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PubMed2001

Antipsychotic prescribing patterns in the Texas prison system.

Although prison inmates are reported to exhibit elevated rates of psychotic disorders, little is known about antipsychotic pharmacotherapy in correctional settings. Therefore, the purpose of this study is to describe antipsychotic prescribing patterns in one of the nation's largest prison systems. The study population consisted of 3,750 Texas Department of Criminal Justice (TDCJ) inmates diagnosed with schizophrenic disorders, nonschizophrenic psychotic disorders, or both. In 1998, among inmates diagnosed with schizophrenic disorders, 14.6 percent were prescribed atypical antipsychotic agents, and 85.4 percent were prescribed typical antipsychotic agents. Among inmates diagnosed with nonschizophrenic psychotic disorders, 89.3 percent were prescribed typical antipsychotic agents, while 10.7 percent were prescribed atypical antipsychotic agents. Black males and females were prescribed atypical antipsychotic agents less frequently than their counterparts. Understanding such prescribing patterns is integral to the efficient and cost-effective planning of correctional mental health care.

Adolescent↗
PubMed2001

Suicide in Travis County, Texas, from 1994 through 1998.

Suicide, the ninth leading cause of death in the United States, has not been adequately studied in Travis County, Texas. To describe the occurrence of completed suicide in Travis County, 426 cases of completed suicide from 1994 through 1998 were collected and the data were analyzed with the chi 2 test and the t test. The annual suicide rate in Travis County is 13.0 per 100,000. Caucasian males have the highest annual suicide rate among all races, followed by Hispanics and, then, blacks. The highest suicide rate was seen in persons aged 75 years and older. The second most frequent rate was for those aged 45 through 54 years. Guns are the most common means of suicide in both males and females (60.8% and 37.3%, respectively). A person who is Caucasian, male, and aged 75 years and older is at the highest risk. Reducing the availability of firearms may have a significant impact on the suicide rates in Travis County.

Adolescent↗
PubMed2000

The development of sirolimus: The University of Texas-Houston experience.

The transplant team at The University of Texas-Houston has studied sirolimus from preclinical through pivotal Phase III trials to single-center Phase IV trials as we continue to refine algorithms for sirolimus therapy. The sirolimus/CsA combination produces a marked reduction in the occurrence and severity of acute allograft rejection episodes. A recently completed post hoc median effect analysis of drug blood concentrations displayed by patients in the 2 pivotal Phase III trials documented that the combination displays synergistic interactions. Patients in the sirolimus/CsA arms did not display an increased incidence of infectious or malignant complications. However, they did experience a range of nonimmune toxicities, including potentiation of putatively CsA-related adverse reactions, such as renal dysfunction and hypercholesterolemia, which appear to be mitigated by reduction or elimination of CsA. However, thrombocytopenia and to a lesser extent leukopenia and anemia appear to be sirolimus-related side effects. The occurrence and severity of these adverse reactions seem to be avoided or ameliorated in most patients by optimizing sirolimus exposure at concentrations (15 ng/mL or by dose reduction. Sirolimus thus appears to be a potent and unique agent for developing new immunosuppressive strategies in organ transplantation.

Animals↗
PubMed2002

Cat-scratch disease in children--Texas, September 2000-August 2001.

Cat-scratch disease (CSD), a bacterial infection caused by Bartonella henselae, has emerged as a relatively common and occasionally serious zoonotic disease among children and adults. To illustrate the spectrum of clinical manifestations of CSD observed during a 1-year period, Texas Children's Hospital (TCH) in Houston reviewed the medical records of 32 children evaluated at TCH during September 2000-August 2001 whose antibody titers indicated recent Bartonella infection. This report summarizes the evaluations of these cases and highlights four manifestations of infection with this pathogen in children. The findings emphasize that although CSD is generally a mild, self-limited illness, the differential diagnosis often includes more serious conditions (e.g., lymphoma, carcinoma, mycobacterial or fungal infection, or neuroblastoma) that might result in protracted hospital stays and lengthy treatments before diagnosis. Timely assessment of CSD is important, particularly when invasive diagnostic measures are being considered.

Bartonella henselae↗
PubMed2002

Prenatal HIV testing in private OB-Gyn practices in Texas.

This study evaluates the prenatal human immunodeficiency virus (HIV) testing behaviors of private obstetrics and gynecology practitioners in Texas. A statewide telephone survey of 614 providers of prenatal care determined the level of HIV testing, how testing is offered, and patient acceptance of the test. Ninety-nine percent of the practices offered HIV testing to all their pregnant patients, and 96% of the practices included HIV testing in the routine panel of tests for pregnant patients. More than 95% of the practices reported that 10% or less of the women refused the test when offered it; 73% of the practices reported no refusals. Less than half of the practices, however, discussed HIV prevention topics, and only 29% of the practices referred high-risk pregnant patients for prevention counseling. Although private practices of obstetrics and gynecology report testing almost all their prenatal patients, survey results suggest that providers could improve their prevention and patient education practices.

AIDS Serodiagnosis↗
PubMed2002

Enforcing prompt-payment regulations: the Texas approach.

To ensure that insurance carriers pay providers in a timely manner, Texas has adopted strict payment regulations. Enforcement of the regulations has led to restitution payments for many providers. However, issues such as clean claims, underpayment, discrepancies in payment dates, and self-funded claims continue to present challenges.

Efficiency, Organizational↗
PubMed2002

An analysis of the reactivity of vaccines administered in Texas from 1991 through 1999.

Vaccination is one of the greatest advances in medical history. Continued improvements in vaccination will include the introduction of new vaccines and the improvement of the efficacy and safety of existing vaccines. This report analyzes the 8623 reports made to the Vaccine Adverse Events Reporting System from the state of Texas from 1991 through 1999. The severity, time of onset, and vaccine type of the reactions, as well as the sex and age of those affected, were examined. Physicians and other health care providers need to be vigilant in their reporting of adverse reactions to vaccines. Persons injured by vaccination should be referred to the National Vaccine Injury Compensation Program.

Adolescent↗
PubMed2002

5' dinucleotide repeat polymorphism of NRAMP1 and susceptibility to tuberculosis among Caucasian patients in Houston, Texas.

SETTING: Houston Tuberculosis Initiative (HTI) and Baylor College of Medicine, Houston, Texas. OBJECTIVE: To further explore the association between the polymorphisms of NRAMP1 and human susceptibility/resistance to tuberculosis (TB), specifically to determine whether the reported association shown for blacks and Asians holds true for Caucasian populations. DESIGN: In a case-control study, 135 adult Caucasian TB patients and 108 adult Caucasian HIV-seronegative non-TB controls were analyzed for the association between the polymorphisms in NRAMP1 gene and clinical TB. RESULTS: Heterozygote at 5'(GT)n, a dinucleotide repeat polymorphism in the promoter of NRAMP1, was observed at significantly higher frequencies among HIV-negative patients with pulmonary TB (41.6%; OR 2.02; 95%CI 1.11-3.64), extra-pulmonary TB (66.7%; OR 4.80; 95%CI 1.34-17.15), and HIV-seropositive TB patients (50%; OR 3.77; 95%CI 1.33-10.66) in comparison with the controls (27.8%). Homozygotes (GT)(10,10) were over-represented among HIV-positive TB patients (18.2%; OR 6.86; 95%CI 1.55-30.21) compared to the controls (5.5%). CONCLUSION: These findings suggest that the 5'(GT)n polymorphism of NRAMP1 modifies TB susceptibility in this Caucasian population, and could possibly be related to the site of infection among HIV-negative individuals and HIV-coinfected TB.

Adult↗
PubMed1983

Potential labor force supply and replacement in Mexico and the states of the Mexican Cession and Texas: 1980-2000.

"The purpose of this article is to carry forward the examination of potential labor force supply and replacement of men in Mexico into the 1980-1990 and 1990-2000 decades so that the possible future course of international migration between that country and the United States may be better anticipated. In addition, to provide a degree of developmental perspective, trends in potential labor force supply and replacement in Mexico since 1930-40 are presented." As a contrast, "ratios of potential labor force supply and replacement in the southwestern United States--the states of the Mexican Cession and Texas, which were formerly part of Mexico--also are shown for the 1980-1990 and 1990-2000 intervals." The results suggest that "in Mexico, the projected number of males entering the labor force ages will be about 48 percent larger in the 1980s than in the 1970s.... Fertility declined significantly in Mexico in the 1970s, and therefore the number of new entrants to the labor force ages in the 1990s will decline...." The implications for international migration between Mexico and the United States are considered.

Americas↗
PubMed1987

Patterns of household immigration into South Texas.

This article examines Mexican migration into South Texas in recent decades and focuses on changes in the characteristics of the migrants' households. An ethnographic approach is used in examining 56 permanent, immigrant households. "This article introduces a hypothesis for explaining the increase and permanency of household immigration." It is found that "immigration often leads to downward social mobility with respect to legal status of household members, type of employment, and property ownership. Of particular note is the transformation of the household from a single to a multiple worker unit, in response to agricultural labor demands and growing employment opportunities in the non-agricultural sector."

Agriculture↗
PubMed2002

Common fraud experienced by the elderly: findings from a 1998 survey in Houston, Texas.

This study investigated the types and frequency of frauds experienced by seniors of different ethnic groups attending senior centers in 1998. Two hundred seniors aged 65 years or older were surveyed at 6 selected senior centers in Houston, Texas, and were asked to report the occurrence of frauds over the past year. Forty-three seniors (27%) responded that they had been victims of frauds, such as fake free prizes, work around the house, products to improve health and beauty, false insurance coverage, fees paid to attorneys and accountants, appliance repairs, credit restoration, investment participation, magazine subscriptions, and training courses. The prevalence of a reported experience with frauds by race or ethnicity was 47% of Hispanic seniors, 35% of African Americans, 25% of non-Hispanic whites, and 10% of Asians. The multivariate analysis adjusting for demographic factors showed that risk of experiencing frauds had no statistically significant association with age, gender, ethnicity, or marital and living status.

Aged↗
PubMedDate not supplied

Needs assessment and the use of services by east Texas rural elderly.

This study is concerned with the methodology of needs assessment and an understanding of why the East Texas rural elderly don't take advantage of existing programs and services. Data were obtained through 25 in-depth interviews and brief interviews of clients and service personnel in senior centers, meal sites, and agencies. It was found that direct assessment of needs (via direct question, suggestion lists, contingency planning, and projection) may not be possible. The elderly are reluctant to admit need in this particular setting or accept help and may even deny using services. They seem to have devised their own model of services with those perceived to have been earned or which require a donation most acceptable and those having a minimum income eligibility least acceptable. Findings are explained in terms of relative deprivation and through an analysis of the social and economic history of age cohorts representing the older, younger, and future elderly. It is concluded that, since successful cohorts have experienced better times and a more liberal social atmosphere, they will feel increasingly needier and be increasingly aggressive about getting assistance.

Aged↗
PubMed2002

A study of hepatitis A seropositivity in Dallas County, Texas, 1998 through 1999.

This paper provides background information on the epidemiology and a descriptive analysis of infection with hepatitis A virus in Dallas County, Texas, for 1998 and 1999. Reported cases were obtained from the Dallas County Health Department, and incidence rates per 100,000 population were calculated. Persons who tested seropositive for hepatitis A virus between January 1, 1998, and December 31, 1999, were included. Variables of interest included age, sex, race, and date of occurrence. The overall incidence rate of this infection in Dallas County for 1998 was 1.9 times higher than that of the United States; in 1999, the overall rate for Dallas County increased by more than 1.6 times. Rates were significantly higher among males, highest among Hispanics, and lowest among blacks for both years. Incidence rates among age groups varied between years by increasing in people 50 years and older from 1998 to 1999 as a result of a single cafeteria-related outbreak of 150 cases in March 1999. Infection with hepatitis A virus remains the most reported vaccine-preventable disease in the United States.

Adolescent↗
PubMed2003

Case report: ophthalmomyiasis externa in Dallas County, Texas.

Ophthalmomyiasis externa is an uncommon condition in North America. If not recognized and managed accordingly, it can be complicated by the potentially fatal condition ophthalmomyiasis interna. Ophthalmomyiasis externa is mainly caused by the sheep bot fly Oestrus ovis; thus, it is more common in farming communities. We report a case of ophthalmomyiasis externa in a young woman from Dallas County, Texas, who had no known history of contact with farm animals.

Adolescent↗
PubMed2003

Transnational licensure: view from Texas.

Texas has a diverse population with many underserved communities and a dentist-to-population ratio only 80% of the national average. Currently dentists trained in other countries can be licensed after completing four years of dental school and passing either the Western or Central Regional Testing Association's examination or by completing a graduate program in an ADA-accredited specialty. Although there have been careful and lengthy analyses of comparability of training across countries, a fundamental issue is that standards for education are developed by a national voluntary organization (Commission on Dental Accreditation) and standards for licensure are determined by individual states in the United States. Elsewhere in the world, the federal government performs these roles.

Education, Dental↗
PubMed2003

Epidemiology and molecular characterization of co-circulating influenza A/H3N2 virus variants in children: Houston, Texas, 1997-8.

Co-circulating variants of influenza A/H3N2 viruses in children were studied in Houston, Texas between October 1997 and March 1998 to assess the effects of a new variant strain on the severity of clinical illness. Influenza A virus was isolated from the nasal wash or nasal aspirate specimens collected from children at two tertiary care hospitals, and 271 isolates were available for variant-specific subtyping using RT-PCR and restriction fragment length polymorphism (RFLP) analysis. We classified 124 (46%) influenza viruses as A/H3N2/Wuhan/359/95-like and 137 (50%) as A/H3N2/Sydney/05/97-like. Ten (4%) virus isolates could not be classified. Ill contacts in the household were reported more frequently in patients infected with A/Sydney-like viruses than in those infected with A/Wuhan-like viruses (85% vs. 71%, respectively, P=0.02). There were no differences in other demographic variables among children infected with these strains. This study found no increase in illness severity in children infected with a newly emerging strain.

Child↗
PubMed2003

The prevalence and patterns of occupational injury among south Texas high school students.

High school students frequently work long hours during the school year, increasing their risk of injury. Few studies have examined the relation between work injury and weekly work hours. This paper describes injuries among students in South Texas, where economically disadvantaged Hispanic students are heavily represented. Anonymous surveys were collected from 3565 secondary students in 23 schools. Self-reported data included weekly work hours and type of injury and job when injured. A dose-response effect was observed: increasing weekly work hours were related to injury (1-10 hours, adjusted odds ratio [AOR] = 1.0; 11-20 hours, 1.4; 21+ hours, 1.5), P < .000. The AOR for restaurant work was 3.2; for construction, 3.0; for factory, office, or skilled labor, 2.9; for agriculture, 2.8; for yard work, 2.0; and for babysitting (1.0). Males (OR = 1.5) were more prone to injury. High-intensity weekly work increased the likelihood of injury. Prevention efforts should be targeted to youth to reduce work injuries.

Accidents, Occupational↗