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PubMed1984

Racial variation in incidence of Wilms' tumor: relationship to congenital anomalies.

This is a study of the occurrence of Wilms' tumor and associated anomalies in all incident cases in the Greater Delaware Valley by race. The average annual incidence of Wilms' tumor in this population of 2 million children is significantly higher among nonwhites than whites. A significantly larger proportion of black cases has a Wilms' tumor-associated condition including aniridia, genito-urinary anomalies, the Beckwith-Wiedemann Syndrome, and hemihypertrophy. For very young patients, there was a greater tendency for blacks to have bilateral tumors or a tumor-associated anomaly, features characteristic of the hereditary form of Wilms' tumor. The excess risk of Wilms' tumor among blacks may be a result of a higher proportion having a hereditary predisposition or more common exposure to agents capable of inducing germinal mutations.

Abnormalities, Multiple↗
PubMed2007

Resistance and cross-resistance to imidacloprid and thiamethoxam in the Colorado potato beetle Leptinotarsa decemlineata.

One of the major challenges in managing the Colorado potato beetle, Leptinotarsa decemlineata (Say) is its remarkable ability to develop resistance to virtually every insecticide that has ever been used against it. Resistance is particularly common throughout northeastern USA as far north as Maine. The first instances of resistance to imidacloprid have already been reported from several locations in New York, Delaware and southern Maine. Rotating insecticides with different modes of action may delay insecticide resistance, but successful implementation of this technique depends on a good understanding of resistance and cross-resistance patterns in populations of target pests. LC(50) values were measured for imidacloprid and thiamethoxam in Colorado potato beetle populations from a variety of locations in the USA and Canada using diet incorporation bioassays. The field performance of imidacloprid, thiamethoxam and clothianidin against imidacloprid-resistant beetles on a commercial potato farm in southern Maine was also evaluated. Correlation between LC(50) values for imidacloprid and thiamethoxam was highly significant, even when populations previously exposed to thiamethoxam were excluded from the analysis. There was no statistically detectable difference in the LC(50) values between populations exposed to both insecticides and to imidacloprid alone. Applications of neonicotinoid insecticides at planting delayed build-up of imidacloprid-resistant beetle populations on field plots by 1-2 weeks but failed to provide adequate crop protection. Consistently with bioassay results, there was also substantial cross-resistance among the three tested neonicotinoid insecticides. Results of the present study support the recommendation to avoid rotating imidacloprid with thiamethoxam as a part of a resistance management plan.

Animals↗
PubMed2002

Hormone replacement therapy formulations and risk of epithelial ovarian carcinoma.

OBJECTIVE: Hormone replacement therapy (HRT) has been inconsistently linked to ovarian cancer. Estrogen formulations in HRT vary in their effects on estrogen-sensitive target tissues, such as the ovary. The aim of the study is to evaluate the impact of various HRT formulations and their characteristics of use on the risk of epithelial ovarian carcinoma (EOC). METHODS: We assessed the association between the use of HRT and the risk of invasive EOC in women participating in a population-based, case-control study conducted in the Delaware Valley from 1994 to 1998. Cases aged 45 or above at diagnosis (n = 484) were compared to community controls (n = 926) frequency matched by age and area of residence. Information on HRT formulation, timing, and duration were obtained by in-person interview by trained interviewers. HRT formulations were classified as opposed (estrogen + progestin) or unopposed (estrogen alone). They were further categorized according to the estrogen component as either conjugated equine estrogen (CEE), the most common formulation, or non-CEE. Multivariate unconditional logistic regression analyses were used to adjust for age at diagnosis, number of live births, use of oral contraceptives, family history of ovarian carcinoma, and history of tubal ligation. RESULTS: Overall, no association was found between any use of HRT and EOC. Although use of unopposed non-CEE was associated with a significant decrease in risk among hysterectomized women (OR = 0.17, 95% CI = 0.04,0.82), this was not true for women with an intact uterus (OR = 1.14, 95% CI = 0.44,2.98; P for interaction = 0.049). No significant differences in EOC risk were observed for other HRT formulations. CONCLUSIONS: Our results did not suggest any consistent pattern of altered risk for EOC and the overall use of HRT by specific formulations of HRT.

Adult↗
PubMed1992

Heavy metal and selenium levels in young cattle egrets from nesting colonies in the northeastern United States, Puerto Rico, and Egypt.

Colonially-nesting species of herons and egrets breed mainly in coastal areas, along rivers or near other large bodies of water. Such areas are also preferred for human development, exposing nesting birds to various pollutants. From 1989-1991, the concentrations of heavy metals and selenium were studied in the feathers of fledgling cattle egrets Bubulcus ibis, a terrestrially-feeding insectivore, from New York and Delaware in the northeastern United States, from Puerto Rico, and from Egypt. There were geographic differences in the concentrations of lead, mercury, cadmium, manganese, selenium, and chromium in the feathers of these egrets. Lead levels were 41 times higher in the feathers of cattle egrets from Cairo compared to the other sites. This difference was attributed to the continuing use of leaded gasoline and the dense automobile traffic in Cairo. However, other differences remain unexplained. Similarly, levels of chromium and manganese were also higher in Cairo than at any other sites. Cadmium levels were similar at all places except for higher levels in eastern Puerto Rico. Mercury concentrations were twelve times higher in the feathers of cattle egrets at Aswan compared to Cairo. In Puerto Rico, we also compared levels in adult cattle egrets with young and found higher concentrations of mercury and manganese, but lower concentrations of selenium in the adults. Using feathers from young cattle egrets is a potentially sensitive tool for biomonitoring for metals, especially lead, since they reflect the local area surrounding the breeding colony.

Animals↗
PubMed1979

Consultation and education in rural community mental health centers.

This paper reports on the status of consultation and education in the rural community mental health center: First, it describes the rural programs on several organizational dimensions as compared to nonrural programs. Second, it identifies several distinctive characteristics of rural programs. Third, it presents a case illustration of a successful consultation-education service. Finally, it discusses strategies for strengthening consultation and education in the rural setting. The paper is based on the findings of a study of prevention programs in community mental health centers in Region III (Pensylvania, Delaware, Maryland, Washington, D.C., Virginia, and West Virginia).

Community Mental Health Centers↗
PubMed1976

Nondestructive neutron activation analysis of marine organisms collected from ocean dump sites of the middle eastern United States.

The concentrations of eight metals were determined by a nondestructive neutron activation technique for eleven species of fish and shellfish. The marine organisms were collected from ocean dump sites off New York City, off New Haven, Connecticut, and off Delaware Bay. Antimony was not detected in most of the organisms examined in thid study; the detection limit was about 0.02 to 0.05 ppm. Antimony levels ranged from 0.01 to 0.129 ppm in fish that had detectable levels. Cobalt levels were low in all samples with most levels in the range of 0.1 to 0.3 ppm. Chromium concentrations at 0.3 to 1.0 ppm were only roughly quantitated by the procedure employed. Most marine organisms examined had chromium levels at or below these values. Nickel was not detected in any of the organisms examined; the detection limit was in the 3 to 6 ppm range. Rubidium concentrations were 0.6 to 1.5 ppm for most organisms; only rough quantitative measurement was possible at these levels. Selenium levels ranged from about 0.3 to 3.8 ppm in all samples. Silver concentrations were below 0.3 ppm in most organisms. Silver concentrations as high as 10 to 30 ppm, however, were found in the digestive gland of rock crab. Zinc levels in windowpane flounder liver were about 6 to 9 times greater than the 4 to 10 ppm levels found in muscle. Zinc concentrations in rock crab muscle, on the other hand, were only slightly higher than the 15 to 32 ppm concentration found in the digestive gland. Fish other than windowpane flounder had zinc levels that ranged from 4 to 9 ppm in the muscle and 14 to 42 ppm in the liver. Shellfish other than rock crab had zinc levels of 15 to 30 ppm in muscle and 17 to 40 ppm in the digestive gland.

Animals↗
PubMed2004

Organochlorines in black-crowned night heron (Nycticorax nycticorax) eggs reflect persistent contamination in northeastern US estuaries.

Colonially nesting aquatic birds can indicate site-specific contamination because they are high-level predators and dependent upon local resources during the breeding season. We compared persistent organochlorine concentrations in black-crowned night heron (Nvcticorax nvcticorax) eggs collected in 1992-93 among areas of known contamination (New York Harbor, Boston Harbor, Cape Cod, and Delaware Bay) and a reference site (Nantucket Island) in the northeastern United States (7-16 eggs/site). Total PCBs, p,p'-DDE, oxychlordane, heptachlor epoxide, and trans-nonachlor were detected in most eggs and were significantly higher in New York Harbor compared to all other sites (ANOVA on factor scores from the first principal component, which accounted for 75% of data variance, p < 0.0001). New York also had the highest contamination index (the number of Superfund sites within 20 km of the colony) among the sites. Nantucket, the reference site, had consistently low contamination in eggs, and the lowest contamination index. We conclude that black-crowned night heron eggs are useful indicators of site-specific persistent organochlorine contamination, as indexed by the number of nearby Superfund sites.

Animals↗
PubMed2004

A population survey of members of the phylum Bacteroidetes isolated from salt marsh sediments along the east coast of the United States.

The population diversity of cultured isolates of the phylum Bacteroidetes was investigated from salt-marsh sediments. A total of 44 isolates that belonged to this phylum were isolated either from high-dilution plates or from end-dilution most-probable-number (MPN) tubes. The majority of the isolates came from Virginia, with others isolated from salt marshes in Delaware and North Carolina. All the isolates were aerobic Gram-negative, catalase positive small rods that formed uniform colonies; most had either yellow or orange pigmentation. Riboprinting of 40 isolates revealed they were genotypically diverse, consisting of 33 different riboprint patterns; there were four riboprint groups with two or more members. The isolates could be divided into 23 different fatty acid methyl ester (FAME) profiles at the species level with 14 of the profiles being unique to single isolates. One group of 10 isolates was closely related, suggesting this group may be well adapted for life in salt marshes. Thirteen of the isolates were selected for sequencing of the small-subunit ribosomal RNA gene representing a diverse group of isolates that fell within the classes Sphingobacteria and Flavobacteria. Only one of the isolates was >97% similar at the 16S rDNA to a described species of Cytophaga marinoflava; the other isolates were 94 to 96.5% related to undescribed isolates mostly within the class Flavobacteria. There was good concordance between the FAME dendrogram and a phylogenetic tree based on comparison of 16S sequences. There were no obvious temporal or spatial distribution patterns to the isolates, suggesting that this group of bacteria is inherently diverse.

Bacteroidetes↗
PubMed2006

Bacterial community structure of biofilms on artificial surfaces in an estuary.

This study examined bacterial community structure of biofilms on stainless steel and polycarbonate in seawater from the Delaware Bay. Free-living bacteria in the surrounding seawater were compared to the attached bacteria during the first few weeks of biofilm growth. Surfaces exposed to seawater were analyzed by using 16S rDNA libraries, fluorescence in situ hybridization (FISH), and denaturing gradient gel electrophoresis (DGGE). Community structure of the free-living bacterial community was different from that of the attached bacteria according to FISH and DGGE. In particular, alpha-proteobacteria dominated the attached communities. Libraries of 16S rRNA genes revealed that representatives of the Rhodobacterales clade were the most abundant members of biofilm communities. Changes in community structure during biofilm growth were also examined by DGGE analysis. We hypothesized that bacterial communities on dissimilar surfaces would initially differ and become more similar over time. In contrast, the compositions of stainless steel and polycarbonate biofilms were initially the same, but differed after about 1 week of biofilm growth. These data suggest that the relationship between surface properties and biofilm community structure changes as biofilms grow on surfaces such as stainless steel and polycarbonate in estuarine water.

Bacteria↗
PubMed1998

Environmental Management of Human Waste Disposal for Recreational Boating Activities

/ A methodology to estimate the number of pump-out facilities and dump stations required to service human waste disposal for recreational power boating activities in Pennsylvania during the 1994 boating season is described. Study results suggest that a total of 39 additional pump-out stations and 13 dump stations may be required on seven major waterbodies: The Three Rivers Area, Lake Erie/Presque Isle Bay, Raystown Lake, the Susquehanna River, the Delaware River, Lake Wallenpaupack, and the Kinzua Reservoir. Suggestions for improving the methodology are provided. KEY WORDS: Human waste; Recreation; Power boating; Waste facilities; Waste disposal; Pennsylvania

Journal Article↗
PubMedDate not supplied

Current GI endoscope disinfection and QA practices.

High-level disinfection (HLD) of GI endoscopes is readily achieved when published guidelines are observed. Contamination is linked to breakdowns in accepted procedure. However, there is no recognized method of verifying adequacy of endoscope reprocessing in routine practice and no data regarding current quality assurance (QA) practice. Prior reports have demonstrated a wide variation in routine clinical practice of GI endoscopy HLD. The goal of this study was to determine current practice at regional endoscopy centers with regard to endoscope cleaning and HLD, maintenance, and QA practice. An anonymous multiple-choice questionnaire was mailed to 367 SGNA members in Pennsylvania, Delaware, Virginia, Maryland, and District of Columbia and completed by 230 (63%). The majority of responders were hospital-based and 59% of the units performed over 3000 procedures per year. After use the endoscope was hand-carried or transported in a dry container (97%) to a separate cleaning room (85%) for HLD by technicians (40%). Wide variations existed in manual step procedures including use of disposable (50%) brushes and number of times channel brushed: once (21%), twice (35%), or three to five times (37%). Soaking duration in disinfectant (70% gluteraldehyde) was for <10 min (8%), 10-20 min (35%), 20-30 min (38%), 30-40 min (7%), and >40 min (3%). Sixty-seven percent had an active unit infection control (IC) service and 98% had a QA program. Monitoring of cleaning effectiveness was by visual inspection (50%) and culturing endoscopes (17%). Culture was done weekly (1%) and <biannually (6.5%) and performed by swabing the endoscope end (5%) or rinsing the biopsy channel (8%). If culture positive, most would remove the instrument from clinical use and reevaluate the protocol and personnel for technique lapses. Two respondents were aware of a procedure-related infection. Wide practice variations were noted in manual cleaning and in soaking time during automated HLD in this community. Fewer variations were noted in cleaning personnel and training, location and methods of cleaning, and presence of IC services and QA programs. Endoscope culturing was infrequently done and positive cultures were rare. While most units claim to have ongoing QA programs, few use objective criteria to monitor effective disinfection or lapses in technique. Iatrogenic infection is uncommonly recognized following GI endoscope procedures.

Disinfectants↗
PubMed2005

Using DNA shuffling to create novel infectious bronchitis virus S1 genes: implications for S1 gene recombination.

We employed the staggered extension process (StEP) to shuffle the S1 genes from four infectious bronchitis virus (IBV) strains representing four unique serotypes. Upon creating a shuffled S1 gene library, we randomly selected 25 clones and analyzed them by DNA sequencing. In total, eleven clones contained novel S1 gene recombinants. Based on sequence data, each recombinant was unique and contained a full-length open reading frame. The average number of crossovers per recombinant was 5 and the average number of point mutations was 1.3, leading mostly to non-synonymous amino acid changes. No recombinant contained sequences from all four parental genes and no recombinant contained any sequence from the distantly related Delaware 072 strain. Our data suggests that recombination between distantly related IBV strains within the S1 gene probably does not readily occur. This finding is extremely important in light of the common industry vaccination practice of mixing different live-attenuated IBV strains.

Animals↗
PubMed1994

Multiple factors affect dietitians' counseling practices for high blood cholesterol.

OBJECTIVE: To examine the association of factors from social cognitive theory with dietitians' counseling practices for high blood cholesterol. DESIGN: A cross-sectional mail survey of 1,500 dietitians that included a 67-item, specially designed questionnaire to collect data. SUBJECTS: The sample comprised clinical dietitians and dietitians in consulting and private practice who were members of The American Dietetic Association and were practicing in Pennsylvania; Delaware; Washington, DC; Maryland; North Carolina; and Virginia (N = 1,500). Questionnaires were returned by 1,011 (67%) respondents; the 508 respondents (50%) who counseled adults for high blood cholesterol completed the entire questionnaire. STATISTICAL ANALYSES PERFORMED: Statistical analyses proceeded in three steps: descriptive statistics on questionnaire items, calculation of composite index scores, and bivariate and multivariate analyses. RESULTS: Of the key hypothesized factors, greater self-efficacy, higher levels of outcome efficacy, and greater adherence expectations significantly correlated with compliance-enhancing counseling practices. Outpatient dietitians used more compliance-enhancing counseling practices than did inpatient dietitians. Stepwise multiple regression analysis showed that the outpatient setting, a greater number of counseling sessions, follow-up counseling, and a charge to patients for counseling positively correlated with compliance-enhancing counseling practices. APPLICATIONS: Recommendations suggested by the findings include structuring professional training and continuing education programs for dietitians to strengthen self-efficacy, providing more feedback to improve perceived outcome efficacy, and changing the organization of the delivery of nutrition counseling services for prevention to allow more outpatient counseling.

Adult↗
PubMed1994

Assessing diagnostic criteria for active infective endocarditis.

A study was performed to describe agreement among experts on their classification of patients, in the absence of information concerning risk factors, as to the presence of infective endocarditis (IE). The study also assessed the clinical characteristics that enabled the experts to determine that a patient had IE. All patients with a discharge diagnosis of IE were identified prospectively from 54 hospitals in the Delaware Valley over a 3-year period. Patients were part of a case-control study of risk factors for IE. Three infectious disease experts independently reviewed abstracted hospital records and classified each of 151 eligible patients as a definite, probable or possible case, or a probable noncase, both based on clinical judgement and using a modified standard definition. Experts were more likely to classify a patient as a definite case of IE on the basis of clinical judgement than by using the modified standard definition. Agreement between reviewers was 92 to 95% when they were distinguishing only probable non-cases from others. Agreement between reviewers on specific categories was lower (40 to 58%). The number of positive blood cultures was a strong predictor of a patient's being classified as a case, as was the type of infecting organism. It is concluded that experts are willing to make a definitive diagnosis of IE on the basis of blood culture information alone. Further supporting evidence, such as the presence of vegetation on an echocardiogram, is needed when blood culture results are ambiguous.

Adult↗
PubMed1991

The composition of Permian seawater.

Forty-nine brine inclusions in marine halite from the Ochoan Salado Formation in the Delaware Basin and fifteen inclusions in halite from the Leonardian Wellington Formation in the Kansas Basin were extracted, and their chemical compositions were determined. The brines are of the Na-K-Mg-Cl-SO4 type; their compositions resemble those of evaporated modern seawater. The values of (mCl(-) - mNa+)/mBr- and (mMg(2+) + mCa(2+) - mSO4(2-) - 1/2mHCO3-)/mBr- of the inclusion brine from the two formations are equal to or slightly higher than those of modern seawater. The original mNa+/mBr- and mCl-/mBr- ratios of the inclusion brines were probably equal to or slightly larger than those of modern seawater. The values of mMg2+/mBr- of the inclusion brines from the Salado Formation are very close to that of modern seawater; the ratios of inclusion brines from the Wellington Formation are slightly lower, probably due to the formation of dolomite/magnesite. The mMg2+/mBr- ratio in the initial seawater was probably close to the parent seawater of the Salado brines. The values of (mSO4(2-) - mCa(2+) + 1/2mHCO3-)/mBr- of the inclusion brines appear to be reduced by the formation of dolomite/magnesite, and the value of this ratio in Permian seawater was probably similar to that of modern seawater. The mK+/mBr- ratios of the inclusion brines are variable, but the original ratios are probably close to or slightly larger than that of modern seawater. If the Br- concentration of Permian seawater was equal to that of modern seawater, the composition of Permian seawater can be narrowly constrained; in mmol/kg H2O, 460 < or = mNa+ < 630, 550 < or = mCl- < 730, mMg2+ = 54 +/- 6, mK+ approximately equal to 11, (mSO4(2-) - mCa(2+) + 1/2mHCO3-) > or = 17, 20 < mSO4(2-) < 45, 5 < mCa2+ < 20, and 0.15 < mHCO3- < 5. The composition of Permian seawater was therefore quite similar to that of modern seawater.

Bicarbonates↗
PubMed1985

Human envenomation from the bite of the eastern garter snake, Thamnophis s. sirtalis (Serpentes: Colubridae).

A 13-yr-old victim of a prolonged eastern garter snake (Thamnophis s. sirtalis) bite was hospitalized following development of coolness, edema and ecchymosis of the bitten hand. Although lymphatic involvement was noted, vital signs and laboratory tests were normal and rapid recovery followed. Subsequent asymptomatic Thamnophis bites of the subject indicate that these clinical changes were not allergic. This case from Delaware suggests that widespread toxicity within the genus is likely.

Adolescent↗
PubMed1989

Luteinizing hormone-releasing hormone (LHRH) agonists for treatment of advanced prostatic carcinoma.

The identification of the decapeptide luteinizing hormone-releasing hormone (LHRH) has led to the development of LHRH agonists, which are a new class of drugs for the treatment of advanced prostate cancer. These peptides have a modified amino acid structure that makes them more potent than LHRH. Prolonged administration of LHRH agonists results in down-regulation of the LHRH receptors in the pituitary and decreased secretion of luteinizing hormone. The result is decreased production of testosterone by Leydig cells, which is the basis for the use of LHRH agonists to treat prostate cancer. The effectiveness of LHRH agonists has been demonstrated in the United States in several randomized, controlled clinical trials. Daily administration of leuprolide produced equivalent results compared with diethylstilbestrol (DES). More recently, in two separate, randomized studies, the long-acting LHRH agonist Zoladex (ICI Pharma, Wilmington, Delaware) produced the same objective response rate as DES or bilateral orchiectomy. The equivalent response rates obtained with LHRH agonists indicate that these drugs can now be considered a reasonable treatment option for patients with metastatic prostatic cancer.

Antineoplastic Agents↗
PubMed1989

Phase III studies to compare goserelin (Zoladex) with orchiectomy and with diethylstilbestrol in treatment of prostatic carcinoma.

Two multicenter, open, randomized phase III clinical trials were conducted in the United Kingdom to compare the effectiveness and safety of the depot formulation of the luteinizing hormone-releasing hormone (LHRH) agonist goserelin (Zoladex, ICI Pharma, Wilmington, Delaware), 3.6 mg sc/28 d, with orchiectomy and with diethylstilbestrol (DES), 1 mg tid, in the treatment of advanced prostatic cancer. In the Zoladex versus orchiectomy trial, there was no significant difference between the treatment groups with regard to subjective and objective responses (British Prostate Group criteria), endocrine responses, clinical effects and side effects, time to treatment failure and death, or survival after similar median follow-up periods. It was concluded that depot Zoladex had behaved as a truly medical alternative to orchiectomy. In the Zoladex versus DES trial, subjective and objective responses (British Prostate Group and National Prostatic Cancer Project criteria), response duration and survival were similar. However, there was a more rapid response to treatment in the depot Zoladex group. Side effects from Zoladex such as flare symptoms during the initial stages of treatment required no discontinuation of therapy; in contrast, 15 percent of patients receiving DES required cessation of therapy during the first three months because of side effects. It was concluded that depot Zoladex was superior to DES in its attainment of an early objective response and in its absence of side effects, and that Zoladex was comparable with DES in terms of response rates and survival.

Antineoplastic Agents↗