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At least 613 records · Page 34Linked to original sources
PubMed1985

Heart substitution: transplantation and total artificial heart. The Texas Heart Institute experience.

Two methods of heart substitution have been used at the Texas Heart Institute: cardiac transplantation and the total artificial heart (TAH). Cardiac transplantation is an effective means of saving patients with endstage heart disease and, since the introduction of the immunosuppressive agent cyclosporine, survival has increased significantly. In a recent series from July 1982 to May 1984, 25 patients underwent cardiac transplantation at the Texas Heart Institute. Nineteen of these patients are alive, in Functional Class I, and leading normal lives. A major disadvantage of cardiac transplantation is that it cannot be used on an emergency basis for postcardiotomy patients. In this situation, TAH has been used twice (1969 and 1981) as the first stage to maintain circulation prior to subsequent cardiac transplantation. In both instances, the TAH functioned well until a satisfactory donor was found. This demonstrates the feasibility of the two-staged concept and encourages further development of cardiac prostheses.

Adult↗
PubMed1984

Evaluation in humans of attenuated Vibrio cholerae El Tor Ogawa strain Texas Star-SR as a live oral vaccine.

Texas Star-SR, an A- B+ mutant derived by nitrosoguanidine treatment from Vibrio cholerae El Tor Ogawa strain 3083, was fed to 68 volunteers as an oral vaccine in doses of 10(5) to 5 X 10(10) organisms with NaHCO3. Sixteen (24%) vaccinees experienced some loose stools (unrelated to vaccine dose), but in only one did the total stool volume exceed 1.0 liter. The vaccine strain was cultured from duodenal fluid of 35 of 46 (76%) persons who ingested doses of 10(8) organisms or greater. No A+ B+ toxinogenic revertants were found among 456 clinical isolates tested. Sixty-three vaccinees (93%) manifested seroconversions of vibriocidal antibody, whereas only 20 (29%) had significant rises in serum antitoxin titers. Paired intestinal fluids from 41 volunteers showed significant rises of secretory immunoglobulin A against lipopolysaccharide (29%), Ogawa outer membrane preparation (29%), and toxin (12%) antigens. In challenge studies with pathogenic V. cholerae El Tor Ogawa and El Tor Inaba, the attack rate in vaccinees (7 of 25) was significantly lower than in controls (18 of 25) (vaccine efficacy, 61%); furthermore, the diarrheal stool volume in vaccinees was significantly less than that in controls (P less than 0.01). Texas Star-SR served as a prototype to investigate the concept of immunoprophylaxis by means of attenuated strains as oral vaccines. These observations provide an invaluable background for planning future studies with newly developed attenuated strains prepared by recombinant DNA techniques.

Administration, Oral↗
PubMed1990

Molecular cloning and nucleotide sequence analysis of cholera toxin genes of the CtxA- Vibrio cholerae strain Texas Star-SR.

The ctx operons from the Vibrio cholerae El Tor strain 3083 and its CtxA- derivative Texas Star-SR were cloned, and their nucleotide sequences were compared. A single missense mutation in the Texas Star-SR ctxA cistron which results in the substitution of threonine for alanine at position 191 of the 258-amino-acid CtxA precursor was identified. Immunoblot analysis detected the mutant CtxA intracellularly early in the culture cycle but not extracellularly at any growth stage.

Amino Acid Sequence↗
PubMed1997

Detection of phosphatidylinositol glycan class A gene transcripts by RT in situ PCR hybridization. A comparative study using fluorescein, Texas Red, and digoxigenin-11 dUTP for color detection.

Gene-specific probes labeled with fluorescein, Texas Red, and digoxigenin-11 dUTP (DIG) were used for RT in situ PCR hybridization to detect PIG-A gene (phosphatidylinositol glycan class A) transcripts. The PIG-A gene is responsible for biosynthesis of the glycosylphosphatidyl-inositol (GPI) anchor. Lack of GPI anchor expression due to mutations can cause an acquired clonal hematologic disorder called paroxysmal nocturnal hemoglobinuria (PNH). In this RT in situ PCR study, two types of labeling methods, a direct method (using fluorescein and Texas Red) and an indirect method (using DIG-11 dUTP) were compared. Both were successfully applied to detect and localize the PIG-A gene transcripts within single cells of the cell lines AA2, H9, and JY. Furthermore, similar results for sensitivity and reproducibility were obtained. Advantages and disadvantages of the different labeling techniques are discussed. In addition, peripheral blood mononuclear cells from PNH patients were also included in this study.

Cells, Cultured↗
PubMed2006

Considerations for increasing the competences and capacities of the public health workforce: assessing the training needs of public health workers in Texas.

BACKGROUND: Over the last two decades, concern has been expressed about the readiness of the public health workforce to adequately address the scientific, technological, social, political and economic challenges facing the field. A 1988 report from the Institute of Medicine (IOM) served as a catalyst for the re-examination of the public health workforce. The IOM's call to increase the relevance of public health education and training prompted a renewed effort to identify competences needed by public health personnel and the organizations that employ them. METHODS: A recent evaluation sought to address the role of the 10 essential public health services in job services among the Texas public health workforce. Additionally, the evaluation examined the Texas public health workforce's need for training in the 10 essential public health services. RESULTS AND CONCLUSION: Overall, the level of perceived training needs varied dramatically by job category and health department type. When comparing aggregate training needs, public health workers with greater day-to-day contact (nurses, health educators) indicated a greater need for training than their peers who did not, such as those working in administrative positions. When prioritizing and designing future training modules regarding the 10 essential public health services, trainers should consider the effects of job function, location and contact with the public.

Journal Article↗
PubMed2000

Three new helminth species from two endemic plethodontid salamanders, Typhlomolge rathbuni and Eurycea nana, in central Texas.

Helminthological examination of two rare, endemic species of plethodontid salamanders, the Texas blind salamander (Typhlomolge rathbuni Stejneger) and the San Marcos dwarf salamander (Eurycea nana Bishop), from the subterranean waters and springs in San Marcos, Hays County, central Texas, USA revealed the presence of three new, previously undescribed species of intestinal helminths: Brachycoelium longleyi sp. n. (Trematoda) from T. rathbuni (type host) and E. nana, Dendronucleata americana sp. n. (Acanthocephala) from T. rathbuni, and Amphibiocapillaria texensis sp. n. (Nematoda) from T. rathbuni; nematode larvae probably belonging to the last named species were recorded from E. nana. Brachycoelium longleyi can be distinguished from all congeners primarily by its conspicuously small eggs among other features, whereas A. texensis differs from its closest congeneric species A. tritonispiunctati mainly in the structure of mature eggs and a markedly shorter spicule. Dendronucleata americana is the first species of the family Dendronucleatidae from the New World, differing from its Asian congeners mainly in the number and arrangement of proboscis hooks, number of giant hypodermic nuclei and in the position of testes.

Acanthocephala↗
PubMed2006

Resistance to stem borers (Lepidoptera: Crambidae) among Texas rice cultivars.

A 4-yr field study was conducted to assess the resistance of rice, Oryza sativa L., cultivars to injury from the sugarcane borer, Diatraea saccharalis (F.), and the Mexican rice borer, Eoreuma loftini (Dyar) (both Lepidoptera: Crambidae). Several cultivars showed reduced levels of injury ('CLXL8', 'XL8', 'Wells', 'Cheniere', and 'XP710' in 2003; CLXL8, XP723, Cheniere, and 'CL161' in 2004) and lower stem borer yield loss (CLXL8 in 2004) than the more susceptible 'Priscilla'. The resistant CLXL8 also had less injury and yield loss in 2004 and higher yield in 2003 than 'Cocodrie', currently the most popular rice cultivar in Texas and Louisiana. Linear regression analyses between whiteheads and main crop rice yield showed steeper negative slopes for the more resistant cultivars than the more susceptible cultivars, indicating a greater yield loss per whitehead on the resistant cultivars. Compensation from insect injury likely explains the positive associations established in our study between main crop yield and whiteheads for some cultivars. Cultivar resistance is anticipated to become a major control tactic in reducing infestations of E. loftini and D. saccharalis in the Texas and Louisiana rice industries.

Animals↗
PubMed2001

Field conditions for agricultural workers in the El Paso, Texas region.

Agricultural workers labor long hours under difficult conditions in many of the nations fields and orchards. Agricultural workers are primarily minority populations, the most dominant group being Hispanic/Latino. The Rural Coalition and the Environmental and Occupational Health Sciences Institute were funded under the National Institute of Environmental Health Sciences (NIEHS) Environmental Justice Program, to investigate health and environmental issues that impact agricultural workers along the Texas-Mexican border area. A Spanish-language field conditions survey was developed and distributed to the workers entering the Sin Fronteras Organizing Project in El Paso, Texas. There were 841 valid surveys collected and analyzed for the calendar year 1998. Workers age mean was 51, with 18.6 years of work experience in agriculture. In the time period surveyed, workers labored for 7.2 hours per day. The primary crop in which they worked were chilies. Of particular concern were issues concerning food, water, and hygiene. Almost all workers stated they had access to fresh drinking water (97 percent), 20 percent did not have access to food, and 30 percent were offered alcohol for purchase. Almost one-third of the workers did not have water available for hand washing in the field. Only 8 percent of the workers reported pesticides used in the fields in which they were working; this number is lower and may be a reflection of the improved training and caution taken by the workers. Clearly additional research in the area of field conditions and the impact and enforcement of state and federal regulation needs to be carried out.

Journal Article↗
PubMedDate not supplied

Lack of serologic evidence for an association between Cache Valley Virus infection and anencephaly and other neural tube defects in Texas.

We tested the hypothesis that Cache Valley Virus (CVV), an endemic North American bunyavirus, may be involved in the pathogenesis of human neural tube defects. This investigation followed a 1990 and 1991 south Texas outbreak of neural tube defects with a high prevalence of anencephaly and the demonstration in 1987 that in utero infection by CVV was the cause of outbreaks of central nervous system and musculoskeletal defects in North American ruminants. Sera from 74 women who gave birth to infants with neural tube defects in south Texas from 1993 through early 1995 were tested for CVV neutralizing antibody. All tested sera did not neutralize CVV. These data suggest that CVV is not involved in the induction of human neural tube defects during nonepidemic periods but do not preclude CVV involvement during epidemics. Other endemic bunyaviruses may still be involved in the pathogenesis of neural tube defects or other congenital central nervous system or musculoskeletal malformations.

Anencephaly↗
PubMed1999

The extraordinary influences of two British physicians on medical education and practice in Texas at the turn of the 20th century.

In 1891, two British doctors emigrated to Galveston, Texas to become professors in a new medical school. During long and outstanding careers, William Keiller and James Edwin Thompson transferred the best of Old World traditions in anatomy and surgery. The University of Texas Medical Branch became an outstanding teaching institution because of their dedication to professional excellence.

Anatomy↗
PubMed1982

Occupational contact dermatitis in the workers employed in production of Texas textiles.

Pathological changes in the skin, of allergic type, have been detected in 35 of 131 weavers, employed in the production of primarily texas textiles. Patch tests yielded in 21 patients positive results with cotton and texas textiles. Approximately 50% of positive results of dermal tests have been found to be induced by naphthol compounds added to dyes in the process of preliminary dying. Moreover, 2 cases of extensive hyperchromatism in persons concerned with the above mentioned textiles have been observed which, due to the treatment procedures and removed from work in exposure have partly subsided.

Adult↗
PubMed1997

Cardiovascular outcomes management and managed care contracting: experience from St. Luke's Episcopal Hospital and the Texas Heart Institute.

The organization and fee structure of health care in the United States continues to change rapidly from fee-for-service insurance plans to managed health care plans. To maintain quality care for patients and a place in the health care market, St. Luke's Episcopal Hospital and the Texas Heart Institute in Houston, Texas, must continually develop and modify their strategic agendas for cardiovascular services. The keys to that agenda are patient-centered care and treatments that positively affect patient outcome. We discuss here methods used to manage quality care for cardiovascular patients as efficiently and cost-effective as possible.

Cardiovascular Diseases↗
PubMed2003

Texas Medication Algorithm Project, phase 3 (TMAP-3): clinical results for patients with a history of mania.

BACKGROUND: The Texas Medication Algorithm Project (TMAP) assessed the clinical and economic impact of algorithm-driven treatment (ALGO) as compared with treatment-as-usual (TAU) in patients served in public mental health centers. This report presents clinical outcomes in patients with a history of mania (BD), including bipolar I and schizoaffective disorder, bipolar type, during 12 months of treatment beginning March 1998 and ending with the final active patient visit in April 2000. METHOD: Patients were diagnosed with bipolar I disorder or schizoaffective disorder, bipolar type, according to DSM-IV criteria. ALGO was comprised of a medication algorithm and manual to guide treatment decisions. Physicians and clinical coordinators received training and expert consultation throughout the project. ALGO also provided a disorder-specific patient and family education package. TAU clinics had no exposure to the medication algorithms. Quarterly outcome evaluations were obtained by independent raters. Hierarchical linear modeling, based on a declining effects model, was used to assess clinical outcome of ALGO versus TAU. RESULTS: ALGO and TAU patients showed significant initial decreases in symptoms (p =.03 and p <.001, respectively) measured by the 24-item Brief Psychiatric Rating Scale (BPRS-24) at the 3-month assessment interval, with significantly greater effects for the ALGO group. Limited catch-up by TAU was observed over the remaining 3 quarters. Differences were also observed in measures of mania and psychosis but not in depression, side-effect burden, or functioning. CONCLUSION: For patients with a history of mania, relative to TAU, the ALGO intervention package was associated with greater initial and sustained improvement on the primary clinical outcome measure, the BPRS-24, and the secondary outcome measure, the Clinician-Administered Rating Scale for Mania (CARS-M). Further research is planned to clarify which elements of the ALGO package contributed to this between-group difference.

Adolescent↗
PubMed1991

Incidence and prevalence of amyotrophic lateral sclerosis in Harris County, Texas, 1985-1988.

The incidence of amyotrophic lateral sclerosis was determined in Harris County, Texas, for the period 1985 through 1988. Amyotrophic lateral sclerosis cases were ascertained from four sources: area neurologists, hospitals, death certificates, and the Muscular Dystrophy Association. The age-adjusted incidences of 1.27 per 100,000 person-years in males and 1.03 per 100,000 person-years in females were lower than recent rates in the northern US, Canadian, and northern European studies but higher than rates in southern European studies. Comparisons with other recent incidence studies show less uniformity in occurrence of amyotrophic lateral sclerosis, in both the overall rates and in the age- and sex-specific patterns, than was suggested by mortality studies. The incidence of amyotrophic lateral sclerosis among blacks and whites was similar. Hispanic males had incidences similar to white males, although a deficit of female Hispanic cases was found in Harris County. The prevalence of amyotrophic lateral sclerosis peaked in the 65- to 74-year age group at 33 per 100,000 population among males and 19 per 100,000 population for females.

Adolescent↗
PubMed2000

The impact of clinical pathways on the practice of head and neck oncologic surgery: the University of Texas M. D. Anderson Cancer Center Experience.

OBJECTIVE: To assess the impact of clinical pathways on the practice of head and neck oncologic surgery in an academic center. DESIGN: Cross-sectional study. SETTING: Cancer treatment center. PATIENTS: The study population consisted of 3 groups of patients who underwent unilateral neck dissection and were treated in the Department of Head and Neck Surgery of the University of Texas M. D. Anderson Cancer Center, Houston. Additional procedures which may have been performed were direct laryngoscopy, rigid esophagoscopy, and/or dental extractions. Ninety-six patients treated during 1993-1994 prior to the implementation of the clinical pathway (historical control group) were compared with 94 patients treated during 1996-1998, 64 who were not (contemporaneous nonpathway group) and 30 who were managed on the clinical pathway (pathway group). Patients from 1995 were excluded since the pathway was in the planning stages then. MAIN OUTCOME MEASURES: Median length of stay; median total costs of care. RESULTS: The median length of hospital stay of the historical control, contemporaneous nonpathway, and pathway groups decreased from 4.0 to 2.0 days (P<.001). The total median costs of care were less in the pathway group as compared with the historical control group ($6,227 and $8,459, respectively, P<.001) and also less in the contemporaneous nonpathway group compared with the historical control group (S6885 and $8,459, respectively, P<.001). Mean and median length of hospital stay and costs were lower in the pathway group as compared with the nonpathway group but not significantly (P = .11 and P = .07, respectively) The contemporaneous nonpathway and pathway groups did not differ in complications or readmissions. CONCLUSIONS: Development and implementation of this clinical pathway played a statistically significant role in decreasing length of hospital stay and total costs of care associated with neck dissection between nonpathway and pathway patients. Thus, a more cost-effective practice environment has resulted for all of our patients.

Academic Medical Centers↗
PubMed2001

Clinical, laboratory, and epidemiologic features of murine typhus in 97 Texas children.

OBJECTIVE: To document the clinical, laboratory, and epidemiologic characteristics of pediatric patients with murine typhus. DESIGN: Pediatric patients were diagnosed using serologic testing, and clinical, laboratory, and epidemiologic data were retrospectively reviewed. SETTING: Of 97 patients, 77 (79%) were identified and treated as inpatients and 20 (21%) were treated as outpatients; most resided in south Texas. PATIENTS: Between 1979 and 1996, medical records and patient-physician interviews were available for 97 patients aged 16 years and younger with murine typhus. MAIN OUTCOME MEASURES: The frequency of clinical symptoms and signs, abnormal laboratory findings, epidemiologic findings, and measures of disease severity were determined. RESULTS: The clinical triad of fever, headache, and rash occurred in only 43 (49%) of 87 pediatric patients throughout the illness. Musculoskeletal symptoms were experienced by 43% of patients, whereas gastrointestinal tract symptoms (nausea, vomiting, anorexia, and diarrhea) occurred in 77%. Systemic involvement was evident by the frequent occurrence of abnormal laboratory findings referable to multiple organ systems, including the liver, kidney, blood, and central nervous system. CONCLUSIONS: Pediatric infection by Rickettsia typhi usually causes mild to moderate systemic illness. In children, the median duration of illness was 12 days (range, 5-29 days), but severe complications were rare. Length of illness was significantly related to the initial diagnosis, whereas the interval to defervescence was related to therapy with a tetracycline or chloramphenicol. Early recognition and treatment is important to prevent prolonged morbidity.

Adolescent↗
PubMed1982

Fluoride supplementation in Harris County, Texas.

We sent questionnaires to 421 physicians in Harris County, Texas, to determine the use of oral fluoride supplementation. The response rate was 56%. Although 95% of the physicians practice in fluoride-deficient areas (less than 0.7 ppm), 36% of those responding stated that the fluoride content of the water was adequate; 25% were unsure. Of those who thought that the fluoride content was adequate, 79% stated that the actual fluoride content was less than 0.7 ppm or were unsure. Only 35% of the responding physicians prescribed fluoride, only 45% knew the correct dose. Only 50% of the responders made routine dental referrals in the 3- and 4-year age group. More physician education is needed to ensure oral fluoride supplementation in communities with inadequately fluoridated water supplies.

Administration, Oral↗
PubMed1988

Kawasaki syndrome clusters in Harris County, Texas, and eastern North Carolina. A high endemic rate and a new environmental risk factor.

Sixty-one cases of Kawasaki syndrome (KS) occurred in Harris County, Texas, during the three-year period from January 1982 through December 1984. Fifty-five (90%) of these 61 patients were under 5 years old, for an annual endemic rate in children under 5 years old of 9.1 cases per 100,000 per year. To our knowledge this is the highest endemic rate reported to date in the continental United States. Between Aug 26 and Sept 19, 1984, seven children with KS were hospitalized in Harris County. The seven children were between 5 months and 5 years old. The number of cases in this cluster was unusual for late summer, which is generally a low-incidence season for KS in Harris County. More important, a case-control study of these children revealed that they resided significantly closer to a bayou or drainage ditch than did randomly selected matched control subjects. A similar association with drainage ditches or creeks was observed in a subsequent cluster of 13 cases of KS in seven eastern North Carolina counties. To our knowledge, this is the first report of a possible association between KS and residing near water.

Child↗