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PubMed1998

Epidemic of congenital syphilis--Baltimore, 1996-1997.

In 1996 and 1997, Baltimore, Maryland, had the highest rate for primary and secondary syphilis among U.S. cities. From 1993 to 1996, the rate for congenital syphilis (CS) in Baltimore increased from 62 to 282 per 100,000 live-born infants. To assess the magnitude of the syphilis epidemic in pregnant women and to identify ways to improve CS prevention, the Baltimore City Health Department (BCHD), the Maryland Department of Health and Mental Hygiene (DHMH), and CDC analyzed CS surveillance data for and reviewed medical records of pregnant women with syphilis. This report summarizes the results of this investigation, which indicated that 90% of cases could have been prevented by adequate prenatal care and more timely syphilis screening and treatment

Baltimore↗
PubMed1989

Fibrinogen Baltimore IV: congenital dysfibrinogenemia with a gamma 275 (Arg----Cys) substitution.

The major functional characteristics of fibrinogen Baltimore IV include delayed fibrin monomer polymerization which is not corrected by the addition of calcium, inhibition of normal plasma coagulation upon mixing, and a biphasic polymerization profile in which the abnormal fibrin monomers appear to polymerize at about 2% of the normal rate (Ebert & Bell, Thromb. Res. 38:121-128, 1985). We now report the detection of an abnormal peptide in a comparative peptide map from a cyanogen bromide digest of fibrinogen Baltimore IV. The sequence of this peptide corresponds to the fibrinogen sequence gamma 265-310, except that Arg275 is replaced by Cys. Amino acid analyses of carboxymethylated peptides from control vs. fibrinogen Baltimore IV confirmed the sequencing data. Both the propositus and his affected daughter were heterozygous for the trait.

Amino Acid Sequence↗
PubMedDate not supplied

Early intervention for human immunodeficiency virus in Baltimore Sexually Transmitted Diseases Clinics. Impact on gonorrhea incidence in patients infected with HIV.

BACKGROUND: High incidences of sexually transmitted diseases (STD) after posttest counseling have been documented in patients diagnosed with human immunodeficiency virus (HIV) in Baltimore STD clinics. In July 1991, the authors instituted an HIV early intervention program providing long-term medical care and social work services. This study compares the incidence of gonorrhea after post-HIV+ test counseling in patients diagnosed with HIV before and after the institution of the early intervention program. METHODS: Medical records of a cohort composed of all patients newly diagnosed with HIV and those who underwent posttest counseling for HIV in 1991 to 1993 in two Baltimore STD clinics were reviewed. Patients were offered early intervention medical and social work services. Gonorrhea incidence in this cohort was compared to a historical cohort diagnosed and counseled for post-HIV+ testing in 1988 to 1989 who were not offered early intervention services. RESULTS: The mean follow-up time was 418 days (range, 26 to 703 days). After post-HIV+ test counseling, gonorrhea developed in 39 of 468 (8.3%) men in the 1989 cohort and 13 of 400 (3.3%) men in the 1991 to 1993 cohort. Controlling for variable length of follow-up, the 1991 to 1993 cohort had a relative risk of 0.442 for the development of gonorrhea during the study period (95% confidence interval, 0.225 to 0.790; P = 0.006). Incident gonorrhea after post-HIV+ test counseling also was associated with a prevalent gonorrhea condition at the time of HIV diagnosis (RR = 3.02; 95% CI, 1.75 to 5.23; P = 0.0001) and failure to return for post-HIV+ test counseling as scheduled (RR = 2.27; 95% CI, 1.17-4.43; P = 0.013). After adjustment for gonorrhea at the time of HIV diagnosis and failure to return for scheduled posttest counseling, the difference in gonorrhea incidence between men in the two cohorts remained statistically significant (RR = 0.494; 95% CI, 0.260 to 0.941; P = 0.032). In comparison, overall gonorrhea rates in Baltimore changed little between 1988 and 1993. No significant difference was found in gonorrhea incidence in women, which may have been the result of active gonorrhea screening during the 1991 to 1993 period, which was not performed in 1988 to 1989. CONCLUSIONS: Providing clinical care to persons with HIV may facilitate the reduction of high-risk behaviors that lead to incident STDs and further HIV transmission.

Adult↗
PubMed2004

Serotype 14 variants of the France 9V(-3) clone from Baltimore, Maryland, can be differentiated by the cpsB gene.

European serotype 14 variants of the France 9V(-3) clone, which have arisen through recombination events involving the penicillin binding protein 1a (pbp1a) gene, have cpsB sequences distinct from those of the 9V(-3) clone. Serotype 14 variants of the 9V(-3) clone have not been compared to genetically diverse serotype 14 strains isolated from an entire metropolitan area in the United States. All serotype 14 non-penicillin-susceptible Streptococcus pneumoniae strains causing invasive disease in Baltimore, Md., from 1995 to 1996 were compared by using pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), pbp1a PCR restriction profiles, and cpsB and pbp1a sequences. The cpsB genes from strains of 13 serotypes also were analyzed to assess the correlation with serotype. Twenty-seven percent (3 of 11) of the serotype 14 strains were related by PFGE and MLST to the 9V(-3) clone. The serotype 14 variants from Baltimore, unlike the European variants, were related neither to the 9V(-3) clone nor to the R6 strain from positions 1498 to 1710 of the pbp1a gene. All serotype 14 strains had cpsB sequences that differed by or=16% (78 to 83 of 476 bp) divergent from that of the 9V(-3) clone. Allowing for a 2-bp difference in the cpsB sequence resulted in the highest correlation between the cpsB gene and serotype. Overall, 95% (84 of 88) of the strains were classified correctly by serotype with the cpsB sequence. The distal recombination site of the Baltimore serotype 14 variants of the 9V(-3) clone was not identical to that of the European serotype 14 variants. The cpsB gene was serotype specific regardless of whether capsular switching occurred. Although the correlation between serotype and the cpsB sequence was high, the overall diversity of the cpsB gene within a serotype likely will limit the role of this gene in a sequence-based serotyping method.

Bacterial Proteins↗
PubMed1994

Hb Lepore Baltimore (delta 50Ser beta 86Ala) identified by DNA analysis in a Brazilian family.

Genomic DNA from two Brazilian hemoglobin (Hb) Lepore heterozygotes of Italian ancestry have been studied in order to identify the Hb Lepore type and to sequence the breakpoint region. The two genes were sequenced after PCR amplification and had the delta globin sequence up to exon 2 codon 68 while the first specific base for the beta globin gene was at codon 86 of the second exon; between the two ends, they had 51 base pairs in common with the delta and beta globin genes. These data indicate that the mutation was of the Hb Lepore Baltimore type. The Lepore chromosome haplotype was different from that previously described in members of a Spanish family with Hb Lepore Baltimore. These data suggest that independent mutations have given rise to Hb Lepore Baltimore in different regions of the world.

Anemia↗
PubMed1993

Questions of scientific responsibility: the Baltimore case.

A number of cases of questionable behavior in science have been extensively reported in the media during the last two or three years. What standards are upheld by the scientific community affect the community internally, and also affect its relations with society at large, including Congress. Here I wish to address questions of scientific responsibility, using the Baltimore case as a concrete instance where they came up. The first part containing historical background is necessary to provide readers with documentation so that they can have some factual bases on which to evaluate respective positions and my conclusions that follow -- based on further but more succinctly summarized documentation. I have reproduced many quotes because I firmly believe people are entitled to be represented by their own wording. Conversely, I hold people accountable for their official positions. Some of these are reproduced in footnotes, and some longer ones are reproduced in appendices. I also do not ask to be trusted. By providing numerous references, I hope that readers who find my documentation insufficient can follow up by looking up these references.... The article is in six parts: Part I. Historical Background. This part gives mostly a historical background of the early phases of the Baltimore case. Part II. The First Issue of Responsibility. This part presents a discussion of certain scientific responsibilities based on that background, specifically: the responsibility of answering questions about one's work, and the responsibility whether to submit to authority. Part III. The NIH Investigations. This part summarizes the two NIH investigations. Part IV. The Dingell Subcommittee. This part deals with the responsibilities of a Congressional Committee vis-à-vis science. Part V. Further Issues of Responsibility. This part goes into an open ended discussion of many issues of responsibility facing scientists, vis-à-vis themselves and vis-à-vis society at large, including Congress. The list is long, and readers can look at the section and paragraph headings to get an idea of their content. Part VI. Personal Credibility, a Shift at the Grass Roots, and Baltimore's Persistence.

Biomedical Research↗
PubMed1993

Hb Sinai-Baltimore or alpha 2 beta (2)18(A15)Val->Gly, a silent, mildly unstable beta chain variant detected by isoelectrofocusing and high performance liquid chromatography.

Isoelectrofocusing and high performance liquid chromatographic methods were used to study an abnormal hemoglobin present in a Black male infant and his mother. The variant, named Hb Sinai-Baltimore, focused slightly behind Hb A and separated incompletely from Hb A by cation exchange high performance liquid chromatography, while the separation of the beta A and beta X chains by reversed phase high performance liquid chromatography was complete. The variant was identified through an analysis of peptides in a tryptic digest of the isolated beta X chain and by sequencing of amplified DNA which included the beta-globin gene. The Val->Gly replacement at position beta 18 (codon 18; GTG->GGG) or at the last position of the A helix decreases the stability of the variant without affecting the hematological parameters of its carrier. The propositus was a compound heterozygote for Hb Sinai-Baltimore and Hb S; the relative quantities of the two variant chains were somewhat different from those of the beta X and beta A chains in the mother with the simple Hb Sinai-Baltimore heterozygosity. An uncertainty about the alpha-globin gene status in the child prevented a further evaluation of these differences.

Chromatography, High Pressure Liquid↗
PubMed1985

Geographical distribution and age related prevalence of antibody to Hantaan-like virus in rat populations of Baltimore, Maryland, USA.

Recent studies indicate that domestic rats (Rattus norvegicus) from harbor-side areas within port cities of the United States are infected with a Hantaan-like virus. The geographical distribution of seropositive rats may be extremely localized within these urban environments. We surveyed four widely separated residential sites distant from the harbor within Baltimore, Maryland, USA, to determine the geographical distribution and prevalence of antibody to Hantaan-like virus in rats from urban areas of high human population density. Captured rats were weighed and examined for sexual maturity to allow some estimation of age, and their sera were examined by indirect immunofluorescent antibody assay for antibody to Hantaan virus. Seropositive rats were found at all four sites within Baltimore. Increasing antibody prevalence and high titers were associated with increasing rat weight and sexual maturity. Our results show that infection of rats by a Hantaan-like virus is widespread in Baltimore. Antibody in rats may be due to infections acquired during maturation or the delayed seroconversion of rats infected prior to weaning.

Age Factors↗
PubMed1980

[Hemoglobin N Baltimore: 28 cases in one Guadeloupe family (author's transl)].

The detection of hemoglobin AN Baltimore in a young man, 28 years old in June 1978, led us make a family study. This family study was very interesting because our proband had 16 brothers and sisters, many of whom also had many children. Research on abnormal hemoglobins was done on 46 family members: 28 were carriers of hemoglobin AN Baltimore and three children, carriers of heterozygote SN Baltimore.

Adolescent↗
PubMed1991

Socioeconomic status and visual impairment among urban Americans. Baltimore Eye Survey Research Group.

The Baltimore Eye Survey is a population-based study of ocular disorders conducted in East Baltimore, Md, designed to determine the prevalence and severity of vision loss and ocular disease and their relationships to socioeconomic and other risk factors. This survey comprised 5300 subjects (2911 whites and 2389 blacks). Visual impairment was associated with age, race, general health status, educational level, income, and employment status. An identified association of race with blindness and visual impairment was reduced, but not eliminated, after adjustment for these socioeconomic factors, indicating that socioeconomic status itself is an important determinant of visual impairment.

Adult↗
PubMed1994

Family history and risk of primary open angle glaucoma. The Baltimore Eye Survey.

OBJECTIVE: Primary open angle glaucoma has been previously associated with a positive family history of glaucoma. We used data from the Baltimore Eye Survey to examine this association. DESIGN: A population-based prevalence survey identified 161 cases of primary open angle glaucoma among 5308 black and white residents of east Baltimore, Md, who were 40 years of age or older. Family history was ascertained by interview and included all first-degree relatives (parents, siblings, and children). RESULTS: Age-adjusted associations of primary open angle glaucoma with a history of glaucoma were higher in siblings (odds ratio [OR] = 3.69) than in parents (OR = 2.17) or children (OR = 1.12). Odds ratios were slightly higher in blacks than in whites, and there was evidence of selection bias, with ORs between two and three times higher for those who had prior knowledge of their glaucoma diagnosis than for those who first received their diagnosis by the study examination (history in siblings OR = 4.72 for those with prior knowledge vs 2.77 for those without). CONCLUSION: Family history is an important risk factor for primary open angle glaucoma, although clinic-based studies are likely to overstate its impact.

Adult↗
PubMed1993

Measles, mumps, and rubella antibodies in vaccinated Baltimore children.

OBJECTIVE: To determine quantitative measles, mumps, and rubella serum antibody levels as a function of time since vaccination in a sample of vaccinated Baltimore children. DESIGN: Cross-sectional serologic survey. SETTING: Pediatric outpatient departments at the University of Maryland Medical Center, Baltimore. PARTICIPANTS: One hundred seventy children, ranging in age from 1.5 through 16 years, who had measles, mumps, and rubella vaccination between ages 12 and 18 months. RESULTS: Serum antibody levels to measles and rubella declined with increasing time since vaccination. However, no such decline in antibody levels to mumps was observed. Children who were vaccinated between ages 12 and 14 months did not have lower antibody levels than children who were vaccinated at age 15 months or older. CONCLUSIONS: In areas free from natural disease, antibody levels resultant from measles, mumps, and rubella vaccine are likely to decline with advancing age. Revaccination with measles, mumps, and rubella vaccine may boost falling antibody titers.

Adolescent↗
PubMed1996

Picture archiving and communication system training for physicians: lessons learned at the Baltimore VA Medical Center.

Physicians practicing at the "filmless" Baltimore VA Medical Center need to be proficient in the use of the picture archiving and communication system (PACS) to be able to view radiologic images and accompanying reports. PACS training is necessary to assure optimal patient care and to satisfy potential medicolegal requirements. Providing such training is the responsibility of both the Imaging Department and the hospital. Training in the use of the PACS at the Baltimore VA is conducted by an on-site application specialist. Data were collected from interviews with the trainer, training log sheets, and physician surveys. Although 100% of radiologists received formal training, only 22% of nonradiologists were formally trained; 32% of these physicians identified themsleves as having been trained by their peers and 41% stated they were self-trained. We identified two goals of a PACS training program. The first is to teach physicians how to retrieve images and reports from current as well as prior studies and display them on a computer workstation. Secondly, the training should include instruction on the use of the various workstation tools to enhance image interpretation. Imaging requirements and usage by different physician groups vary, and PACS training should be tailored accordingly. Difficulties in the scheduling of training sessions during working hours and the widespread use of a "generic" log-on identification have contributed to the low (22%) compliance of nonradiologists with the formal training program. Although we believe that one-on-one training is most effective and can be best tailored to the needs and computer expertise of an individual particular physician, computer based training (both on and off-line) may provide an acceptable, and in some cases, a preferred alternative.

Baltimore↗
PubMed2006

Engaging older adults in high impact volunteering that enhances health: recruitment and retention in The Experience Corps Baltimore.

Engagement in social and generative activities has benefits for the well-being of older adults; hence, methods for broadly engaging them in such activities are desired. Experience Corps Baltimore, a social model for health promotion for older adult volunteers in public schools, offers insight to such successful recruitment and retention. We report on data over a 4-year period in Baltimore City, Maryland, and describe a five-stage screening process implemented to recruit a diverse group of senior volunteers who would remain in the program for at least 1 year. The sample consisted of 443 older adults expressing an interest in and screened for volunteering. Comparisons were made with Chi-square and Fisher's t-test between those who entered the program and those who did not and those who were retained in the program. Gender, race, age group, and prior volunteering were significant in ultimate volunteer service in the schools. Overall, 38% of 443 persons recruited entered the schools; 94% of participants were over 60 years (p = 0.05) with a mean age of 69 years; 90% were women (p = 0.03), and 93% African-American (p = 0.005); 57% had not volunteered in the past year (p = 0.004). Ninety-two percent were retained in the first year; 80% returned a second year. Among the latter, 83% had <12 years of education (p = 0.001). Participants remained in the program for a second year of volunteering regardless of baseline MMSE score, self-reported health, and motivation for volunteering. In conclusion, it is possible to recruit and retain a diverse pool of older adults to participate in a high-intensity volunteer program, including non-traditional volunteers. Of special note is the success in recruiting African-American women and those with lower education, who may particularly benefit from health promotion.

Black or African American↗
PubMed2005

Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner-city Baltimore.

This paper presents indoor air pollutant concentrations and allergen levels collected from the homes of 100 Baltimore city asthmatic children participating in an asthma intervention trial. Particulate matter (PM), NO2, and O3 samples were collected over 72 h in the child's sleeping room. Time-resolved PM was also assessed using a portable direct-reading nephelometer. Dust allergen samples were collected from the child's bedroom, the family room, and the kitchen. The mean PM10 concentration, 56.5+/-40.7 microg/m3, is 25% higher than the PM2.5 concentration (N=90), 45.1+/-37.5 microg/m3. PM concentrations measured using a nephelometer are consistent and highly correlated with gravimetric estimates. Smoking households' average PM2.5 and PM10 concentrations are 33-54 microg/m3 greater than those of nonsmoking houses, with each cigarette smoked adding 1.0 microm/m3 to indoor PM2.5 and PM10 concentrations. Large percentages of NO2 and O3 samples, 25% and 75%, respectively, were below the limit of detection. The mean NO2 indoor concentration is 31.6+/-40.2 ppb, while the mean indoor O3 concentration in the ozone season was 3.3+/-7.7 ppb. The levels of allergens are similar to those found in other inner cities. Results presented in this paper indicate that asthmatic children in Baltimore are exposed to elevated allergens and indoor air pollutants. Understanding this combined insult may help to explain the differential asthma burden between inner-city and non-inner-city children.

Air Pollutants↗
PubMed2004

Incident hypertension associated with depression in the Baltimore Epidemiologic Catchment area follow-up study.

BACKGROUND: This study evaluates the role of depression as a specific risk factor for hypertension. METHODS: This study analyzed the prospective data in the Baltimore Epidemiologic Catchment Area (ECA) Follow-up Study (n=1920), a longitudinal population-based study of mental illness in East Baltimore. Incident cases of hypertension as assessed by self-report (n=148) in 1993 were compared to the remaining cohort without hypertension (n=901) across three waves of ECA interviews (1981, 1982, 1993). Depression and related symptoms were measured at baseline (1981) by the Diagnostic Interview Schedule (DIS) and categorized as dysphoria, dysthymia, or major depressive episode (MDE) according to Diagnostic and Statistical Manual (DSM) III criteria. RESULTS: Individuals with a major depressive episode compared to those who reported never having dysphoria had a marginally significant increased risk for hypertension (Odds Ratio (OR)=2.16; 95% Confidence Interval (CI) (0.94,4.98)) after adjustment for age, gender, race, body mass index, Nam-Powers socioeconomic score, alcohol usage, smoking, exercise, diabetes status, and number of general medical visits. MDE reported to have begun more than a year before the baseline measurement was associated with an increased risk for incident hypertension (Adjusted OR=3.67, 95% CI (1.25,10.79). LIMITATIONS: Potential misclassification of self-reported hypertension outcome. CONCLUSIONS: Even though the data are based on self-report of hypertension, these findings suggest that depression may be an independent risk factor for hypertension particularly for those with recurrent episodes or a long term history of the disease.

Adolescent↗
PubMed2003

Association of energy intake with prostate cancer in a long-term aging study: Baltimore Longitudinal Study of Aging (United States).

OBJECTIVES: To examine the association of total energy intake and macronutrient contributors to energy with prostate cancer risk among men in the Baltimore Longitudinal Study of Aging. METHODS: In the Baltimore Longitudinal Study of Aging cohort, 444 men completed at least one food frequency questionnaire (FFQ). At their earliest FFQ completion, men were 45 to 92 years old. The total number of prostate cancer cases (n = 68) consisted of men who were diagnosed with cancer before their FFQ completion (n = 46) and those who were diagnosed after their FFQ completion (n = 22). Multiple logistic regression analysis was used to calculate the odds ratio of prostate cancer and its 95% confidence interval. RESULTS: Total energy intake was positively associated with prostate cancer. Compared with the lowest quintile of energy intake, the odds ratio for the highest quintile was 3.79 (95% confidence interval 1.52 to 9.48, P TREND = 0.002). Energy-adjusted intakes of protein, fat, and carbohydrates were not statistically significantly associated with prostate cancer risk. CONCLUSIONS: This analysis, in which we used current energy intake as a surrogate for past prediagnostic intake, suggests a higher risk of prostate cancer with increased energy intake.

Aged↗
PubMed1995

Diabetes, intraocular pressure, and primary open-angle glaucoma in the Baltimore Eye Survey.

BACKGROUND: The association of diabetes with primary-open angle glaucoma (POAG) has been controversial and often confused by varying definitions of both diabetes and POAG. The purpose of this study is to evaluate this association in a population-based sample of subjects from the Baltimore Eye Survey. METHODS: A stratified sample of residents in 16 cluster areas of east Baltimore was recruited for a detailed ophthalmologic screening examination. A total of 5308 black subjects and white subjects participated. Of these participants, 161 received a diagnosis of POAG. During a detailed interview with each subject, diabetes was defined based on a reported history of diabetes. Persons with diabetes were classified as "insulin-users" and "noninsulin-users" based on their current method of treatment. RESULTS: Diabetes was highly prevalent in this population, with 10.6% of white subjects and 17.2% of black subjects reporting a positive history. Diabetes was associated with higher intraocular pressure, but differences were not large (means, 17.4, 18.0, and 17.8 mmHg) among subjects without diabetes, those with diabetes who were not using insulin, and those with diabetes who were using insulin, respectively. Diabetes was not associated with POAG (age-race-adjusted odds ratio, 1.03; 95% confidence interval, 0.85, 1.25). This was true for both types of diabetes. Persons whose POAG had been diagnosed before the examination showed a positive association with diabetes (odds ratio, 1.7, 95% confidence interval, 1.03, 2.86), indicating that selection bias could explain the positive results of previous clinic-based investigations. CONCLUSION: There is no evidence from this population-based investigation that supports an association between diabetes and POAG.

Adult↗