confirming that process validation data sets conform to the larger 'reference' database (n = 386) for processes that are out of control in such a way that their k NBD parameter is less than the k parameter of the in control process.

Blood Component Removal↗
PubMedDate not supplied

Bearing witness to suffering in AIDS: constructing meaning from loss.

The phenomenon of AIDS volunteerism has been described as an act of bearing witness. It has been suggested that bearing witness assists individuals affected by the suffering in HIV/AIDS to heal. The purpose of this research was to explore AIDS volunteerism as a potentially healing phenomenon. Using grounded theory methodology, open-ended interviews were conducted with 17 participants over a 7-month period of time. The constant comparative method was used for data analysis. A substantive theory was generated that identified the basic sociological process as constructing meaning from loss and described the transformative psychosocial and spiritual healing process individuals undergo as they volunteer. Constructing meaning from loss is described within the following three major stages: (a) experiencing suffering, (b) containing suffering, and (c) transforming suffering. Characteristics within each stage are described. Suffering and complex loss are major issues in HIV/AIDS. Interventions are recommended for nurses who care for those affected by HIV disease.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Functional rapidly folding proteins from simplified amino acid sequences.

Early protein synthesis is thought to have involved a reduced amino acid alphabet. What is the minimum number of amino acids that would have been needed to encode complex protein folds similar to those found in nature today? Here we show that a small beta-sheet protein, the SH3 domain, can be largely encoded by a five letter amino acid alphabet but not by a three letter alphabet. Furthermore, despite the dramatic changes in sequence, the folding rates of the reduced alphabet proteins are very close to that of the naturally occurring SH3 domain. This finding suggests that despite the vast size of the search space, the rapid folding of biological sequences to their native states is not the result of extensive evolutionary optimization. Instead, the results support the idea that the interactions which stabilize the native state induce a funnel shape to the free energy landscape sufficient to guide the folding polypeptide chain to the proper structure.

Amino Acid Sequence↗
PubMed1991

Report on the Fourth Conference for Federally Supported Human Nutrition Research Units and Centers.

The Fourth Conference for Federally Supported Human Nutrition Research Units and Centers, sponsored by the Interagency Committee on Human Nutrition Research, addressed two topics: nutrition and function, and nutrient interactions and toxicities. This article summarizes the conference's introductory remarks and the contents of the 34 papers presented. Future meetings of federally supported nutrition research units and centers will focus on other human nutrition research topics and will be held biennially.

Humans↗
PubMed1987

Reversible activation of hydrogenase from Escherichia coli.

Hydrogenase from Escherichia coli exhibited low activity when assayed for hydrogen:methyl viologen reductase activity and no activity when assayed for hydrogen-uptake activity with acceptors of high redox potential (dichloroindophenol, methylene blue). Nor did the enzyme as isolated catalyse proton-tritium exchange activity. Incubation under hydrogen resulted in an increase in hydrogen-uptake activity with methyl viologen and the appearance of hydrogen-uptake activity with dichloroindophenol and methylene blue. Following such treatment, the enzyme also readily catalysed isotope exchange. This process is interpreted as the conversion of the hydrogenase from an inactive 'unready' state to an 'active' state. Oxidation of active hydrogenase with dichloroindophenol caused conversion to a state resembling that of the enzyme as isolated but capable of more rapid activation under reducing conditions. This form is termed the 'ready' state. Such interconversions have been reported for hydrogenases from Desulfovibrio gigas and D. desulfuricans, and the possibility that they constitute a regulatory mechanism suggested.

Catalysis↗
PubMed2002

Possible pairing-induced even-denominator fractional quantum Hall effect in the lowest Landau level.

We report on our theoretical investigations that point to the possibility of a fractional quantum Hall effect with partial spin polarization at nu = 3/8. The physics of the incompressible state proposed here involves p-wave pairing of composite fermions in the spin reversed sector. The temperature and magnetic field regimes for the realization of this state are estimated.

Journal Article↗
PubMed2006

Early orthodontic treatment as a means to increase access for children enrolled in Medicaid in Washington state.

BACKGROUND: The authors assessed the likelihood that interceptive orthodontic Medicaid programs would increase access to care for Washington children. METHODS: The authors surveyed 210 Washington state orthodontists, including questions on demographics, attitudes toward early treatment, use of innovations and perceptions of Medicaid. Respondents were either Medicaid participants or nonparticipants. RESULTS: Fifty of 159 respondents were Medicaid participants. Most respondents perceived early orthodontic treatment as beneficial. Medicaid participants were more willing to participate in Medicaid early-treatment programs, had slightly fewer patients in the "other insurance" category, provided more discounted fees, received more Medicaid inquiries, practiced in rural areas with lower household incomes, reported feeling overworked and experienced fewer Medicaid problems. The principal problem reported with the Medicaid system was low fee reimbursement. CONCLUSIONS: Programs offering early orthodontic treatment could increase access. Important barriers would be low fees and unfamiliarity with Medicaid. PRACTICE IMPLICATIONS: Medicaid should design programs aimed at early treatment with reasonable reimbursement and an educational component.

Attitude of Health Personnel↗
PubMed1998

Developing a funding model for an after-hours primary medical care service in a rural town.

The study described in this paper aimed to determine a funding model for an after-hours primary medical care service in the rural town of Moe, a socioeconomically disadvantaged area of Victoria suffering the rigours of industry restructuring and privatisation. It has 12.5 equivalent full-time general practitioners servicing 21,966 persons. A break-even analysis of the financial viability compared the expected costs of providing the service with the anticipated income. A mixed funding model is recommended. This would incorporate a general practitioner incentive scheme and State Government underwriting of infrastructure and basic non-medical staffing costs during the business development phase to supplement the income from the Health Insurance Commission.

Demography↗
PubMed1995

Health effects related to releases of hazardous substances on the Superfund priority list.

The Agency for Toxic Substances and Disease Registry maintains an active, state-based surveillance system to record the public health consequences of hazardous substance releases. During 1992, the 9 participating states reported 1,876 events; 80% of the events occurred at fixed facilities, and 20% were transportation related. The most frequently released substances were volatile organic compounds, acids, herbicides, and ammonia. In 263 events, 600 people were injured and 4 died. Employees were injured more frequently (71%) than first responders or the general public. The most frequently reported injuries were respiratory and eye irritation. Evacuations occurred in 13% of the events. These results provide information for preparedness planning and training of first responders and employees.

Accidents↗
PubMed2004

Reptile-associated salmonellosis in preschool-aged children in Michigan, January 2001-June 2003.

OBJECTIVES: Determine the incidence of reptile-associated salmonellosis in preschool-aged children in Michigan. METHODS: Cases of reptile-associated salmonellosis in children < or =5 years of age occurring in Michigan January 2001-June 2003 were identified through review of individual patient case-history forms provided by local health departments to the Michigan Department of Community Health and by identification of Michigan Department of Community Health laboratory-confirmed cultures of reptile-associated serotypes, determined by evaluation of the Public Health Laboratory Information System's Clinical Nonhuman Salmonella data for 1990-2001. RESULTS: The incidence of reptile-associated salmonellosis was 11.8% of all Salmonella cases reported in Michigan children aged < or =5 years for the period January 2001 through June 2003. CONCLUSIONS: Despite the recommendations of the Centers for Disease Control and Prevention to avoid the exposure of children <5 years old to reptiles, reptile-associated salmonellosis in preschool-aged children continues to be a public health problem in Michigan.

Animals↗
PubMedDate not supplied

Is hypercholesterolemia a risk factor and should it be treated in the elderly?

PURPOSE: The 1993 National Cholesterol Education Program guidelines recommend cholesterol screening for elderly patients with and without known coronary heart disease. This review summarizes clinical trial evidence from the medical literature that addresses cholesterol treatment in the elderly. DATA SOURCES: References were obtained from a MEDLINE search, bibliographies, metaanalyses, and review articles. STUDY INCLUSION AND EXCLUSION CRITERIA: Randomized, controlled clinical trials, including all lipid intervention trials with elderly participants or subgroup analyses of the elderly designed to measure major cardiovascular disease endpoints, were selected. DATA EXTRACTION METHODS: A MEDLINE search of all clinical trials using key search terms yielded 1360 references. Journal titles and abstracts were reviewed for all references by one of us (K.M.H.). A full journal review was undertaken for 41 references to clinical trials. Five clinical trials fulfilled all criteria and represented unique data. DATA SYNTHESIS: A MEDLINE search (from 1966 to January 2000) and bibliography reviews yielded five important clinical trials with analyses of elderly participants. Data are presented in text form and a summary table. MAJOR CONCLUSIONS: Clinical trial evidence supports treating hyperlipidemia in elderly persons for secondary prevention of coronary heart disease. Evidence from four secondary prevention trials demonstrated that major coronary heart disease risk decreased by 25% to 30% in elderly subjects treated for 5 years. Unanswered questions include cholesterol treatment for primary prevention in the elderly, gender effect, and benefit of treatment in persons older than 70.

Aged↗
PubMed2001

Half-polarized quantum hall states.

We report a theoretical analysis of the half-polarized quantum Hall states observed in a recent experiment. Our numerical results indicate that the ground state energy of the quantum Hall nu = 2 / 3 and nu = 2 / 5 states versus spin polarization has a downward cusp at half the maximal spin polarization. We map the two-component fermion system onto a system of excitons and describe the ground state as a liquid state of excitons with nonzero values of exciton angular momentum.

Journal Article↗