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Seasonal persistence and population characteristics of Escherichia coli and enterococci in deep backshore sand of two freshwater beaches.

We studied the shoreward and seasonal distribution of E. coil and enterococci in sand (at the water table) at two southern Lake Michigan beaches-Dunbar and West Beach (in Indiana). Deep, backshore sand (approximately 20 m inland) was regularly sampled for 15 months during 2002-2003. E. coli counts were not significantly different in samples taken at 5-m intervals from 0-40 m inland (P = 0.25). Neither E. coli nor enterococci mean counts showed any correlation or differences between the two beaches studied. In laboratory experiments, E. coli readily grew in sand supplemented with lake plankton, suggesting that in situ E. coil growth may occur when temperature and natural organic sources are adequate. Of the 114 sand enterococci isolates tested, positive species identification was obtained for only 52 (46%), with E. faecium representing the most dominant species (92%). Genetic characterization by ribotyping revealed no distinct genotypic pattern (s) for E. coli, suggesting that the sand population was rather a mixture of numerous strains (genotypes). These findings indicate that E. coli and enterococci can occur and persist for extended periods in backshore sand at the groundwater table. Although this study was limited to two beaches of southern Lake Michigan, similar findings can be expected at other temperate freshwater beaches. The long-term persistence of these bacteria, perhaps independent of pollution events, complicates their use as indicator organisms. Further, backshore sand at the water table may act as a reservoir for these bacteria and potentially for human pathogens.

Bathing Beaches↗

Dihydropyrimidine dehydrogenase activity in human peripheral blood mononuclear cells and liver: population characteristics, newly identified deficient patients, and clinical implication in 5-fluorouracil chemotherapy.

Dihydropyrimidine dehydrogenase (DPD) is the initial and rate-limiting enzyme in the catabolism of 5-fluorouracil (FUra), one of the most widely used anticancer drugs. Previous studies from our laboratory demonstrated the clinical importance of DPD in cancer patients (G. D. Heggie, J-P. Sommadossi, D. S. Cross, W. J. Huster, and R. B. Diasio. Cancer Res., 47: 2203-2206, 1987; B. E. Harris, R. Song, S-j. Soong, and R. B. Diasio. Cancer Res., 50: 197-201, 1990), particularly in those with DPD deficiency who experience severe FUra toxicity (including death) following FUra treatment [R. B. Diasio, T. L. Beavers, and J. T. Carpenter. J. Clin. Invest., 81: 47-51, 1988; B. E. Harris, J. T. Carpenter, and R. B. Diasio. Cancer (Phila.), 68: 499-501, 1991]. We now suggest that measurement of DPD activity may be useful in routine screening of cancer patients prior to FUra treatment. In this paper, we describe the following serial studies: (a) we developed a sensitive, accurate, and precise DPD assay and a storage method to stabilize DPD activity, permitting large scale DPD screening in cancer patients; (b) we demonstrated a normal distribution (Gaussian distribution) of human DPD activity from peripheral blood mononuclear cells (PBM-DPD) in a population study. Baselines for PBM-DPD with fresh and frozen samples were 0.425 +/- 0.124 (SD) and 0.189 +/- 0.064 nmol/min/mg protein, respectively. The 95% and 99% distribution ranges for both fresh and frozen samples were also determined, providing criteria for detection of DPD-deficient patients; (c) we identified nine new patients with profound or partial DPD deficiency; (d) we determined a baseline for human liver DPD activity, which was shown to be 0.360 +/- 0.182 nmol/min/mg protein (frozen samples); (e) we did a preliminary evaluation of liver DPD from deficient patients. Low liver DPD activity in two deficient patients correlated with low PBM-DPD activity. Using a polyclonal antibody raised against human liver DPD in our laboratory (Z. Lu, R. Zhang, and R. B. Diasio. J. Biol. Chem., 267: 17102-17109, 1992), Western blot analysis demonstrated decreased DPD protein in the liver cytosol from DPD-deficient patients compared to normal subjects. These results may be useful in improving the effectiveness and/or lessening the toxicity of FUra chemotherapy.

Adult↗

Mechanical ventilation in an obstetric population: characteristics and delivery rates.

OBJECTIVE: The purpose of this study was to describe the characteristics and outcomes of obstetric patients who require mechanical ventilation. STUDY DESIGN: A review was conducted of obstetric patients who required mechanical ventilation and who received care at our institutions between 1990 and 1998. Data that were collected included maternal demographics, medical condition that necessitated ventilation, delivery status, duration of ventilation, onset of parturition while receiving ventilation, mode of delivery, and maternal and early neonatal morbidity or death. RESULTS: Fifty-one women were identified; 43 women(84%) received care in the labor and delivery setting. The most common admission diagnoses were preeclampsia/eclampsia (44%), labor/preterm labor (14%), and pneumonia (12%). Forty-three women (86%) were undelivered on admission (mean gestational age, 31.6 weeks). Delivery occurred in 37 women (86%) during their admission; 24 women (65%) underwent cesarean delivery. Eleven women began labor while receiving ventilation; 6 were delivered vaginally. The maternal mortality rate was 14% (7/51 women), and the perinatal mortality rate was 11% (4/37 fetuses). CONCLUSION: A large number of obstetric patients who receive mechanical ventilation will require delivery because of their condition. Centers that care for such women should form a treatment strategy to coordinate obstetric and medical care for this unique population

Adult↗

Population characteristics and the modulation of the renin-angiotensin system in the treatment of hypertension.

Clinical evidence supports the concept that there are racial differences in response to antihypertensive drugs. The high frequency of dietary salt sensitivity and low plasma renin activity (PRA) in hypertensives of African-American descent has been suggested by some to be the critical factor which explains this difference. Evaluation of the antihypertensive response of African-Americans to diuretics and calcium channel blockers compared to other drugs suggest that they may have an advantage in controlling blood pressure (BP). However, these comparative clinical trials have not assessed dietary salt consumption, the salt sensitivity status of the participants, nor have they explored full titration dosages of the comparative drugs. For these reasons, there is insufficient information to state with certainty whether some drugs may be more effective than others as monotherapy in controlling BP in hypertensives of African-American descent.

Black People↗

Population characteristics of markets of safety-net and non-safety-net hospitals.

RESEARCH OBJECTIVES: To compare and contrast the markets of urban safety-net (USN) hospitals with the markets of other urban hospitals. STUDY DESIGN: To develop profiles of the actual inpatient markets of hospitals, we linked 1994 patient-level information from hospital discharge abstracts from nine states with 1990 data at the ZIP code level from the US Census Bureau. Each hospital's market was characterized by its racial and ethnic composition, median household income, poverty rate, and educational attainment. Measures of hospital competition were also calculated for each hospital. The analysis compared the market profiles of USN hospitals to those of other urban hospitals. We also compared the level of hospital competition and financial status of USN and other urban hospitals. PRINCIPAL FINDINGS: The markets of USN hospitals had higher proportions of racial and ethnic minorities and non-English-speaking residents. Adults residing in markets of USN hospitals were less educated. Families living in markets of USN hospitals had lower incomes and were more likely to be living at or below the federal poverty level. USN hospitals and other urban hospitals faced similar levels of competition and had similar margins. However, USN hospitals were more dependent on Medicare disproportionate share payments and on state and local government subsidies to remain solvent. CONCLUSION: USN hospitals disproportionately serve vulnerable minority and low-income communities that otherwise face financial and cultural barriers to health care. USN hospitals are dependent on the public subsidies they receive from federal, state, and local governments. Public policies and market pressures that affect the viability of USN hospitals place the access to care by vulnerable populations at risk. Public policy that jeopardizes public subsidies places in peril the financial health of these institutions. As Medicare and Medicaid managed care grow, USN hospitals may lose these patient revenues and public subsidies based on their Medicaid and Medicare patient volumes. The loss of these funds would hinder the ability of USN hospitals to finance uncompensated care for uninsured and underinsured patients.

Demography↗

[A population survey on a mass screening program for gastric cancer. 1. Population characteristics related to examination rates for the screening program].

The types of examination received for gastric cancer during the past 3 years have been surveyed by a self-administered questionnaire among residents of a small town near Kitakyushu City. Among 3660 surveyed, 2205 subjects who completed the questionnaire are analyzed in this study. Examination rates of mass screening for males were higher than those for females. Males in their forties and fifties and females in their forties through sixties have higher examination rates than other age groups. Higher examination rates were seen in public officials and employees who have opportunities to receive the screening program at work site. On the other hand, among people without a job and housewives who have opportunities to receive a screening program offered only by the town hall, examination rates of the mass screening program were low. More people with a family history of cancer death were examined than those without a similar family history. There was no difference in the examination rates by the mass screening program between the people who took care of their health and those who did not. In order to raise examination rates for the mass screening program, it is essential to improve the systems of this program which can be easily accepted, and to educate residents in order to stimulate motivation for screening.

Adult↗

Population characteristics of extinct hominid endocranial volume.

Distribution and variation statistics of hominid endocranial volume (ECV) have been investigated. Within the interpretative constraints imposed by (very) small sample sizes, the requirements for normality are met, as are those for heteroscedasticity. A significant difference in means can be demonstrated for only two comparisons. With one exception, overall distribution characteristics differ significantly in pairwise comparisons between taxa. The coefficient of variation of ECV that characterizes a group composed of all Plio-Pleistocene gracile hominids does not support a single polytypic species interpretation of this assemblage. Significant differences in the coefficient of variation exist between all possible pairs of taxa with the exception of Homo habilis and Homo erectus.

Africa↗

The elusive population: characteristics of attenders versus non-attenders for community mental health center intakes.

The present investigation was an attempt to determine characteristics of those who appeared versus those who did not appear for initial intake evaluation appointments at a traditional community mental center. Subjects were 189 individuals contacting the center for service from November of 1989 to April of 1990. Data were collected via self-report questionnaire and blind rating by clinical social workers of presenting problem for diagnostic category. Data analysis involved Chi-square procedures and Analysis of Variance. Those who appeared for initial appointment versus those who did not were differentiated with respect to employment versus unemployment, length of unemployment, tenure at current job, number of jobs in the past year, number of residences in the past year, tenure at current residence and number of marriages. Groups did not differ with respect to age, gender, ethnicity, martial status, income, educational attainment, legal difficulties, public assistance, referral sources, alcohol/drug problems, and a variety of variables related to mental health or treatment history and diagnostic category. Results were interpreted as supporting the hypothesis that attendance was related to recent life stability as opposed to more general demographic and socioeconomic factors and clinically related variables. Implications for increasing treatment utilization, particularly by those who are underserved in community mental health, were discussed.

Adolescent↗

Population characteristics of hepatic dihydropyrimidine dehydrogenase activity, a key metabolic enzyme in 5-fluorouracil chemotherapy.

Dihydropyrimidine dehydrogenase is the initial rate-limiting enzyme in catabolism of 5-fluorouracil, one of the most widely used cancer chemotherapeutic agents. Previous studies have shown the clinical importance of determination of dihydropyrimidine dehydrogenase in patients with cancer, particularly in those with deficiency of this enzyme who experience severe 5-fluorouracil-associated toxicity (including death) after 5-fluorouracil treatment. In the present study, dihydropyrimidine dehydrogenase activity was determined in 138 donor liver samples. A normal distribution of human liver dihydropyrimidine dehydrogenase activity was shown. The mean enzyme activity was compared across different groups by age, gender, and race, with no significant differences observed except that the mean enzyme activity in women was slightly higher than that observed in men. With use of a polyclonal antibody generated against human liver dihydropyrimidine dehydrogenase, Western blot analysis showed that dihydropyrimidine dehydrogenase protein in the liver cytosol correlated with the activity of this enzyme.

Adult↗

"Population" characteristics of birthweight in an animal model of alcohol-related developmental effects.

A retrospective analysis of a large database of maternal and litter variables in rats collected over several years evaluated the robustness of fetal alcohol effects on birthweight. Pregnant rats were fed a liquid diet in which 35% of the calories were derived from alcohol. Control dams were pairfed an isocaloric liquid diet or were fed lab chow ad lib. Alcohol exposure produced large, highly significant, and reliable decreases in birthweight of male and female pups. Multiple regression analyses indicated that alcohol exposure per se, much more than restricted caloric intake alone, caused these effects. Litters of pairfed dams weighed less than chowfed controls but the effects were less consistent, varying with season and requiring more litters to discriminate the effects of restricted caloric intake. Power analyses indicated that 7 to 12 litters per group are needed for detecting a statistically significant reduction in birthweight due to prenatal alcohol exposure, even with single pups selected at random from each litter. Alcohol-exposed pups also weighed consistently and significantly less than both the chowfed and pairfed pups, whereas differences between chowfed and pairfed groups were much smaller and inconsistent. The results imply that decreased birthweight is a consistent characteristic of prenatal alcohol exposure.

Animals↗

Population characteristics of traffic accident-related deaths in Japan and Ireland, 1950-2000.

To compare epidemiological characteristics of traffic accidents in Japan and Ireland, we analyzed mortality and the negative effect on life expectancy between 1950 and 2000 and generated a multivariate model. The characteristics were similar in the two countries: The time trends showed an increase in mortality followed by a decrease. The mortality rates were about 13 and 5/100,000 for males and females, respectively, in 2000. Correlation coefficients for sex were over 0.9. Age distribution obeyed the natural logarithm regularity. The negative effect on life expectancy was about 0.34 year for males, and 0.13 year for females. The economic level was positively associated with mortality, whereas "number of vehicles owned" was associated negatively. In conclusion, we can take advantage of the broad consistencies in these two countries when we draw up an intervention strategy. Any preventive strategy should be directed to the young, particularly males.

Accidents, Traffic↗

Epilepsy and workplace discrimination: population characteristics and trends.

This study investigates the nature of allegations of workplace discrimination made by job seekers and workers with epilepsy. Demographic characteristics of individuals making allegations were consistent with those of individuals with epilepsy nationwide. Approximately three-fourths of allegations were related to post-hire issues, such as discrimination in promotion and termination, disciplinary actions, and harassment. The lowest rate of merit allegation was related to discrimination in hiring. Comparison of merit allegations before and after the U.S. Supreme Court's Sutton decision revealed that claimants have had higher rates of success following the decision, suggesting that the Sutton decision has had no negative effect on claimants with epilepsy.

Adult↗

Low-dose computed tomography screening for lung cancer in a general population: characteristics of cancer in non-smokers versus smokers.

RATIONALE AND OBJECTIVES: To report the detection rate for lung cancers in computed tomography (CT) screening in Japanese adults, and to analyze differences in the appearance of the cancers in non-smokers versus smokers. MATERIALS AND METHODS: Subjects consisted of 7,847 Japanese adults who received low-dose CT screening at least once in a 3-year period. The detection rate of lung cancers and the correlation of imaging, clinical, and pathologic findings of cancers in non-smokers versus smokers were examined. RESULTS: The detection rate for lung cancer was 1.1% for both non-smokers (45 of 4,251) and smokers (39 of 3,596). The prevalence of well-differentiated adenocarcinomas was greater in non-smokers (88%; 22 of 25) than in smokers (29%; 4 of 14) (P < .001). The prevalence and incidence of pathologic stage IA disease were greater in non-smokers than in smokers (92%; [22 of 24] vs 58% [7 of 12], and 100% [19 of 19] vs 70% [14 of 20]) (both P < .05). The mean size of the tumors in the non-smokers (12.4 mm) was smaller than that in smokers (18.2 mm) (P < .001). The percentage of cancers categorized as pure or mixed ground-glass opacity (86%; 38 of 44) on CT was greater in non-smokers than in smokers (46%; 16 of 35) (P < .001). CONCLUSION: Most of the lung cancers in non-smokers were slow-growing adenocarcinomas appearing as faint ground-glass opacities on CT, whereas rapidly growing cancers appearing as solid nodules were more commonly seen in smokers.

Adenocarcinoma↗