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At least 73 records · Page 4Linked to original sources
PubMed1981

Prevalence of Dirofilaria immitis and Dipetalonema reconditum infections in Missouri dogs.

The prevalence of Dirofilaria immitis and Dipetalonema reconditum infections in Missouri dogs was investigated by means of a statewide veterinary mail survey and a study of shelter dogs from central Missouri and Mississippi River communities. The veterinary survey revealed microfilariae of D immitis in 447 of 11,823 (3.8%) dogs, microfilariae of D reconditum in 14 (0.1%), and microfilariae of both species in 8 (less than 0.1%). Of 493 shelter dogs examined, using the modified Knott test, 23 (4.7%) were positive for D immitis, 23 (4.7%) for D reconditum, and 2 (0.4%) for both helminths. The prevalence of infection with both D immitis (9.4%) and D reconditum (6.3%) was higher in shelter dogs from the Mississippi River communities than in those from central Missouri (1.7% for D immitis, 3.7% for D reconditum). The microfilariae of D immitis in shelter dogs ranged in length from 255 to 343 micrometer (mean, 314 micrometer) and in width from 5.0 to 7.5 micrometer (mean, 6.5 micrometer); those of D reconditum ranged in length from 238 to 295 micrometer (mean, 257 micrometer) and in width from 3.2 to 6.5 micrometer (mean, 4.9 micrometer). Buttonhook tails were seen in 41% of D reconditum. In the final analysis, the shape of the anterior end was considered the most reliable criterion for differentiation.

Animals↗
PubMedDate not supplied

Case management of HIV-infected children in Missouri.

The early referral of HIV-exposed children and their mothers to coordinated medical and social services has become increasingly important. In July 1989, the Missouri Department of Health initiated the Service Coordination Program to provide individualized referral (case management) for Missouri residents who were reported to have acquired immunodeficiency syndrome (AIDS) or HIV infection. The purpose of the Service Coordination Program is to assist persons in accessing medical and social services. The authors describe the characteristics of the 36 children (18 enrolled in the Service Coordination Program, and 18 not enrolled) reported to the Missouri Department of Health through September 1992. Although more detailed evaluations are necessary, preliminary data suggest that opportunities for early intervention may be facilitated by the Service Coordination Program if the child's HIV status is recognized early.

Child↗
PubMed1995

Lyme and/or Lyme-like disease in Missouri.

Missouri patients who fulfill the strict CDC surveillance definition for Lyme disease have been reported in significant numbers since 1987, although there are no viable Missouri human cultures of Borrelia burgdorferi. The Missouri erythema migrans rashes are indistinguishable from those in other areas, and the clinical syndrome appears similar to Lyme disease nationally. The authors suspect atypical B. burgdorferi, and/or other Borrelia spirochetes of causing this clinical borreliosis syndrome.

Adult↗
PubMed1994

Patterns of sedentary lifestyle in Missouri.

Sedentary lifestyle is a major modifiable risk factor for chronic disease in Missouri. Survey data was examined for the prevalence of sedentary lifestyle in Missouri. Sedentary lifestyle was higher among blacks, older adults, persons with lower levels of education or income, and obese persons. Based on the current trend, Missouri is unlikely to achieve the year 2000 objective of < or = 50% prevalence of sedentary lifestyle.

Adult↗
PubMed1994

Informal discovery between treating physicians and defense counsel in Missouri.

In recent years, Missouri courts have grappled with the issues of informal contacts between treating physicians and defense counsel in medical malpractice and personal injury lawsuits. Recently, in Brandt v. Pelican and Brandt v. Medical Defense Associates the Missouri Supreme Court ruled that discussions between the treating physician and counsel for the defense which take place outside the methods of formal discovery, are not prohibited. This article will examine the court's decisions in the Brandt cases and will discuss the practical effects of the decisions upon Missouri physicians.

Malpractice↗
PubMed1993

Flood-related mortality--Missouri, 1993.

Public health surveillance documented the impact of flood-related morbidity following the floods in the midwestern United States during the summer of 1993 (1,2). Because of extensive flooding of the Missouri and Mississippi rivers and their tributaries, the Missouri Department of Health (MDH) initiated surveillance to monitor flood-related mortality. This report summarizes epidemiologic information about deaths in Missouri that resulted from riverine flooding and flash flooding during the summer and fall of 1993.

Adolescent↗
PubMed1996

The continuing impact of treatment of eye disease on optometric practice in Missouri.

BACKGROUND: This study is a follow-up to a study performed in 1991 to determine the continuing impact of the use by optometrists in Missouri of therapeutic agents (TPA) to treat eye diseases. METHODS: Sixty-four percent of the Missouri optometrists certified to use therapeutic pharmaceutical agents responded to a 1995 questionnaire. RESULTS: More than 90 percent of those responding prescribe all categories of topical agents, while oral agents are used at lower percentages. Almost two-thirds of optometrists are registered with the Drug Enforcement Administration to prescribe controlled substances. The median number of therapeutic prescriptions written per year was 240, an increase of 67 percent from the previous study. More than half of the respondents now receive in-office detailing by drug company representatives. A small percent of optometrists have hospital clinical privileges and about one-fourth have privileges in nursing homes. CONCLUSIONS: The percentage of TPA-certified optometrists residing and practicing in Missouri has risen from one-half to slightly more than three-fourths of practitioners in a 4-year time period. This increase, coupled with the demonstrated increase in therapeutic prescriptions written, enhanced exposure to in-office detailing, and recent amendment of the optometry law to include the management of glaucoma bodes well for the delivery of primary eye care to citizens of the state.

Drug Prescriptions↗
PubMedDate not supplied

Selected chronic disease risk factors in Missouri: 10-year trends and predictions for the year 2000.

INTRODUCTION: A study was undertaken to determine the prevalence rates of three chronic disease risk factors among adult Missourians from 1986 to 1995, to predict rates, and to compare them with national and Missouri's goals for the year 2000. METHODS: Using data from Missouri Behavioral Risk Factor Surveillance System Surveys (BRFSS) 1986-1995, prevalence rates of smoking, physical inactivity, and obesity were calculated across age, gender, race, and educational levels. Linear regression was used to predict rates for year 2000, for the adults of Missouri as a whole and for particular subgroups. RESULTS: There was a 0.9% annual decrease in smoking prevalence and a 4.6% annual increase in obesity over the 10 years, controlling for age and gender. The trend in rates of physical inactivity was nonsignificant. Continuation of these rates will give smoking rates of 23.6%, obesity rates of 35.5%, and sedentary rates of 36.3% by the year 2000. Those with less than a high school education had higher rates for each of the risk factors. CONCLUSIONS: This rate of decrease in rates of cigarette smoking is not sufficient to enable the year 2000 goal to be reached until year 2040, and the rates of obesity and sedentary lifestyle are increasing. The BRFSS, which has now been implemented in all 50 states and the District of Columbia, is a useful tool for monitoring progress towards health behavior targets.

Adult↗
PubMedDate not supplied

Cross-cultural analysis of longevity among Swedish and American elders: the role of social networks in the Gothenburg and Missouri longitudinal studies compared.

This paper reports the results of a cross-national comparison of the 'H70' longitudinal study of elders in Gothenburg, Sweden, with the 'Rural Missouri Elders' longitudinal study in Missouri, USA. Analysis of the combined data sets focused on the question of how longevity was affected by culturally divergent forms of social network participation. The H70 study was a representative, systematic 3/10 sample of 70-year-old (in 1971) men and women living in Gothenburg. Follow-up data was gathered when the respondents were 75, 79, 81, 82, 83, 85, 88, 90 and 95 years of age. Face-to-face interviews and physical medical examinations were the major source of data. The Missouri study involved a representative cluster proportional-to-size sample of all rural Missourians 65 years of age and older. Face-to-face interviews were conducted in 1966, 1974 and 1987. Logistic regression and cross-tabular analyses revealed that social networks were important predictors of longevity for both samples. However, marital status and participation in formal organizations predicted longevity for the Americans, whereas contact with children emerged as the predictor variable for the Swedes. Specific functions of the different network patterns in the two countries are discussed.

Journal Article↗
PubMed1987

The Missouri Inpatient Behavior Scale.

The Missouri Inpatient Behavior Scale (MIBS) is described, and data are presented from the Missouri automated mental health information system (N = 12,106). The factor structure for MIBS was replicated and shown to be robust. Data on intrascale consistency and interscale correlations are presented, as well as a validity study that showed MIBS to be sensitive to changes on acute-receiving services and a comparison of MIBS and NOSIE-30 scores.

Adolescent↗
PubMed1992

Occupation, smoking, and the risk of high-grade invasive bladder cancer in Missouri.

Numerous epidemiological studies have established that occupational exposures and smoking are the two major known risk factors for the development of bladder cancer. Using data from the Missouri Cancer Registry, we investigated the hypothesis that individuals with occupationally-related bladder cancer are more likely to have a more invasive form of the disease. Data were analyzed for 2,893 white males diagnosed with primary bladder cancer in Missouri between 1984 and 1988. Of the 1,415 cases whose occupational status was recorded, 236 (17%) were employed in high-risk occupations. Cases with high-grade disease were more likely to have been employed in a high-risk occupation, after adjustment for age and smoking (adjusted odds ratio [AOR] = 1.7, 95% confidence interval [CI] = 1.1-2.6). High-risk workers under 60 years of age were most at risk for developing high-grade bladder tumors (AOR = 2.3, 95% CI = 1.0-5.3). There was no overall association between high-risk occupation and late-stage disease (AOR = 1.1, 95% CI = 0.7-1.5), but it was present in the men younger than 60 years of age (AOR = 2.0, 95% CI = 1.0-3.8). No association was found between tobacco use and grade (AOR = 1.1, 95% CI = 0.8-1.5), but cases with late-stage disease were more likely to be smokers (AOR = 1.5, 95% CI = 1.1-1.9). When occupations were examined individually, motor vehicle operators, truck drivers, vehicle mechanics, other mechanics, and janitors were among those most likely to be diagnosed with high-grade or late-stage tumors. Although further studies are necessary to confirm these results, they suggest that surveillance and targeted screening of workers in high-risk occupations may result in a greater yield of early invasive cancers and possibly decrease the mortality associated with this disease.

Aged↗
PubMed1989

Caries prevalences among geochemical regions of Missouri.

Our objectives were to determine how the prevalences of caries in elementary school children vary between geochemically defined regions of the state of Missouri and to compare this variation with that found for prehistoric Missouri inhabitants (Hildebolt et al.: Am. J. Phys. Anthropol. 75:1-14, 1988). Caries data on 6,584 school children were used in the study of second and sixth graders drinking optimally and suboptimally fluoridated water. Geochemical regions were based on maps recently published by the United States Geological Survey. Differences in mean caries scores and proportions of children with caries were tested by analysis of covariance, analysis of variance, Student t, and chi-squared tests. We found that caries prevalences do vary between the geochemical regions of the state. In the total sample, however, there were no significant differences between those children drinking optimally fluoridated water and those drinking suboptimally fluoridated water. We conclude that there is variation in caries rates among geochemically defined regions of the state and that geochemical factors associated with young parent materials may be antagonizing the action of fluoride.

Child↗
PubMed1991

Echinococcosis (hydatid disease) in Missouri: diagnosis by fine-needle aspiration of a lung cyst.

Echinococcus granulosus was diagnosed by fine-needle aspiration cytology of a lung cyst in a 6-yr-old white female in central Missouri. No adverse reaction occurred following the aspiration. The cytologic sample yielded clear fluid containing numerous clearly identifiable protoscoleces diagnostic for echinococcosis using routine PAP staining. Since hydatid disease is extremely uncommon in the Midwest, it had not initially been considered in the differential diagnosis. The infection was probably not indigenous to Missouri, since the patient lived the first 3 1/2 yr of life in Alaska, where the organism is endemic. This can only be speculative, however, since echinococcal organisms are found in wildlife in the Midwest.

Biopsy, Needle↗
PubMed1993

Occupational risk factors for lung cancer among nonsmoking women: a case-control study in Missouri (United States).

Occupationally related risk of lung cancer among women and among nonsmokers has not been widely studied. A recently conducted population-based, case-control study in Missouri (United States) provided the opportunity to evaluate risk of lung cancer associated with several occupational factors. Incident cases (n = 429) were identified through the Missouri Cancer Registry for the period 1986 through 1991, and included 294 lifetime nonsmokers and 135 ex-smokers who had stopped at least 15 years prior to diagnosis or had smoked for less than one pack-year. Controls (n = 1,021) were selected through driver's license and Medicare files. Risk was elevated among women exposed to asbestos (ever: odds ratio [OR] = 3.5, 95 percent confidence interval [CI] = 1.2-10.0; > 9 yrs: OR = 4.6, CI = 1.1-19.2) and pesticides (ever: OR = 2.4, CI = 1.1-5.6; > 17.5 yrs: OR = 2.4, CI = 0.8-7.0). Risk also was elevated among dry cleaning workers (ever: OR = 1.8, CI = 1.1-3.0; > 1.125 yrs: OR = 2.9, CI = 1.5-5.4). Occupational risks for lung cancer among women merit further study.

Adult↗
PubMed2006

Biomonitoring of lead, zinc, and cadmium in streams draining lead-mining and non-mining areas, southeast Missouri, USA.

We evaluated exposure of aquatic biota to lead (Pb), zinc (Zn), and cadmium (Cd) in streams draining a Pb-mining district in southeast Missouri. Samples of plant biomass (detritus, periphyton, and filamentous algae), invertebrates (snails, crayfish, and riffle benthos), and two taxa of fish were collected from seven sites closest to mining areas (mining sites), four sites further downstream from mining (downstream sites), and eight reference sites in fall 2001. Samples of plant biomass from mining sites had highest metal concentrations, with means 10- to 60-times greater than those for reference sites. Mean metal concentrations in over 90% of samples of plant biomass from mining sites were significantly greater than those from reference sites. Mean concentrations of Pb, Zn, and Cd in most invertebrate samples from mining sites, and mean Pb concentrations in most fish samples from mining sites, were also significantly greater than those from reference sites. Concentrations of all three metals were lower in samples from downstream sites, but several samples of plant biomass from downstream sites had metal concentrations significantly greater than those from reference sites. Analysis of supplemental samples collected in the fall of 2002, a year of above-average stream discharge, had lower Pb concentrations and higher Cd concentrations than samples collected in 2001, near the end of a multi-year drought. Concentrations of Pb measured in fish and invertebrates collected from mining sites during 2001 and 2002 were similar to those measured at nearby sites in the 1970s, during the early years of mining in the Viburnum Trend. Results of this study demonstrate that long-term Pb mining activity in southeast Missouri has resulted in significantly elevated concentrations of Pb, Cd, and Zn in biota of receiving streams, compared to biota of similar streams without direct influence of mining. Our results also demonstrate that metal exposure in the study area differed significantly among sample types, habitats, and years, and that these factors should be carefully considered in the design of biomonitoring studies.

Animals↗
PubMed2004

Review of the professional medical liability insurance crisis: lessons from Missouri.

OBJECTIVE: This study was undertaken to document and generalize the professional liability insurance (PLI) crisis. STUDY DESIGN: Data analysis from physician surveys, Missouri Department of Insurance, and court records. RESULTS: In 2001-2002, many insurers stopped writing new and existing PLI. A survey found 1 in 7 physicians had their PLI terminated and/or application for new insurance denied. Average premiums increased 22% in 2001 and 60% in 2002. Accordingly, 50% of surveyed obstetricians took salary cuts, 18% secured loans, 9% liquidated assets, and 55% significantly limited their clinical services. An adverse court ruling caused insurers to double reserves. Incomplete data led the Missouri Department of Insurance to erroneously conclude a decrease in claim frequency and severity. In contrast, courthouse records and missing data sources revealed increased malpractice filings. PLI premiums continue to rise. CONCLUSION: Many life-saving specialists are being forced out of business. Specialists are less willing to care for emergency and indigent patients for fear of liability exposure. Legislative enactments leading to meaningful tort reform, public support, and judicial restraint must occur to save health care.

Defensive Medicine↗
PubMed2004

Child maltreatment in Missouri: combining data for public health surveillance.

BACKGROUND: Public health surveillance was established for nonfatal child maltreatment in Missouri using two data sources. This paper describes the epidemiology of nonfatal child maltreatment using this surveillance system, and assesses the usefulness of combining medical data with child protective services (CPS) reports for child maltreatment surveillance. METHODS: Child abuse and neglect reports for children aged <10 years for 2000 were obtained from the Missouri Division of Family Services (DFS) and linked to hospital discharge and emergency department (ED) data for 2000. Children were classified as maltreated if they had an International Classification of Disease (ICD) maltreatment code for a hospital or ED visit, or a substantiated report to DFS. Validity of the ICD maltreatment codes was assessed in a 10% random sample of the hospital/ED visits. Medical records were reviewed to determine the accuracy of the maltreatment code assigned. The data analyses reported here were conducted in 2002 and 2003. RESULTS: In the linked data, 5657 children met the case definition of maltreatment, providing a nonfatal maltreatment rate of 7.4/1000 children. Rates were higher among children aged <1 year (8.4/1000), females (7.7/1000), African Americans (11.8/1000), and children residing in rural counties (8.7/1000). The hospital/ED data identified proportionately more children who were African American, urban, physically abused, or infants, and uniquely identified only 10% of the total cases. In the validation sample, maltreatment was documented in 110 (87%) of the 127 records reviewed. CONCLUSIONS: CPS and medical data can be linked for surveillance. However, the medical data add few unique cases and identify only a subset of maltreated children.

Age Distribution↗
PubMed1997

Estimated prevalence of paratuberculosis in Missouri, USA cattle.

An absorbed ELISA for detection of antibodies against Mycobacterium paratuberculosis was performed on serum samples obtained from the Missouri Animal Health Laboratory. Samples from 1954 Missouri cattle representing 89 herds were randomly selected from samples submitted for brucellosis testing. The apparent seroprevalence of paratuberculosis in dairy cattle (8 +/- 3%) was similar to that in beef cattle (5 +/- 2%). When herds were classified as dairy or beef, 74% (14 of 19) of dairy herds and 40% (27 of 68) of beef herds were positive.

Animals↗