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On October 19 and October 23, 1997, a man in Texas and a man in New Jersey, respectively, died from rabies. This report summarizes the clinical features of these cases and the epidemiologic investigations by the Texas Department of Health and the New Jersey State Department of Health and Senior Services, which indicated that a bat-associated variant of the rabies virus was responsible for infection in both cases.
The Venezuelan equine encephalitis epidemic which occurred in Texas in 1971 produced a wide range of predominantly mild clinical symptoms. This epidemic, which peaked on 13-14 July, was most intensely felt in the far-south counties of Cameron and Hidalgo. In all, 88 laboratory-confirmed human cases were reported to the U.S. Center for Disease Control by the Texas State Department of Health. The ratio of male to female cases was about two to one. An attack of 20.8 cases per 100,000, observed in both the 20-29 and 30-39 age groups, was higher than attack rates experienced by other age groups and by the population at large. Together, Cameron and Hidalgo counties experienced a much higher overall attack rate (21.7 cases por 100,000) than did affected counties in the Corpus Christi area (4.9 cases per 100,000). Knowledge about when various patients were first exposed points to an incubation period ranging from 27.5 hours to four days. In those 79 cases for which clinical data were available, the most common clinical manifestations were found to be fever, severe headache, myalgia, and chills. Evidence of mild to moderate central nervous system involvement was found in 10 out of 25 children and young people under 17 years of age, and in six out of 54 adults. Two children still had residual paralysis six weeks after onset of illness, but by 10 months these sequelae had disappeared. Seven of the 54 adults, however, still complained of tiring easily a year after onset of illness. Leukopenia, as demonstrated by a count of less rhan 4,500 white blood cells per cubic millimeter, was observed in 75 per cent of the patients examined.
OBJECTIVE: To compare prevalence estimates of brucellosis (BR) in adult beef cattle that originated from different states and regions of Mexico and that were shipped direct-to-slaughter into Texas during 1995. DESIGN: Epidemiologic survey. ANIMALS: About 65,000 adult beef cattle. PROCEDURE: Blood samples were collected during postmortem examinations and were tested for serum antibodies to Brucella abortus, using the particle concentration fluorescence immunoassay and automated complement-fixation test. Prevalence estimates and 95% confidence intervals of BR were calculated by state of origin in Mexico. The difference among prevalence estimates of BR in cattle from different states and regions was tested for significance (P < 0.05), using the proportion test. RESULTS: On the basis of serologic test results, the overall prevalence estimate of BR was 0.32%. The prevalence estimate of BR in cattle from the state of Chihuahua (0.10%) was significantly different than that in cattle from the states of Nuevo Leon (0.23%), Zacatecas (0.34%), Durango (0.47%), Chiapas (1.81%), Tamaulipas (2.71%), Aguascalientes (7.89%), and Campeche (12.24%). In addition, prevalence estimates of BR in cattle were significantly different among the northern (0.22%), south-central (3.18%), and south coastal (9.42%) regions of Mexico. CLINICAL IMPLICATIONS: Results of this study indicate that the number of cattle exposed to B abortus may be significantly different among states and regions of Mexico. Current import sanitary requirements should continue to mitigate potential risk of transmission of BR from sexually intact cattle of Mexican origin to Texas cattle.
This article describes the conceptual framework upon which the Bachelor's Degree program in Dental Laboratory Sciences at the University of Texas Health Science Center was constructed. Development of specific program objectives rested on the following four guiding principles: 1) combine professional laboratory training with management education; 2) focus on a problem-based pedagogy; 3) provide flexibility to accommodate today's "nontraditional" student population; and 4) utilize the close relationship with the University of Texas Dental School at San Antonio.
Management strategies for optimal stroke prevention depend on the cause of threatened stroke. We know relatively little about the etiology of stroke in Mexican Americans, who make up one quarter of the population in Texas. A retrospective case series of 159 consecutive patients hospitalized in San Antonio, Tex, for acute, first-ever stroke compared risk factors, features, and causes of stroke between Mexican Americans and whites. Mexican Americans who had strokes were significantly younger than whites and had diabetes mellitus more often. Intracerebral hemorrhage and lacunar infarcts occurred often in Mexican Americans. Ethnicity appeared to be an independent risk factor for lacunar infarction. Mortality and functional outcome at the time of hospital discharge were similar in Mexican Americans and whites. Intrinsic small-vessel disease causing lacunar infarcts and intracerebral hemorrhage accounts for about one half of strokes in Mexican Americans. Stroke among Mexican Americans in South Texas has a distinctive profile with implications for its prevention.
This study examined, risk factors and trends related to tuberculosis (TB) in Texas from 1987 through 1993. We found a significantly greater incidence of TB among racial/ethnic minorities than among whites. Country of origin, group risk, individual risk, and occupational risk were investigated also. The percentage of affected persons born in either Mexico or Vietnam increased throughout the time of the study. The state-level percentage trends of the individual risk group (alcohol and/or drug abuse) mirrored those of the national level. The most striking observation, however, proved to be the poor quality of data. Drastic yearly differences existed in completion of the "country of origin" field. The fields for "individual risk," "group risk," and "occupational risk" showed completion rates of less than 50%; completeness continued to be a problem in 1997. The poor quality of data diminishes the validity of conclusions about trends in TB in Texas. Recommendations for improving the quality of data are noted.
The Center for Pulmonary and Infectious Disease Control (CPIDC), located on the campus of The University of Texas Health Center in Tyler, manages a toll-free infectious disease consultation hotline advertised to public and private physicians and to health care agencies throughout the state. From January 1994 through December 1996, as part of a statewide initiative to curb an unprecedented increase in the incidence of tuberculosis observed since 1985, a concentrated effort was made to solicit health care providers for consultation requests that involved the diagnosis and management of tuberculosis, in particular, drug-resistant varieties. During that period, 3447 calls were made to the CPIDC by 1682 physicians and nurses. While most of the calls originated from 4 major urban areas plus health care facilities along the border, calls were received from more than half of all the counties in Texas. The value of providing an infectious disease consultation service, readily available, without charge, to all members of the health care community is discussed.
The rapidity and degree of development of regulation by boards of nursing of advanced practice nurses (APNs) and programs for their preparation has varied from state to state over the past 20 years. In general, boards have authority only to regulate advanced practice through the recognition of APNs and the setting of standards and scope of their practice. In the early 1990s, lack of consistent APN educational program standards and experiences and criteria for recognition of APNs was problematic at the levels of accreditation, certification, and regulation. The interdependency of these concepts as well as the necessity and difficulty of linking them in a consistent, effective manner has become increasingly evident. The Texas Board of Nurse Examiners has been involved in deriving a model designed to ensure the education and recognition of APNs with emphasis on both professionalism and public safety. Because Texas is unique in size and geography, it mirrors many problems and issues of both large and small states.
Society remains sharply divided as to the deterrent value of capital punishment. Following the reintroduction of the death penalty in the United States, Texas law mandates the affirmative predictability of future dangerousness beyond a reasonable doubt before a jury can impose the ultimate penalty for capital murder. The validity of prediction of dangerousness has been challenged in three Texas landmark cases before the U.S. Supreme Court. The case of Karla Faye Tucker highlights the moral controversy that occurs when execution follows an appeals process stretching over more than a decade, during which time personality growth and the effects of prison rehabilitation may have eliminated or curbed criminal tendencies.
Two related infants with indistinct slow-moving minor hemoglobin bands were detected by electrophoretic cord blood screening. The variant separated into a major and a minor band on isoelectric focusing (IEF), anion exchange chromatography (AEC), and high-performance liquid chromatography (HPLC). Analysis of the products of tryptic hydrolysis of the abnormal chain revealed a truncated A gamma T-1 peptide containing a glu----lys substitution at position 5, identifying the variant as Hb F Texas I. Microsequencing of the major early peak from AEC confirmed the substitution. However, gamma chains from the minor peak resisted Edman degradation and were shown to be acetylated by fast atom bombardment mass spectrometry (FABMS). Acetylation of HbF Texas I was nearly three times that of normal HbF measured in the same hemolysate, and this ratio remained constant for over 1 year in the proband. This represents the first demonstration of increased N alpha-acetylation of a variant fetal hemoglobin.
We have found previously that different fluorescent dyes cannot be efficiently excited by the bis(2,4,6-trichlorophenyl)oxalate (TCPO)-H(2)O(2) reaction when they are intercalated between the DNA bases or bound to the minor groove of the double helix. Here we show that the fluorescent dye Texas red, covalently bound to the 3' ends of double-stranded DNA molecules, exhibits a high emission intensity when excited by the TCPO-H(2)O(2) reaction. In this case, the charge transfer between the intermediate produced in the peroxyoxalate chemiluminescent reaction and Texas red can take place because this fluorophore is not buried inside the DNA structure. We describe the application of this chemiluminescent reaction to the detection of blotted DNA on nylon membranes.
PURPOSE: The TEXAS (Taxotere EXperience with Anthracyclines Study) study examined docetaxel in combination with an anthracycline, as first line treatment of metastatic breast cancer (MBC), in everyday practice, and compared the findings with a randomised controlled trial. METHODS: Four hundred and seventy patients were registered on the TEXAS trial. Patients were assigned, according to treating clinician's discretion, to either doxorubicin 50 mg/m2 or epirubicin 75 mg/m2 both given day1 15 min intravenous bolus every 3 weeks, followed by docetaxel 75 mg/m2, day 1, 1 h intravenous infusion every 3 weeks. RESULTS: The overall response rate (ORR) was approximately 61%. The main toxicity reported was neutropenia, with 75 patients (55%) in the AT group and 203 (61%) in the ET arm. Febrile neutropenia or neutropenic sepsis was reported for 32 (24%) of the AT arm and 78 (23%) of the ET arm. CONCLUSIONS: This open access study demonstrates that AT or ET are highly active treatments for MBC, with similar response rates to those observed in a phase III clinical trial. This may be important for patients with rapidly progressive visceral disease. Side effects can be managed effectively with growth factors and/or prophylactic antibiotic.
A method for visualization of individual human brain cells and their dendritic extensions in combination with immunofluorescence is described. Microinjection of Lucifer Yellow was used to reveal the dendritic morphology of cortical brain cells. Indirect immunofluorescence with Texas Red as label was used to investigate the distribution of 3 different groups of immunogens: enzymes (monoamine oxidase A and B), receptors (beta-adrenoceptor protein), and synaptic vesicle proteins (synapsin I and synaptophysin) in each cortical slice. A dual-channel confocal laser scanning microscope with an argon/krypton laser was used for imaging these double-stained fluorescent specimens. Lucifer Yellow and Texas Red were recorded simultaneously or separately, taking advantage of the different activating lines (488 lambda and 568 lambda) of the laser and using the two filter blocks (K1 and K2) supplied with the instrument (BioRad MRC-600) for recording the emission of either fluorophore. Using this technique we have demonstrated the localization of immunoreactive material in relation to the dendritic morphology of cortical cells.
The Texas brown tide bloom is noted for a concordant decline in benthic biomass and species diversity. However, the link between harmful effects induced by Texas brown tide and benthos has not been demonstrated. It has been proposed there may be a larval bottleneck, where larvae, but not adults, suffer adverse effects. This study was performed to test the effect of brown tide alga, Aureoumbra lagunensis, on mortality, growth and behavior of Streblospio benedicti larvae. Growth rates and swimming speeds, but not mortality rates, of polychaete larvae were reduced in cultures with brown tide relative to Isochrysis galbana, which is about the same size as brown tide. Results from this research indicate that brown tide does have harmful sublethal effects for one dominant species of meroplanktonic larvae, which could help explain reduced adult population size.
A study was conducted with a 1998 retained-ownership population of Texas (USA) beef calves to determine the ranch-management practices associated with calf seroprevalence to Neospora caninum. Management practices of 76 Texas ranches that consigned 760 calves to a retained-ownership feedlot program were reviewed from a mailed questionnaire. Ninety-nine of 760 (13%; 95% CI, 9.4%, 17.7%) calves were positive to N. caninum and 59% of the ranches consigned at least one positive calf. In the logistic multiple-regression model which controlled for overdispersion, increased odds of calf-level seropositivity was associated with seasonal calving patterns, with stocking>1cow/calfunit/2.2ha, using a round-bale feeder, allowing wildlife access to the weaning supplement, and self-reared replacement heifers. However, decreased odds of seropositivity was associated with using a cattle-working dog and with using a self-contained cattle feeder. There was substantial overdispersion due to ranch.
PURPOSE: Kaposi's sarcoma-associated herpesvirus (KSHV, or human herpesvirus 8) is etiologically associated with Kaposi's sarcoma (KS) and primary effusion lymphoma (PEL). Although previous studies have assessed the geographic distribution of KSHV genotypes, the molecular epidemiology of KSHV remains largely unknown. The purpose of the present study was to examine the genotypes of KSHV isolates from KS patients in South Texas.METHODS: Eighteen KSHV isolates from 16 KS and 1 PEL patients in South Texas were collected between 1996 and 1998 and analyzed for KSHV subtypes by PCR sequencing of ORFK1 gene and KS330 fragment, and by PCR of ORFK15 gene. DNA sequences were aligned with known sequences and KSHV subtypes were assigned based on sequence variations.RESULTS: Of 18 KSHV isolates, 13 exhibited C subtype, and 5 exhibited A subtype in ORF K1 gene. ORF K15 genotyping showed that 10 of the isolates exhibited M form, of which 9 had C3 subtype. A unique C subtype isolate was found and classified as C6 clade. All of the M form KSHV isolates were found among KS patients over 50 years of age. Conversely, all KS patients under 40 years of age had only the P form KSHV isolates.CONCLUSIONS: In South Texas there is a distinct distribution of C3/M KSHV isolates, which are rarely found in other US regions (1 of 29). The C3/M KSHV genotype is more prevalent in HIV-negative elderly KS patients while the P-form of KSHV is more common among many young AIDS-KS patients.
There have been increasing human health and ecological concerns about ionic perchlorate (ClO4-) since it was detected in drinking water sources in 1997. Perchlorate is known to affect thyroid function, causing subsequent hormone disruption and potential perturbations of metabolic activities. According to current estimates, perchlorate is found in the surface of groundwater of 14 states, including Texas. Longhorn Army Ammunition Plant, located in east central Texas, was a facility historically associated with perchlorate-containing propellants and rocket motors. Subsequently, perchlorate contamination in ground and surface waters at the facility has been reported. Soil, sediment, water, vegetation, and animal tissue samples were collected from several locations within the plant for a preliminary site assessment of perchlorate contamination. Perchlorate concentrations ranged from 555-5,557,000 ppb in vegetation, 811-2038 ppb in aquatic insects, below detection limits (ND) to 207 ppb in fish, ND-580 ppb in frogs, and ND-2328 ppb in mammals. Consistent with our hypothesis, aquatic organisms inhabiting perchlorate-contaminated surface water bodies contained detectable concentrations of perchlorate. Additionally, terrestrial organisms were exposed through pathways not necessarily related to contaminated surface waters. Therefore, these data demonstrate that aquatic and terrestrial species are exposed to perchlorate in the environment. To our knowledge, this represents the first incidence of perchlorate exposure among wild animals reported in the scientific literature.
The drought that affected the US states of Oklahoma and Texas in the summer of 1998 was strong and persistent, with soil moisture reaching levels comparable to those of the 1930s 'dust bowl'. Although other effects of the record-strength 1997-98 El Niño were successfully predicted over much of the United States, the Oklahoma-Texas drought was not. Whereas the response of the tropical atmosphere to strong anomalies in sea surface temperature is quite predictable, the response of the extratropical atmosphere is more variable. Here we present results from mechanistic experiments to clarify the origin and maintenance of this extratropical climate extreme. In addition to global atmospheric models, we use a regional model to isolate regional climate feedbacks. We conclude that during April and May 1998, sea surface temperature anomalies combined with a favourable atmospheric circulation to establish the drought. In June-August, the regional positive feedback associated with lower evaporation and precipitation contributed substantially to the maintenance of the drought. The drought ended in the autumn, when stronger large-scale weather systems were able to penetrate the region and overwhelm the soil-moisture feedback. Our results show the potential for numerical models including appropriate physical processes to make skillful predictions of regional climate.