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PubMedDate not supplied

Human papillomaviruses and cervical neoplasia in South Carolina.

Human papillomaviruses (HPVs), particularly types 16, 18, and 33, have recently been suggested as etiological agents for cervical neoplasia. However, few studies have explored this relationship among low-income minority women. This case-control study of cervical intraepithelial neoplasia (CIN), detected by Pap smear screening among South Carolina women, investigates the association between HPV positivity and the cytological continuum of CIN. Cervical spatulas and cytobrushes used to collect Pap smears from all women attending health department family planning clinics in three coastal South Carolina counties were saved for subsequent HPV detection and typing. Among this cohort of approximately 6000 cervical samples collected from March through December 1991, those with CIN, atypia, and other cervical abnormalities and women with normal cervical cytology were identified. Women with CIN II or III (n = 28) were 21.9 times more likely to be HPV 16, 18, or 33 positive, while women with CIN I (n = 114) were 11.7 times more likely to be HPV 16/18/33 positive when compared with women having normal cervical cytology (n = 223) and adjusting for potential confounders. Women with atypia (n = 115) were 3.0 times more likely to be HPV 16/18/33 positive. A chi 2 test for trend in increasing HPV 16/18/33 prevalence with increasing severity of cervical lesions was highly significant (P = 0.0001). HPV 6 and 11 were not associated with CIN, nor was there a significant trend of increasing prevalence with increasing severity of cervical lesions. Worthy of further research is our finding that the overall prevalence of HPV positivity was low in this relatively high-risk population of low-income, primarily black women.

Adolescent↗
PubMed2005

Molecular subtyping of Treponema pallidum from North and South Carolina.

Patients from five clinics in North and South Carolina who had lesions suggestive of primary or secondary syphilis were evaluated using molecular techniques that allow the differentiation of Treponema pallidum strains on the basis of two variable genes, tpr and arp. Lesion samples were screened for the presence of T. pallidum DNA using PCR for polA, which represents a segment of the polymerase I gene that is unique to the spirochete. Twenty-seven of 154 lesion samples were found to contain T. pallidum, 23 of which had typeable DNA. Seven molecular subtypes were found (10f, 12f, 13f, 14f, 14g, 15f, and 16f); one to four subtypes were identified at each clinic. Subtype 14f was found in 52% of the typeable specimens and was distributed in four of the five clinics. Subtype 16f was found in 22% of specimens and was concentrated at one clinic. Further data are needed to define the role of this technique in examining the epidemiology of syphilis.

Adult↗
PubMedDate not supplied

Association of environmental factors to meeting physical activity recommendations in two South Carolina counties.

PURPOSE: The purpose of the study was to examine associations between environment and policy factors and physical activity. DESIGN: A random-digit-dialed, cross-sectional telephone survey was administered. SETTING: The setting was a two-county area of eastern South Carolina. SUBJECTS: Before weighting, the sample included 1936 adults; 36.9% African-American, 63.1% white, and 60.1% women. The age group distribution was 28.8% 55+ years, 39.3% 35-54 years, and 31.9% 18-34 years of age. The response rate was 62.9%. MEASURES: Six physical activity questions (2001 Behavioral Risk Factor Surveillance Survey [BRFSS]) were used to create a dischotomous variable, "meets/does not meet recommendation for moderate or vigorous physical activity." Self-report items assessed knowledge, presence, and use of recreational facilities; presence of environmental and worksite supports; perceived safety; condition of sidewalks; and quality of street lighting. RESULTS: Linear and logistic regression were used to analyze the data. Unadjusted odds for meeting the recommendation were significantly greater for well-maintained sidewalks (OR = 1.90); safe areas for walking/jogging (OR = 1.39); knowledge of routes for bicycling (OR = 1.38) and walking/jogging (OR = 1.32); and worksites with sports teams (OR = 1.53), exercise facilities (OR = 1.33), flexible time for exercise (OR = 1.33), and preventive checkups (OR = 1.26). Among persons who met the recommendation, means were greater for number of known walking/jogging routes (p = .04); number of known bicycling routes (p < .01); number of days per month uses tracks, trails, routes, pathways (p < .01); and number of days per month uses outdoor recreation areas (p < .01). CONCLUSION: The results support an association between level of physical activity and environmental and policy factors in two southeastern counties in South Carolina. Limitations of the study include self-reported data and cross-sectional design.

Adolescent↗
PubMed1989

Update on hospitalized pesticide poisonings in South Carolina, 1983-1987.

Three hundred twelve hospitalizations for pesticide poisoning occurred in South Carolina during 1983-1987. This represents a twenty percent decline from an average of 78.5 cases hospitalized per year (1979-1982) to 62.4 cases hospitalized per year currently. Non-occupational poisonings accounted for one-half of the hospitalizations while 20% were related to occupation. Intentional poisonings represented 27% of the total. Two deaths as a result of suicide occurred during the four year period giving a case fatality of less than 1.0%. This five year update reenforces the need for continued education and prevention efforts.

Adult↗
PubMed2004

Neural tube defects and associated anomalies in South Carolina.

BACKGROUND: Neural tube defects (NTDs) occur as isolated malformations and in the company of other birth defects. This study was conducted to determine the frequency of coexisting anomalies and the relationship between them. METHODS: Since 1992, NTDs have been identified through prenatal and postnatal surveillance activities in South Carolina. The type of NTD and presence of associated anomalies were determined by prenatal ultrasound, postnatal and/or postmortem examination. RESULTS: During the ten-year period from 1992 to 2002, 564 NTDs were identified by the surveillance system. Seventeen percent of NTDs (98/564) had associated malformations. In approximately half (n = 51) of these cases, the NTDs and associated anomalies were components of a recognizable syndrome. In the remaining cases (n = 47), no syndrome was identified or suspected, but the associated anomalies were believed in most instances to be secondary to space limitation or neural crest abnormalities imposed by the NTD. CONCLUSION: Seventeen percent of NTDs in South Carolina have associated malformations. In most cases, the associated anomalies are considered either components of a multiple malformation syndrome or secondary to the NTD.

Adult↗
PubMed1976

Comparative findings on the skelic index of black and white children and youths residing in South Carolina.

This paper pertains to one facet of human body form, the relation of lower limbs to stem as quantified by the skelic index (lower limb height x 100/sitting height). The subjects were North American black and white pupils measured during 1974-1975 at elementary and high schools in Columbia, South Carolina. Females were measured at ages 9 and 13 years, males at ages 11 years and 15 years. At each childhood and adolescent age studied, skelic index means were considerably higher for the black than for the white pupils. Standard deviations and distances between spaced percentiles showed that variability of the skelic index at a given age was similar for white and black school pupils of South Carolina. Supplementary means for components of the skelic index indicated (1) black children and youths were shorter in sitting height than their white age peers, and (2) white children and youths were shorter in lower limb height than their black age peers. The skelic index of both ethnic groups increased between late childhood and mid-adolescence.

Adolescent↗
PubMedDate not supplied

Prevalence of aneuploidies in South Carolina in the 1990s.

PURPOSE: Folate insufficiency due to nutritional deficiency or folate processing gene mutations has been proposed as a trisomy 21 risk factor. This study examined the possibility that increased folic acid intake among women of childbearing age may decrease the prevalence of trisomy 21 and other aneuploidies. METHODS: The prevalence of aneuploidies from 1990 through 1999 was compared with folic acid use in women of childbearing age in South Carolina. RESULTS: Folic acid use and the prevalence of all aneuploidies significantly increased during this period. CONCLUSION: Increased folic acid utilization in South Carolina was not associated with decreased prevalence of trisomy 21 or other aneuploidies.

Aneuploidy↗
PubMed1993

Approaches to improving adherence to antituberculosis therapy--South Carolina and New York, 1986-1991.

Patients with tuberculosis (TB) who fail to complete a standard course of antituberculosis (anti-TB) therapy are at increased risk for treatment failure and may play a role in both the emergence of drug-resistant strains of Mycobacterium tuberculosis and further spread of TB. During 1986-1991, the South Carolina Department of Health and Environmental Control and the New York City Department of Health (NYCDH) attempted to improve patient adherence to anti-TB therapy by employing a combination of strategies that included incentives, directly observed therapy (DOT) (i.e., health-care worker observation of the patient ingesting each dose of medication), court-ordered DOT, and commitment for inpatient management. This report describes the experiences of selected strategies in South Carolina and New York City and provides recommendations for improving patient adherence to anti-TB therapy.

Antitubercular Agents↗
PubMed1992

Human immunodeficiency virus testing experience and hepatitis B vaccination and testing status of healthcare workers in South Carolina: implications for compliance with US Public Health Service guidelines.

OBJECTIVE: To assess the previous human immunodeficiency virus (HIV) testing experience and the hepatitis B (HB) vaccination and testing status of healthcare workers potentially involved in invasive surgical procedures. DESIGN: Anonymous questionnaire survey. SETTING: Tertiary care and community-teaching medical center and affiliated healthcare facilities in Greenville County, South Carolina. PARTICIPANTS: Physicians (including residents in training), dentists, nurses and surgical technicians working in the operating room and labor/delivery areas. RESULTS: Of 506 responding physicians and dentists (65% of the sample), 60% previously had had a test for HIV, and 72% had received HB vaccine. Testing had occurred most often because of a requirement by an insurance company or because of blood donation. Eighty percent of tested respondents had their most recent test within 2 years of the time of the survey (August 1991). Of 145 responding nurses and surgical technicians (73% of the sample), 26% had had a test for HIV and 77% had received HB vaccine. CONCLUSIONS: The majority of surgeons and dentists in Greenville County, South Carolina, already have been tested for HIV for a variety of reasons and thus are aware of their HIV infection status, at least as of the time of the most recent test. The majority of local healthcare workers who are potentially involved with invasive surgical procedures have received HB vaccine. Programs developed in response to recent US Public Health Service guidelines should take HIV testing of healthcare workers for any reason into consideration and should emphasize HB vaccination and testing for vaccine-induced HB immunity.

AIDS Serodiagnosis↗
PubMed2002

The economic impact of motor vehicle crashes: the cost of restrained versus unrestrained occupants in South Carolina.

The purpose of our study was to evaluate the difference in hospital charges between restrained and unrestrained motor vehicle occupants. We were also interested in identifying whether a relationship existed between restraint usage and insurance status. The data for this study were collected from two sources. The 1998 and 1999 Crash Outcome Data Evaluation System was used to compare the hospital charges and restraint usage for all motor vehicle crashes in the state of South Carolina. The patient's insurance status was also analyzed. The hospital charges and restraint usage were also compared from one of the state's Level I trauma centers for the year 1999. These data were prospectively collected and retrospectively reviewed. The average inpatient hospital charges for the state of South Carolina were approximately 25 per cent greater or $4500 more per admission for an unrestrained versus a restrained occupant. There also appears to be a relationship between payer status and restraint usage. Medicaid and self-pay patients were least likely to be using a restraining device at the time of a motor vehicle crash. The data from a Level I trauma center showed similar but more dramatic trends. Hospital charges for unrestrained occupants were 87 per cent higher than those for restrained occupants, which translates into a cost difference of $22,358 per hospital admission. This study highlights the significant economic impact of a simple preventative strategy. The cost savings for a single Level I trauma center translate into almost 9.4 million dollars for a single year. There also appears to be a relationship between usage of a restraining device and payer status.

Accidents, Traffic↗
PubMed1980

Pharmacy services for diabetic patients in South Carolina: a survey of physician and patient attitudes.

Diabetic patients and physicians in South Carolina were surveyed to gauge their attitudes to 13 potential pharmacy services. Approximately 33% of the physician sample and 42% of the patient sample responded to a self-administered, mailed questionnaire. The results indicated that both groups held favorable attitudes toward services aimed at improving the patient's knowledge of diabetes but reacted negatively to services in which the pharmacist would be involved in the collection of information relating to diabetic control. Although the attitudes of patients and physicians were highly congruent, patients typically held more favorable attitudes than physicians when significant differences were found. It also was found that patient and physician characteristics were incapable of segregating respondents into groups with varying attitudes.

Attitude of Health Personnel↗
PubMed1987

Maternal mortality in South Carolina from 1970 to 1984: an analysis.

Although the maternal mortality rate in South Carolina has decreased at an impressive and statistically significant rate over the past 15 years, the overall rate is still 77% higher than in the United States as a whole. Certain epidemiologic variables related to the maternal deaths were analyzed statistically for three five-year periods: 1970-1974, 1974-1979, and 1980-1984. Deaths were more frequent in older, nonwhite, single mothers. Amniotic fluid embolus and ectopic pregnancy have become the leading causes of death. Maternal mortality declined more rapidly in smaller hospitals than in larger ones, probably due to the transfer of high-risk patients. Improved obstetric techniques and practice have reduced these mortality rates thus far. If rates are to decrease still more, this trend must continue along with a sustained effort to provide comprehensive prenatal care to indigent pregnant women in a regionalized perinatal care system.

Embolism, Amniotic Fluid↗
PubMed1999

Fire ants: a continuing community health threat in South Carolina.

Imported fire ants are now firmly established in all 46 counties of South Carolina. In 1998 there were an estimated 660,000 cases in the state of which approximately 33,000 sought medical treatment at an estimated cost of 2.4 million dollars. Residents and visitors are at risk for IFA attacks that may occur indoors as well as outdoors. While IFA sting victims in endemic areas of the state may be less likely to seek medical treatment, patients in recently infested areas seem to be more likely to seek treatment since they are relatively unfamiliar with the multiple, painful IFA stings and pustules. Citizens need to control IFA infestations around and within their homes according to guidelines recommended by the Clemson University Cooperative Extension Service. Regional IFA control programs were discontinued in the past because of costs and environmental chemical concerns. Obviously, we need to support ongoing research aimed at developing improved and safe strategies for the local and regional control of IFA.

Animals↗
PubMed1991

A study in post-Flexner survival. The Medical College of the State of South Carolina, 1913.

The Flexner report of 1910 resulted in the closing of many marginal medical schools and opened a new era in medical education in the United States. Caught in Abraham Flexner's net were several old schools with long histories and, as he said, "traditions and a certain present dignity" that lacked the minimum resources needed to meet the standards of the Council on Medical Education of the American Medical Association. One example was the Medical College of the State of South Carolina. It was consigned to oblivion in Flexner's plan, but survived. Dean Robert Wilson, MD, in his efforts to save his school, turned politician, enlisted the aid of the state's highly controversial governor, and initiated an effective lobbying campaign in the state legislature. The Council on Medical Education became involved unofficially in the person of its secretary, Nathan P. Colwell, MD. His presence in South Carolina was turned to advantage by Wilson and others and contributed substantially to the success of their efforts.

Education, Medical↗
PubMed2005

Prevalence of epilepsy and health-related quality of life and disability among adults with epilepsy--South Carolina, 2003 and 2004.

Epilepsy is a common neurologic disorder and poses substantial burdens on physical and mental health. Epilepsy can interfere with social functioning by limiting employment, educational opportunities, and interpersonal relationships and can increase the risk for death. The annual cost of cases of epilepsy in the United States, including direct medical costs and productivity losses, was estimated at $12.5 billion in 1995. Depending on case definitions and populations studied, epilepsy affects an estimated 0.4%-1.0% of the population with a lifetime prevalence of 1.8%-2.6% in certain state populations. This report analyzes data from the 2003 and 2004 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) surveys, which included questions on epilepsy, health-related quality of life (HRQOL), and disability. This report summarizes the results of that analysis, which determined that 2.2% of adults in South Carolina had ever been told they had epilepsy, 1.1% had active epilepsy, and both groups reported worse HRQOL and higher prevalence of disability than those who had never had epilepsy. Health-care providers should screen epilepsy patients for cognitive, emotional, and physical health problems that might negatively affect HRQOL. Patients with active epilepsy and recent seizures should be targeted with interventions that will decrease the risk for adverse physical (e.g., injury) and psychosocial (e.g., unemployment) outcomes that accompany continued seizures.

Adult↗
PubMed1997

Metal levels in mourning doves from South Carolina: potential hazards to doves and hunters.

Most game birds are found in lower trophic levels, but since such birds are harvested and consumed by humans, there is a particular need to assess their contaminant levels. In this paper, we report concentrations of mercury, lead, cadmium, selenium, manganese, and chromium in the breast feathers, liver, and muscle of mourning doves (Zenaida macroura) collected at a partially drawn-down, contaminated reactor-cooling reservoir (Par Pond) on the Department of Energy's Savannah River Site in South Carolina and at nearby agricultural fields managed as dove hunting areas. We test the hypothesis that the levels in doves are not harmful to either dove populations or humans. We also tested the simultaneous effects of collection location, year (1992, 1993), and dove age-class (hatch-year vs after hatch-year) on heavy metal and selenium levels. For all three tissues, mercury levels were nondetectable at all locations. Lead was highest in tissues from agricultural fields with prior histories of dove hunting activities. Doves at those fields were likely ingesting lead shot to a greater degree than at the recently drawn-down reservoir which was closed to public access and hunting. For other metals, Par Pond doves had equally high or higher tissue levels. For all metals, levels in doves from South Carolina were generally within the lower range of those reported in the literature, suggesting that these metals were likely to pose no health problems to these doves. Except for lead and selenium, metal levels in dove muscle that we observed were well below reference metal doses established for human intake. Lead and selenium, at the levels described here, would only be a problem if a child (not an adult) ate 120 g of dove meat every day of the year. Thus, we conclude that meat from these doves, if consumed by hunters, would not pose a risk.

Adult↗
PubMed2003

Incidence of astrocytoma in South Carolina: follow-up study.

As a result of a statewide cancer registry in South Carolina, we are able to conclude that there is a higher probability for occurrence of astrocytoma in the Upstate when compared to the remainder of the state. Hopefully these results will foster additional research into potential etiologies for this phenomenon.

Astrocytoma↗