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PubMed2005

Measuring progress to protect workers from job-related secondhand smoke in Texas.

Exposure to secondhand smoke is a significant public health problem, causing 38,000 premature deaths annually in nonsmokers. The two major sources of exposure are the home and work. We analyzed occupational data from the Census Bureau's Current Population Survey for smoke-free policy trends among various categories of Texas workers. Nearly three quarters of white collar workers in the state are currently smoke free, but proportionately fewer blue collar and service workers enjoy this level of protection. Hispanics report lower rates of smoke-free policies than whites and African-Americans, and younger workers are less protected than older workers. Smoke-free policies increased 27% from 1992-93 through 1995-96 but only 5% over the next 6 years, indicating a significant slowing in the rate of adoption of such policies. Compliance with a smoke-free policy is not a significant workplace issue in Texas; only 2.7% of workers in 2001-02 reported that someone violated their company's smoke-free policy, down from 5.1% in 1992-93.

Adolescent↗
PubMed2006

Investigation of Texas poison center calls regarding a chlorine gas release: implications for terrorist attack toxicosurveillance.

The investigation reported here was conducted to describe the pattern of calls received by the Texas Poison Center Network (TPCN) in relation to a chlorine gas release that resulted from a train collision in Bexar County, Texas, on June 28, 2004, and to test various methods for conducting toxicosurveillance. TPCN received a total of 42 calls; the first call was received approximately 35 minutes after the collision. Calls continued for 10 days after the collision. Comparison of the number of calls received from Bexar County on the collision date with the number of similar calls received in the past revealed that numbers for this collision date were elevated for total calls, total information calls, total human exposure calls, chlorine gas calls, and calls involving coughing or choking, headache, throat irritation, or bronchospasm. When a similar analysis was performed for the entire state, call numbers were elevated only for chlorine gas calls and calls involving bronchospasm.

Accidents↗
PubMed1991

Clinical and laboratory features of murine typhus in south Texas, 1980 through 1987.

OBJECTIVE: --The clinical and laboratory features of patients with murine typhus have not been extensively reviewed since 1946. We have updated these findings in patients from south Texas who were examined by modern clinical and laboratory methods from 1980 through 1987. DESIGN: --Patients were identified by serological methods in this case series, and clinical, epidemiologic, laboratory, and therapeutic data were compiled and analyzed. SETTING: --The majority of patients (77 of 80) were identified in a primary care community hospital setting; the remainder (3 of 80) were ambulatory hospital outpatients. PATIENTS: --From 1980 through 1987, a total of 345 patients were diagnosed with murine typhus; 90 of these patients were seen at four hospitals in south Texas; of these, 80 had clinical and laboratory data available for review. MAIN OUTCOME MEASURES: --The frequency of common clinical manifestations (eg, headache, fever, and rash) and laboratory findings (eg, leukocyte and platelet counts and serum chemistry abnormalities) of patients with infectious diseases was tabulated. Clinical severity was semiquantitatively assessed and was correlated with clinical, laboratory, and therapeutic results. RESULTS: --Most cases (69%) occurred from April through August. Rash occurred in 54%; the triad of fever, headache, and rash was observed in only 12.5% of patients when first examined by a physician; respiratory and gastrointestinal symptoms were also frequent. Multiple organ involvement was documented by frequent abnormal laboratory findings of the hematologic, respiratory, hepatic, and renal systems. Disease severity was related to older patient age, the presence of renal dysfunction, leukocytosis, and hypoalbuminemia, and previous therapy with sulfa antibiotics. CONCLUSIONS: --Infection by Rickettsia typhi causes a systemic illness with clinical and laboratory abnormalities not previously recognized or described. Early clinical diagnosis and treatment are needed to avoid undue morbidity and mortality.

Diagnosis, Differential↗
PubMed1991

Human rabies--Texas, 1990.

On June 5, 1990, a 22-year-old man died of rabies encephalitis in Hidalgo County, Texas, along the Mexican border. This was the fourth case of human rabies known to be acquired in the United States since 1980 and the first case in Texas since 1985. This report summarizes the case investigation.

Adult↗
PubMedDate not supplied

Motorcycle helmet use in Texas.

Helmets worn by motorcyclists decrease head injuries and the likelihood of being killed in a crash by about 30 percent. From 1968 to 1977, Texas had a comprehensive motorcycle helmet use law, which was estimated to have saved 650 lives. But the law was amended in 1977 to apply only to motorcycle operators and passengers under age 18. In September 1989, a new law was passed that required helmets for all motorcycle operators and passengers. Observations of helmet use were conducted before and after the law took effect in 18 Texas cities using a survey design providing a cross-section of urban and suburban traffic across the State. The surveys indicated that helmet use increased from less than 50 percent just before the law to 90 percent immediately after, and it increased further to more than 95 percent 2 months later. These results confirm the unique effectiveness of comprehensive helmet use laws in applying the proven public health benefits of helmets to the reduction of motorcycle injuries and deaths.

Head Protective Devices↗
PubMed1991

Medicine meets politics in the 72nd Texas Legislature.

Experts predict that legislative redistricting and budget stretching will dominate the 72nd session of the Texas Legislature, convening January 8 in Austin. In the midst of those debates, Texas physicians will mount an all-out effort to push health-related issues to the top of the lawmakers' agenda. Most important among those issues is restoring access to health care and health insurance. Here's a look at what happens when medicine meets politics.

Legislation, Medical↗
PubMed1991

Medical ethics in Texas: concepts, issues, and resources.

Ethical issues pervade medicine, and no practicing physician can avoid them. The physician must be able to recognize ethical issues in his practice, analyze them critically, and resolve them properly. Because these issues will arise even more frequently and become even more complex in the 1990s than before, Texas Medicine is devoting the Journal sections in its January and February editions to ethical issues in medical practice. This opening article outlines the factors exacerbating medical ethics issues in recent decades, describes the medical ethics teaching and research programs in Texas, and introduces the other articles in the series.

Education, Medical↗
PubMed1990

Cutaneous leishmaniasis in Texas: report of a case and review of the literature.

Cutaneous leishmaniasis is endemic in south central Texas. There have been at least eight cases, four of which have been reported since 1980. An additional case of cutaneous leishmaniasis is reported in a 56-year-old woman from Sandia, Texas. The diagnosis was confirmed by culture of Leishmania mexicana var. mexicana.

Aged↗
PubMed1990

Clinical and epizootiologic characteristics of dogs seropositive for Borrelia burgdorferi in Texas: 110 cases (1988).

Of 2,409 canine serum samples submitted to the Texas Veterinary Medical Diagnostic Laboratory between Jan 1, 1988 and Dec 31, 1988 and tested by immunofluorescent antibody technique for antibody to Borrelia borgdorferi, 132 (5.5%) had positive results. Clinical and epizootiologic characteristics of seropositive dogs from Texas (n = 110) were examined. Male dogs were more likely than female dogs to be seropositive for B burgdorferi. The most frequent clinical sign of disease described in seropositive dogs was lameness; neurologic, ophthalmologic, dermatologic, renal, and hepatic signs also were reported by referring veterinarians.

Age Factors↗
PubMed1990

Cardiac surgery for inmates in the Texas Department of Corrections.

All Texas prison inmates requiring hospitalization since 1983 have been transferred to a separate prison hospital adjacent to a tertiary care university hospital. We reviewed and analyzed the data regarding one major tertiary care service, namely cardiac surgery, to describe the rate of utilization of this service and its results. From January 1, 1984, to June 30, 1988, 73 inmates underwent 74 cardiac operations, 50 of which were coronary revascularizations. The age-adjusted rates of utilization for coronary artery bypass grafting were substantially higher for inmates over age 45 than for that described for the general population, whereas the utilization rates for valve surgery were comparable. There were no perioperative or late deaths, and 86% of the inmate patients are currently employed within the Texas Department of Corrections system or were employed at the time of their release. The utilization rates and the results of this representative tertiary medical care service for the state's prison population are comparable to those achieved in the private sector, and may have a substantial beneficial effect on inmate rehabilitation.

Adolescent↗
PubMedDate not supplied

TSRH instrumentation: evolution of a new system. Part 1. Texas Scottish Rite Hospital.

The TSRH System was designed at Texas Scottish Rite Hospital for Crippled Children in Dallas, Texas, to correct spinal deformities in a three-dimensional plane. The system's greatest advantage is its application in spinal revisions. The other advantage to the TSRH system is the crosslink system used in linking paralleling rods for spinal fusion. The TSRH spinal system is paralleled to the Cotrel-Dubousset (CD) system. Advantages of both systems are discussed in this article.

Child↗
PubMed1990

Childhood and adolescent cancer in a southwestern region of Texas: 1976-1980.

The Cancer Registry Division of the Texas Department of Health identified 349 malignant tumors among Anglo and Hispanic children and adolescents less than 20 years of age who lived in a southwestern region of Texas during the period 1976-1980. The ethnic distribution of cases consisted of 184 Anglos (53%) and 165 Hispanics (47%). The total cancer incidence rate per million for Anglos was 198.2 for males and 141.2 for females; for Hispanics the rate was 130.7 for males and 142.0 for females. The rates for all sites combined were higher for Anglo males than for US white (Anglo and Hispanic) males. Anglo females, Hispanic males, and Hispanic females had all sites combined rates that were similar to the rates for US white males and females. Anglo males were at increased risk for brain/central nervous system and kidney tumors. Leukemia was the most frequent cancer seen. All ethnic/sex groups were at increased risk for leukemia; however, only females had significantly higher rates.

Adolescent↗
PubMed1990

Preventing child abuse and neglect in Texas.

The rising prevalence of child abuse and neglect in Texas underscores the need to encourage innovative programs across the state. Primary prevention efforts catalyzed by the Children's Trust Fund of Texas demonstrate such projects. Specific evaluation techniques are also reviewed with some explanation of why some programs may be more effective than others.

Child↗
PubMed1990

Experimental verification of the metacercarial stage of Rhipidocotyle lepisostei (Trematoda: Bucephalidae) with notes on the natural occurrence of its adult stage in gars in Texas and Virginia.

Bucephalid metacercariae found encysted in the caudal fin rays of striped mullet (Mugil cephalus) were fed to bucephalid-free spotted gars (Lepisosteus oculatus) in the laboratory. Gravid specimens of Rhipidocotyle lepisostei were recovered from the intestinal tracts of 2 of 3 gars from 7 to 28 days later. Further attempts to complete the entire life cycle were unsuccessful. Natural infections of adult R. lepisostei were found in the type host, the alligator gar Lepisosteus spatula, from Galveston Bay, Texas, and in the long-nose gar, Lepisosteus osseus, from the York River, Virginia. This report confirms the identity of the metacercarial stage in the mullet as R. lepisostei and extends the known range of this parasite from the Louisiana and Texas area to the U.S. Atlantic coast.

Animals↗
PubMed1990

The Texas Family Practice Residency Program: a profile.

In 1977, the 65th Texas Legislature created the Texas Family Practice Residency Program to encourage the training of family physicians and to improve access to health care in medically underserved areas. During the past 12 years, the number of family practice residency programs has grown from 12 to 25, with 1,174 graduates as of September 1988. This article discusses the program's origins, administration, effectiveness, and future.

Family Practice↗
PubMed1989

Health care spending in Texas: 1980-1986.

This paper reports health care spending and payment patterns for Texas by category of service. Various methods and sources are used to generate annual estimates of total spending, state government spending, and spending per person. The basic approach is similar to that used by the US Health Care Financing Administration in estimating national health care spending. Comparisons between spending in Texas and the nation are made and various reasons for differences are discussed.

Health Expenditures↗
PubMed1989

Rocky Mountain spotted fever in Texas, 1978 through 1987.

From 1978 through 1987, there were 397 laboratory-confirmed cases of Rocky Mountain spotted fever reported in Texas. The annual number of cases ranged from 21 cases in 1986 to 108 cases in 1983. A total of 262 cases were in males. Most of the patients (52%) were 19 years of age or younger. April through August were the months of onset of symptoms for 66% of the cases. Eighty-two percent of the infected patients were hospitalized; 14 patients died. An endemic focus of Rocky Mountain spotted fever exists in north central and northeastern Texas.

Adolescent↗
PubMed1989

Pilot study report: obstetrical care by Texas family physicians.

Fewer family physicians are including obstetrics in their practices. This has caused concern about access to obstetrical care and has fueled the debate about the need for obstetrics curriculum in family practice residencies. Reasons frequently cited by previous research for this change in practice pattern include the rapidly escalating cost of liability insurance and the threat of lawsuit for obstetrical malpractice. The decrease in the availability of obstetrical care from family physicians has hampered access to obstetrical care, especially for rural Texans. Texas family physicians have not been surveyed previously about their obstetrical practices. For this pilot study I surveyed 205 of Texas' 4,700 family physicians and general practitioners (4%) about their past and present obstetric practices. The sample was randomly selected, and included both MDs and DOs. Of the 64.9% who responded, 28% were practicing obstetrics, 11% had never included obstetrics in their practices, and 61% had practiced obstetrics in the past. Forty percent of those who had discontinued obstetric practice did so after 1983. High malpractice premiums and fear of lawsuits were the most frequently chosen reasons for discontinuing the obstetric component of practice. Documenting this trend of decreasing availability of obstetrical care from family physicians, and sharing the data with policymakers, may help to prevent the disappearance of the family physician who delivers babies.

Female↗