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At least 919 records · Page 51Linked to original sources

Minimally invasive surgeons of Texas: a new concept in fellowship training.

Minimally invasive fellowship training has seen phenomenal growth, with 94 organized fellowship programs in North America. Training experience is varied across programs owing to the differences in surgical practices. Many programs are often weighted to a specific field of advanced laparoscopic surgery, which can limit a fellow's clinical experience. Minimally Invasive Surgeons of Texas (MIST) is a combined organization of four independent private practice and academic MIS fellowships brought together for the common goal of improved fellowship training.

Academic Medical Centers↗

Characterization of a novel autosomal dominant bleeding disorder in a large kindred from east Texas.

A large east Texas family with autosomal dominant inheritance of a novel bleeding disorder has been identified. The disorder is characterized clinically by easy bruising, life-threatening bleeding with trauma or surgery, and menorrhagia in affected women. Laboratory studies demonstrated prolongation of the prothrombin time and activated partial thromboplastin time in affected individuals. Paradoxically, assays of known coagulation factors are all within normal limits. To determine the molecular basis of this disease, a candidate gene linkage analysis in this kindred was done. Initially it was hypothesized that the cause of the disease in this family could be an antithrombin III (AT3) mutation that resulted in a constitutively active AT3 in the absence of heparin binding. Linkage studies using DNA from the family and an intragenic polymorphic marker within the AT3 gene showed that the disease mapped to this locus. The coding region and intron/exon junctions of AT3 were sequenced using the proband's DNA, but this analysis failed to identify a mutation. Additional family members were recruited for the study, and 16 polymorphic markers around the AT3 gene were analyzed. Using 2 recombinants, the critical interval for the defective gene was narrowed to approximately 1.5 Mb, centromeric to AT3. The factor V (FV) gene was mapped into the disease interval and sequenced; there were no mutations found. Elucidation of the genetic defect causing the bleeding disorder in this family may reveal a novel protein involved in the coagulation cascade.

Adult↗

Development and assignment of bovine-specific PCR systems for the Texas nomenclature marker genes and isolation of homologous BAC probes.

In 1996, Popescu et al. published the Texas standard nomenclature of the bovine karyotype in which 31 marker genes, already mapped in man, were chosen to permit unambiguous identification and numbering of each bovine chromosome. However, specific PCR systems were not available for each marker gene thus preventing the assignment of part of these markers by somatic cell hybrid analysis. In addition, some difficulties remained with the nomenclature of BTA25, BTA27 and BTA29. In this work, specific PCR systems were developed for each of the marker genes except VIL1 (see results), from either existing bovine or human sequences, and a bovine BAC library was screened to obtain the corresponding BAC clones. These PCR systems were used successfully to confirm the assignment of each marker gene (except for LDHA, see results) by analysis on the INRA hamster-bovine somatic cell hybrid panel. The difficulties observed for LDHA and VIL1 are probably due to the fact that these genes belong to large gene families and therefore suggest that they may not be the most appropriate markers for a standardisation effort. This panel of BACs is available to the scientific community and has served as a basis for the establishment of a revised standard nomenclature of bovine chromosomes.

Animals↗

26th Annual San Antonio Breast Cancer Symposium, San Antonio, Texas, USA, 3-6 December 2003: update on clinical research.

The San Antonio Breast Cancer Symposium is an international meeting dedicated to the translation of advances in cellular and molecular biology of breast disease into clinical improvements in prevention, diagnosis and treatment. This report summarizes the clinical highlights of the 26th annual meeting held in San Antonio, Texas on 3-6 December 2003. Breast care for women will be improved by reports concerning optimal adjuvant hormonal therapy, advances in chemotherapy and a shift in the clinical philosophy of breast cancer care from maximum tolerable treatment to minimum effective therapy.

Antibodies, Monoclonal↗

Folic acid calls to poison centers in Texas, 1998-2003.

Folic acid (folacin, pteroylglutamic acid) is a monoglutamate form of the water-soluble B vitamin that is involved in the synthesis of nucleotides and amino acids and the normal maturation of red blood cells. This study describes the folic acid calls received by Texas poison centers during 1998-2003. There were 650 calls involving folic acid as a single-ingredient product, of which 55.1% were human exposures. Children age <6 years accounted for 80.1% of the human exposures. Patients were managed outside of the health care facilities in 92.1% of the cases. Of those cases with a known medical outcome, 94.8% had no clinical effects. This study found folic acid exposures reported to poison centers were unlikely to have more than minor adverse affects.

Adolescent↗

Nutmeg intoxication in Texas, 1998-2004.

Nutmeg is a spice that contains volatile oils comprised of alkyl benzene derivatives (myristicin, elemicin, safrole, etc.), terpenes and myristic acid. Nutmeg has a long history of abuse. This study describes the nutmeg ingestion calls received by Texas poison centers from 1998 to 2004. There were 17 calls involving nutmeg ingestion, of which 64.7% involved intentional abuse. When abuse and non-abuse ingestions were compared, abuse ingestions were more likely to involve males (100 versus 66.7%) and adolescents (55.6 versus 16.7%). The majority of both abuse and non-abuse calls were managed outside of health care facilities (54.5 and 66.7%, respectively). None of the ingestions resulted in more than moderate clinical effects or death.

Adolescent↗

Celecoxib exposures reported to Texas poison control centers from 1999 to 2004.

Concerns have been raised about the safety of celecoxib. This study described the pattern of exposures involving only celecoxib (isolated exposures) reported to Texas poison control centers from 1999 to 2004. The mean dose was 701 mg. The patient age distribution was < or = 5 years (48%), 6-19 years (8%), and > or = 20 years (44%). In 78% of cases, exposure was unintentional. Of the exposures, 74% were managed outside of health care facilities. The final medical outcome was classified as no effect for 82% of the cases, and minor effects for 12% of the cases. Adverse clinical effects were listed for 5% of the patients, the most frequently reported being rash (3%), drowsiness (3%), pruritus (2%), and vomiting (2%). The most frequently listed treatment was decontamination by dilution (43%) or food (32%). The majority of isolated celecoxib exposures could be managed outside of health care facilities, and the outcome was generally favorable.

Adolescent↗

Assessing breast cancer knowledge, beliefs, and misconceptions among Latinas in Houston, Texas.

BACKGROUND: Limited breast cancer knowledge and beliefs, risk factors, screening procedures, and cultural barriers may keep Latinas from seeking health care. METHOD: We examined the breast cancer knowledge, beliefs, and misconceptions of 63 Latinas residing in Houston, Texas. RESULTS: More than a third of participants held a negative or fatalistic view of breast cancer, 29% believed pain was a warning sign for the disease, and 11.1% had never heard of breast cancer. CONCLUSIONS: Our findings indicate this population holds many misconceptions about breast cancer, which may have a negative impact on preventive behaviors on this minority population.

Adult↗

HTLV-I-associated myelopathy endemic in Texas-born residents and isolation of virus from CSF cells.

We report three Texas-born patients with spastic paraparesis and well-documented infection with HTLV-I. CSF examination showed moderate pleocytosis, protein elevation, and elevated IgG index. Oligoclonal bands were present in two patients. On MRI, one patient had frontal lobe lesions that were low intensity on T1- and high intensity on T2-weighted images. HTLV-I immunoblot studies of serum and CSF revealed reactivity to p19, p24, p53, gp46, or gp68 from all three patients. Titration studies of serum and CSF antibodies on ELISA and immunoblot assays indicated an intrathecal virus-specific response. HTLV-I-specific p19 antigen capture assay and polymerase chain reaction (PCR) demonstrated HTLV-I in lymphocyte cultures derived from each patient's peripheral blood mononuclear cells (PBMC) or CSF cells. Using HTLV-I- and HTLV-II-specific pol and gag primers, PCR studies of PBMC cells obtained directly from the patients demonstrated that the patients were infected with HTLV-I and not HTLV-II. These three cases are to our knowledge the only US cases in whom virus isolation from the CSF has been accomplished. Importantly, two patients may be the first US cases of myelopathy arising from endemic infection.

Adult↗

Neurosurgical oncology at the university of Texas M. D. Anderson Cancer Center: its genesis and evolution.

The practice of neurosurgery at The University of Texas M. D. Anderson Cancer Center began in 1944 with one neurosurgeon among the 11 physicians present in a makeshift 16-room outpatient clinic at a temporary location. Neurosurgical oncology evolved as the hospital did, first as a neurosurgery service in 1951, then as the Section of Neurosurgery within the Department of Head and Neck Surgery in 1979, and finally, as the Department of Neurosurgery in 1990. Although M. D. Anderson is now one of the largest institutions in the world devoted exclusively to cancer patient care, research, education, and prevention, it has an unusual history, which is reviewed in terms of the institution's origin in 1941, its development under three presidents, and its fostering of neurosurgical oncology. We chronicle the growth and development of the department from 1990 to 2003 and describe the unique opportunities it presents for surgical innovation, for clinical and basic research, for training residents and fellows, and for multidisciplinary collaboration in neurosurgical oncology.

Hospitals, University↗

Congenital syphilis in Harris County, Texas, USA, 1990-92: incidence, causes and risk factors.

From local health department data, we determined the 1990-92 incidence of congenital syphilis (CS) in Harris County, Texas, USA, applying for the first time the Centers for Disease Control and Prevention (CDC) 1990 surveillance case definition to a population-based sample. We also evaluated factors that discriminated between women whose infants were or were not cases. The incidence of CS per 1000 live births was 3.2 in 1990, 4.6 in 1991 and 4.2 in 1992. Because of failure to apply part of the case definition, the local health department reported only 60% (418/694) of the cases that we identified. In the multivariate analysis, the significant factors for CS were lack of prenatal care and late latent syphilis. No factor identified high-risk women to target for special public health interventions. Improved laboratory services and better education of local providers and surveillance workers will solve some problems in the diagnosis and therapy of syphilis during pregnancy. Ambiguity in the CDC's case definition of CS needs correction.

Female↗

Assessing exposure to disinfection by-products in women of reproductive age living in Corpus Christi, Texas, and Cobb county, Georgia: descriptive results and methods.

We conducted a field study in Corpus Christi, Texas, and Cobb County, Georgia, to evaluate exposure measures for disinfection by-products, with special emphasis on trihalomethanes (THMs). Participants were mothers living in either geographic area who had given birth to healthy infants from June 1998 through May 1999. We assessed exposure by sampling blood and water and obtaining information about water use habits and tap water characteristics. Two 10-mL whole blood samples were collected from each participant before and immediately after her shower. Levels of individual THM species (chloroform, bromodichloromethane, dibromochloromethane, and bromoform) were measured in whole blood [parts per trillion (pptr)] and in water samples (parts per billion). In the Corpus Christi water samples, brominated compounds accounted for 71% of the total THM concentration by weight; in Cobb County, chloroform accounted for 88%. Significant differences in blood THM levels were observed between study locations. For example, the median baseline blood level of bromoform was 0.3 pptr and 3.5 pptr for participants in Cobb County and Corpus Christi, respectively (p = 0.0001). Differences were most striking in blood obtained after showering. For bromoform, the median blood levels were 0.5 pptr and 17 pptr for participants in Cobb County and Corpus Christi, respectively (p = 0.0001). These results suggest that blood levels of THM species vary substantially across populations, depending on both water quality characteristics and water use activities. Such variation has important implications for epidemiologic studies of the potential health effects of disinfection by-products.

Activities of Daily Living↗

The nursing home crisis: a consumer study of Texas nursing home care.

This article discusses the findings of a consumer-oriented survey to ascertain the perceptions of Texas nursing home residents, their families, and nursing home administrators about what factors they believe contribute to quality of care. The findings from previous studies and established practice standards are then used to further delineate the practice roles and functions of social workers in nursing facilities (NFs) and to inform social work curriculum.

Aged↗

Texas entry-year agriculture teachers' perceptions, practices, and preparation regarding safety and health in agricultural education.

The purpose of this study was to gather benchmark data for the assessment of the knowledge, attitudes, and perceptions regarding agricultural safety issues and curricula held by Texas agricultural teachers with less than two full years of teaching experience (entry-year teachers). Seventy-four of 118 well-distributed teachers responded to this survey. Researchers concluded that more females were entering a traditionally male-dominated field. Overall, teachers addressed safety within units of instruction rather than as separate units. The most useful forms of new teaching resources that this group of teachers would like to see produced were safety videos and study guides, and class demonstration/simulation activities. There was a significant difference in rankings between teachers less than 26 years old and teachers more than 26 years old regarding the usefulness of transparencies as a new teaching resource (F = 5.00, p = 0.0268). Few teachers were currently CPR and first aid certified, even though most had received training and completed a general safety and/or health related course while in college. Teachers generally agreed philosophically with most practices and exhibited personal beliefs consistent with proper safety preparedness and practice in agricultural settings. However, many of these teachers failed to practice what was expected of safe tractor operators, such as wearing safety belts and allowing younger drivers to operate the equipment.

Adult↗

Barriers to counseling patients with obesity: a study of Texas community pharmacists.

OBJECTIVE: To assess barriers to the counseling of obese patients and identify pharmacists' characteristics associated with these barriers. DESIGN: Cross-sectional mail survey. SETTING: Texas. PARTICIPANTS: 139 community pharmacists. INTERVENTION: Self-administered questionnaire. MAIN OUTCOME MEASURES: Respondents' perceived barriers to pharmacists' counseling of obese patients. RESULTS: The top three barriers to counseling included lack of time (76.8%), lack of patient demand or expectations (55.8%), and lack of reimbursement/compensation (49.3%). Pharmacists indicated that they rarely to sometimes counseled obese patients and were somewhat comfortable with counseling about obesity management. They perceived obesity management strategies to be somewhat effective in weight loss, but were neutral regarding their confidence in achieving positive outcomes with counseling. Pharmacists who were more experienced were more likely to indicate that obesity is controllable without medications. Those who considered obesity controllable without medications were significantly more likely to view the various obesity management strategies as less effective, compared with those who did not share this belief. Pharmacists who viewed lack of privacy as a barrier were significantly less confident in achieving positive outcomes as a result of counseling. Creating awareness among patients about pharmacists' ability to counsel was perceived as most important in overcoming barriers. CONCLUSION: Pharmacists identified several barriers to counseling of obese patients. Pharmacists' demographics and beliefs about obesity were significantly associated with their perceived barriers.

Community Pharmacy Services↗

Economic consequences of unused medications in Houston, Texas.

BACKGROUND: It is likely that a large amount of unused and outdated medications exists in households throughout the US; however, the amount and potential costs of these medications are unknown. OBJECTIVE: To determine the amount, types, and costs of unused medications present in a neighborhood surrounding a community pharmacy in Houston, Texas. METHODS: A community trial was conducted between April and September 2002. This pilot study investigated the quantity and types of drugs returned to a community pharmacy over a 6-month period. RESULTS: During the study period, approximately 17000 oral pills worth over US dollars 26000 were collected in 1315 medication containers. Medications collected were from all drug classes and types (pharmaceutical samples, over-the-counter and prescription drugs). CONCLUSIONS: This study demonstrated that an enormous amount of unused medications were present in a community in the US. Community pharmacies may be an ideal venue to collect and destroy these unused drugs.

Community Pharmacy Services↗

Adult atomoxetine ingestions reported to Texas Poison Control Centers, 2003-2005.

BACKGROUND: Limited information exists on outcomes from adult ingestions of atomoxetine reported to poison control centers. OBJECTIVE: To identify factors that might affect the outcome of adult atomoxetine ingestions reported to poison control centers. METHODS: Using adult ingestions of atomoxetine alone reported to Texas poison control centers during 2003-2005, the proportion of cases involving serious outcomes was determined for selected variables and evaluated for statistical significance by calculating the rate ratio (RR) and 95% confidence interval (CI). RESULTS: Of 64 cases identified, 9 (14%) involved serious outcomes. No serious outcomes were reported with a maximum dose of 100 mg or less. Serious outcomes were significantly more likely to occur with a maximum dose of more than 2 capsules (RR 8.25; 95% CI 1.48 to 83.58), where the circumstances of the exposures involved self-harm or malicious intent (RR 6.02; 95% CI 1.30 to 30.35) or when the patient was already at or en route to a healthcare facility when the poison control center was contacted (RR 18.75; 95% CI 2.10 to 886.83) or was referred to a healthcare facility by the poison control center (RR 22.50; 95% CI 1.81 to 1181.19). CONCLUSIONS: The severity of the outcomes associated with adult atomoxetine ingestions depended on the dose taken and the circumstances of the ingestion. The management of patients with serious outcomes was more likely to involve healthcare facilities. Such information is useful in creating triage guidelines for the management of adult atomoxetine ingestions.

Adult↗

Demographic and audiological profiles of deaf children in Texas with cochlear implants.

This paper reports the findings of a study that examined the demographic, educational, and audiological characteristics of a sample of children in Texas who had received cochlear implants. Children who had received implants and children who had not were compared. Differences between the two groups are discussed in the context of the criteria that have been published in the literature for selecting implant candidates. Results indicate that although the published selection criteria were predictive of the characteristics of the implanted sample, there was a degree of flexibility in applying the criteria to choose implant recipients. Audiological comparisons revealed that cochlear implant recipients experience greater reductions in average hearing thresholds than do users of conventional aids, although these findings should be viewed as preliminary.

Achievement↗