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PubMed1999

Vitamin-mineral intake and intelligence: a macrolevel analysis of randomized controlled trials.

CONTEXT: Two independent groups suspected that poor diets in school children might impair intelligence. Because dietary changes produce psychological effects, both groups conducted randomized trials in which children were challenged with placebo or vitamin-mineral tablets. Both reported significantly greater gains in intelligence among the actives. The findings were important because of the apparent inadequacy of diet they revealed, and the magnitude of the potential for increased intelligence. However, 5 of 11 replications were not significant, leaving the issue in doubt. OBJECTIVE: To determine if school children who receive low-dose vitamin-mineral tablets produce significantly higher IQ scores than children who receive placebo. DESIGN: A macrolevel analysis of the 13 known randomized, double-blind trials was undertaken. SETTING AND SUBJECTS: A total of 15 public schools in Arizona, California, Missouri, Oklahoma, Belgium, England, Scotland, and Wales participated, with 1477 school children, aged 6 to 17 years, and 276 young adult males, aged 18 to 25 years, in 2 American correctional facilities. MAIN OUTCOME MEASURES: All studies used 1 of 3 standardized tests of nonverbal intelligence: the Wechsler Intelligence Scale for Children-Revised, the Wechsler Adult Intelligence Scale, or the Calvert Non-verbal test. RESULTS: The activities in each study performed better, on average, than placebo in nonverbal IQ, regardless of formula, location, age, race, gender, or research team composition. The probability of 13 randomly selected experimental groups always performing better than 13 randomly selected independent control groups is one-half to the 13th power (p = 0.000122). The mean difference across all studies is 3.2 IQ points. Furthermore, the standard deviation in the variable "IQ change" was also consistently larger in each active group when compared to its controls. This confirms that a few children in each study, presumably the poorly nourished minority, were producing large differences, rather than a 3.2 point gain in all active children. CONCLUSION: There are important health risks when school children's dietary habits depart substantially from government guidelines; poor dietary habits may lead to impaired intelligence. Low-dose vitamin-mineral supplementation may restore the cognitive abilities of these children by raising low blood nutrient concentrations. However, there is also evidence that supplementation has no measurable effect on the intelligence of well-nourished children with normal blood nutrient concentrations.

Adolescent↗
PubMed1995

Shockwave lithotripsy and pacemakers: experience with 20 cases.

Lithotripsy treatment of urinary tract calculi initially excluded patients with cardiac pacemakers. Continued research and clinical study of patient outcomes has promoted a change in that initial concept. The Oklahoma Lithotripsy Center has successfully treated 20 patients with various types of pacemakers. No significant cardiovascular events occurred during treatment. Patients should be evaluated before the procedure by a cardiologist, and dual-chamber pacemakers should be reprogrammed to the single-chamber mode. Patients who cannot tolerate this should not undergo SWL. Rate-responsive pacemakers should be programmed to the non-rate-responsive (VVI) mode. The pacemaker should be at least 5 cm from the blast path. With these precautions and careful monitoring, SWL can be performed safely in most patients with pacemakers.

Adult↗
PubMed1997

Parity, postmenopausal estrogen use, and cardiovascular disease risk factors in American Indian women: the Strong Heart Study.

Studies have suggested that high parity is related to an increased risk of cardiovascular disease (CVD). Reasons for an increased risk are unclear but may include influences of child-bearing on levels of CVD risk factors. The present study examined the associations of parity and CVD risk factors in American Indian women, among whom large families are common. Estrogen use and CVD risk factors also were assessed. The study included 1982 ever-married, postmenopausal women aged 45 through 74 years who participated in the Strong Heart Study (SHS), a large study of American Indians in three geographic areas of the United States. Information was obtained during a physical examination and interview. Parity ranged from 0 to 18 (median 5). Current estrogen use varied from 5% in Arizona to 21% in Oklahoma. Multivariable analyses found a statistically significant, inverse association between parity and high-density lipoprotein (HDL) cholesterol, although the difference with increasing parity was small (-0.26 mg/dl per additional live birth). Estrogen users had significantly lower levels of low-density lipoprotein cholesterol (-6.4 mg/dl) and fibrinogen (-26.2 mg/dl) and a lower waist/hip ratio (-0.02), and higher values of HDL (5 mg/dl) and logarithm (ln) triglyceride (0.13 mg/dl). Current users were slightly more likely to be hypertensive (prevalence odds ratio, 1.56). Relations between parity and CVD risk factors in American Indian women with high parity suggested only small differences with increasing parity. Associations with estrogen use are much stronger and are similar to those observed in other groups of women.

Aged↗
PubMed1984

Erythrocyte and dietary zinc in adolescent females.

Erythrocyte zinc has been suggested as an index of zinc status. This study was undertaken to investigate the possible relationships of erythrocyte zinc concentration to age, physical maturity, and zinc intake of teenage girls of two races. Dietary zinc was calculated from two 1-day food recalls, and erythrocyte zinc was determined for over three hundred 12-, 14- and 16-yr-old girls in Oklahoma and Virginia. Erythrocyte zinc concentration increased and the intake of zinc from the diet decreased after attainment of menarche. Among girls of the same menarcheal state, age was not related to zinc intake, but concentration of zinc in erythrocytes increased with each 2-yr age increment in those that were past menarche. Results did not show a direct relationship of erythrocyte zinc values to calculated intakes of zinc by adolescent females. Black and white races did not differ in either zinc intake or red cell zinc content.

Adolescent↗
PubMed1996

Pharmaceutical services in an Army field hospital in Haiti during Operation Uphold Democracy.

The pharmaceutical services provided by an Army field hospital in Haiti during Operation Uphold Democracy are described. In January 1995, 155 soldiers of the 47th Field Hospital from Ft. Sill, Oklahoma, were deployed to Haiti to provide medical care for 2400 U.S. troops and 7000 multinational troops and police officers. The pharmacy staff (one pharmacist and two technicians) provided patient counseling, drug information, staff consultation, and clinical support to the intensive and intermediate care wards and emergency medical tent of the field hospital. Other responsibilities were providing nonprescription drugs to outpatients, interpreting and evaluating drug orders, participating in drug selection, and ordering supplies. A 30- to 60-day drug supply was maintained. The formulary was designed by the pharmacist and an internist and was based on the mission requirements and conditions in Haiti. Of the 10 oral medications most commonly dispensed to outpatients, 6 were antibacterials and 1 was an antimalarial. An average of two patients were admitted to the hospital daily. Some 240 inpatients were recorded in the pharmacy computer during the hospital's six-month deployment, and more than 5000 were treated in the emergency tent. The pharmacy service of the 47th Field Hospital met the challenge of supporting U.S. and multinational troops in Haiti during Operation Uphold Democracy.

Haiti↗
PubMed1998

Development of an interdisciplinary, telephone-based care program.

An interdisciplinary, telephone-based care program at a Veterans Affairs medical center (VAMC) is described. Patients telephoning the Oklahoma City VAMC complained that they were transferred multiple times and that they had difficulty contacting their provider between scheduled visits. Some went to the walk-in urgent care clinic with nonurgent problems. The average waiting time in the clinic exceeded three hours. An interdisciplinary, telephone-based care program was begun in 1995 to allow efficient problem resolution over the telephone; provide clinical consultations, interventions, and referrals as necessary; and reduce use of the urgent care clinic for nonurgent problems. A team consisting of a patient service representative, a pharmacist, and a nurse was established to handle calls. Policies and procedures were designed to respond appropriately to patients' problems and document the telephone "visits." The pharmacist was given practice privileges, including prescribing authority. A questionnaire indicated patient satisfaction with the new service. Mean waiting times in the urgent care clinic were reduced to less than two hours, and an estimated annual net cost avoidance of $677,671 was achieved by the program's averting unnecessary visits to the urgent care clinic. An interdisciplinary, telephone-based care program at a VAMC successfully responded to patients' concerns, improved their access to care, and conserved urgent care resources.

Drug Prescriptions↗
PubMed1995

Pigmented subcutaneous spindle cell tumors in native gizzard shad (Dorosoma cepedianum).

An epizootic of pigmented subcutaneous spindle cell tumors affected nearly 25% of the adult gizzard shad (Dorosoma cepedianum) sampled from Lake of the Arbuckles in central Oklahoma over a 2 year period. Grossly, the tumors were primarily distributed over the head, trunk and fins as superficial raised masses that were almost always darkly pigmented. Histologically, they were located in the dermis, had a variable amount of connective tissue, and consisted of cells in a variety of forms and arrangements. Most tumors were composed of fusiform or spindle cells arranged in wavy bundles, whirling patterns or interwoven fascicles. Pigmentation was attributed to large dense deposits of melanin or to scattered individual melanin-containing cells. Immunohistochemical detection of proliferating cell nuclear antigen revealed a high proliferative activity in the spindle cells. Electron microscopy showed that the tumors were composed of several cell types, including host reactive cells, melanocytes in stages of maturity, and fibroblast-like cells. Tumor cells had neither cell-to-cell junctions nor an external lamina. Although the cell of origin of the tumors was not identified, evidence points toward melanocytes or, possibly, nerve sheath cells. However, an origin from fibroblasts or some other poorly differentiated cell cannot be ruled out. The etiology of the tumors was not determined. Fractionation of lake water and sediment samples followed by GC-MS analysis revealed no carcinogenic compounds. A retroviral etiology is unlikely because assays for reverse transcriptase in tumor homogenates were negative, and no evidence of viral particles was found in specimens examined by electron microscopy.

Animals↗
PubMed1999

Measurement of low breath-alcohol concentrations: laboratory studies and field experience.

Recent federal rules and traffic law changes impose breath-alcohol thresholds of 0.02 and 0.04 g/210 L upon some classes of motor vehicle operators, such as juveniles and commercial vehicle operators. In federally regulated alcohol testing in the workplace, removal of covered workers from safety-sensitive duties, and other adverse actions, also occur at breath-alcohol concentrations (BrACs) of 0.02 and 0.04 g/210 L. We therefore studied performance of vapor-alcohol and breath-alcohol measurement at low alcohol concentrations in the laboratory and in the field, with current-generation evidential analyzers. We report here chiefly our field experience with evidential breath-alcohol testing of drinking drivers on paired breath samples using 62 Intoxilyzer 5000-D analyzers, for BrACs of 0-0.059 g/210 L. The data from 62 law enforcement breath-alcohol testing sites were collected and pooled, with BrACs recorded to three decimal places, and otherwise carried out under the standard Oklahoma evidential breath-alcohol testing protocol. For 2105 pooled simulator control tests at 0.06-0.13 g/210 L the mean +/- SD of the differences between target and result were -0.001 +/- 0.0035 g/210 L and 0.003 +/- 0.0023 g/210 L for signed and absolute differences, respectively (spans -0.016-0.010, 0.000-0.016). For 2078 paired duplicate breath-alcohol measurements with the Intoxilyzer 5000-D, the mean +/- SD difference (BrAC1-BrAC2) were 0.002 +/- 0.0026 (span 0-0.020 g/210 L). Variability of breath-alcohol measurements was related inversely to the alcohol concentration. Ninety-nine percent prediction limits for paired BrAC measurements correspond to a 0.020 g/210 L maximum absolute difference, meeting the NSC/CAOD recommendation that paired breath-alcohol analysis results within 0.02 g/210 L shall be deemed to be in acceptable agreement. We conclude that the field system for breath-alcohol analysis studied by us can and does perform reliably and accurately at low BrACs.

Breath Tests↗
PubMed2003

Identification of Reticulitermes spp. (Isoptera: Reticulitermatidae) from south central United States by PCR-RFLP.

Because of morphological ambiguity, traditional identification of Reticulitermes Holmgren termites has always been difficult and unreliable. A molecular diagnostic method is presented for differentiating Reticulitermes species occurring in the south central United States, which are economically important urban pests. A 379-bp region of the mtDNA COII gene and a 415-bp region of the mtDNA 16S rRNA gene were amplified using polymerase chain reaction (PCR) and sequenced from Reticulitermes flavipes (Kollar), Reticulitermes virginicus (Banks), Reticulitermes hageni Banks, and Reticulitermes tibialis (Banks). Applying DNA sequence data, the PCR-restriction fragment length polymorphism (PCR-RFLP) analysis of two restriction enzymes each for the COII amplicon and the 16S amplicon, were diagnostic for all of the Reticulitermes species analyzed. Based on putative mutation rates, >87% and 97% of the samples should be successfully identified to species with PCR-RFLP of COII and 16S, respectively. To verify the accuracy of our predictions, we examined unclassified Reticultermes populations from Arkansas, Louisiana, Missouri, Oklahoma, Texas, and Virginia using PCR-RFLP. Applying PCR-RFLP, 97 samples were correctly classified to species. This technique allows the use of field-collected specimens preserved in alcohol and can identify termite specimens regardless of caste. PCR-RFLP, resolved with agarose or polyacrylamide gel electrophoresis, provided an efficient method for identification of Reticulitermes species from the south central United States for diagnostic purposes.

Animals↗
PubMed1990

Identification of horse flies (Diptera: Tabanidae) by analysis of cuticular hydrocarbons.

Thin-layer chromatography of the cuticular lipids of horse flies from Oklahoma revealed that hydrocarbon was the major lipid class present. The hydrocarbon fraction was composed of n-alkanes and methyl branched alkanes with only a small amount of alkenes present. Gas chromatography of the isolated cuticular hydrocarbons from a single species, Tabanus abactor Philip, showed no major differences in the profiles between individuals or between the sexes. Analysis of extracts of fresh, frozen, and pinned specimens yielded nearly identical hydrocarbon profiles. Profiles of several species were examined and found to be unique for each. Three species with similar morphological characteristics and similar geographical ranges. Tabanus abdominalis F., T. limbatinevris Macquart, and T. sulcifrons Macquart, were differentiated easily by comparison of the hydrocarbon profiles.

Animals↗
PubMed1993

Description of the immature stages of Ixodes (Pholeoixodes) baergi (Acari: Ixodidae), a parasite of cliff swallows in the United States.

The larva and nymph of Ixodes (Pholeoixodes) baergi Cooley & Kohls are described for the first time. This tick has been collected only in the United States on cliff swallows, Hirundo pyrrhonota, in their nests, or in adjacent habitats. To date, it has been reported from Arkansas, Colorado, Illinois, Oklahoma, and Texas. Brief notes on the synchronization of the life cycle of I. baergi with that of its host are included.

Animals↗
PubMed1993

New version of LSTSIM for computer simulation of Amblyomma americanum (Acari: Ixodidae) population dynamics.

A previous version of Lone Star Tick Simulation Model (LSTSIM) for a wildlife ecosystem was revised and expanded to include a beef cattle forage area and improved handling of tick-host-habitat interactions. Relationships between environmental and biological variables were also refined in the new version. General validity of the revised model was established by comparing simulated and observed host-seeking populations of Amblyomma americanum (L.) at five geographic locations, three in Oklahoma and two in Kentucky-Tennessee. Additional validity was indicated from comparisons of simulated and observed seasonality of lone star ticks at one location in Kentucky. The model produced acceptable values for initial population growth rate, generation time, and 15-yr population density when historical weather files for 14 locations in the United States were used. The model of A. americanum population dynamics was used to study the relationship between tick density and density of white-tailed deer, Odocoileus virginianus (Zimmerman), and cattle. The revised model can be used for additional simulation studies on effects of tick control technologies and integrated management strategies.

Animals↗
PubMed1997

Simulation of blacklegged tick (Acari:Ixodidae) population dynamics and transmission of Borrelia burgdorferi.

A model (LYMESIM) was developed for computer simulation of blacklegged tick, Ixodes scapularis Say, population dynamics and transmission of the Lyme disease agent. Borrelia burgdorferi Johnson. Schmid, Hyde, Steigerwalt & Brenner, LYMESIM simulates the effects of ambient temperature, saturation deficit, precipitation, habitat type, and host type and density on tick populations. Epidemiological parameters including host infectivity, tick infectivity, transovarial transmission, and transstadial transmission are included in the model to simulate transmission of the Lyme disease spirochete between vector ticks and vertebrate hosts. Validity of LYMESIM was established by comparing simulated and observed populations of immature I. scapularis on white-footed mice. Peromyscus leucopus, (Rafinesque), at 2 locations in Massachusetts. Validity also was indicated by comparisons of simulated and observed seasonality of blacklegged ticks in New York, Massachusetts, Florida, and Oklahoma-Arkansas. Further model validity was shown by correlation between simulated and observed numbers of immature ticks engorging on white-footed mice at 3 sites in Massachusetts. The model produced acceptable values for initial population growth rate, generation time, and 20-yr population density when historical meteorological data for 16 locations in eastern North America were used. Realistic rates of infection in ticks were produced for locations in the northeastern and northcentral United States. LYMESIM was used to study the effect of white-footed mouse and white-tailed deer, Odocoileus virginianus (Zimmerman), densities on tick density and infection rates. The model was also used to estimate tick density thresholds for maintenance of B. burgdorferi.

Animals↗
PubMed1998

Risk factor clustering in the insulin resistance syndrome. The Strong Heart Study.

The objective of this study was to examine how the major components of the insulin resistance syndrome relate to each other and to macrovascular disease in American Indians in the Strong Heart Study. The study cohort (4,228 resident tribal members 45-74 years old) underwent a personal interview and a physical examination between July 1989 and January 1992 at three centers: Arizona, Oklahoma, and North and South Dakota; blood samples were drawn and a 75-g oral glucose tolerance test was performed. Factor analysis was used to assess the clustering and interdependence of groups of insulin resistance syndrome variables. Within both diabetic and nondiabetic groups, three factors emerged. In nondiabetic participants, a cluster of glucose, body mass index, and insulin accounted for 35% (male) and 32% (female) of the total variance in all variables considered, and a cluster of systolic blood pressure and diastolic blood pressure accounted for 25% and 22% in men and women, respectively. Both clusters were positively associated with coronary heart disease but not peripheral vascular disease. In diabetic participants, the combination of systolic and diastolic blood pressures was the most important factor, but the cluster was not associated with coronary heart disease or peripheral vascular disease. A component containing high density lipoprotein cholesterol, triglycerides, and glucose had a positive association with coronary heart disease in diabetic women and with peripheral vascular disease in both sexes. The association of clusters of risk factors and their relations with coronary heart disease provide important clues that may be used in understanding the metabolic disorders associated with insulin resistance and diabetes.

Aged↗
PubMed1999

Prevalence of peripheral arterial disease and associated risk factors in American Indians: the Strong Heart Study.

Studies of peripheral arterial disease (PAD) in minority populations provide researchers with an opportunity to evaluate PAD risk factors and disease severity under different types of conditions. Examination 1 of the Strong Heart Study (1989-1992) provided data on the prevalence of PAD and its risk factors in a sample of American Indians. Participants (N = 4,549) represented 13 tribes located in three geographically diverse centers in the Dakotas, Oklahoma, and Arizona. Participants in this epidemiologic study were aged 45-74 years; 60% were women. Using the single criterion of an ankle brachial index less than 0.9 to define PAD, the prevalence of PAD was approximately 5.3% across centers, with women having slightly higher rates than men. Factors significantly associated with PAD in univariate analyses for both men and women included age, systolic blood pressure, hemoglobin A1c level, albuminuria, fibrinogen level, fasting glucose level, prevalence of diabetes mellitus, and duration of diabetes. Multiple logistic regression analyses were used to predict PAD for women and men combined. Age, systolic blood pressure, current cigarette smoking, pack-years of smoking, albuminuria (micro- and macro-), low density lipoprotein cholesterol level, and fibrinogen level were significantly positively associated with PAD. Current alcohol consumption was significantly negatively associated with PAD. In American Indians, the association of albuminuria with PAD may equal or exceed the association of cigarette smoking with PAD.

Aged↗
PubMed1990

The Strong Heart Study. A study of cardiovascular disease in American Indians: design and methods.

Available data indicate that cardiovascular disease has become the leading cause of death in American Indians. However, limited information is available on cardiovascular disease incidence, prevalence, and risk factors in this population. Reported cardiovascular disease rates vary greatly among groups in different geographic areas. These rates have been obtained from studies of varying sizes and different methodologies. The Strong Heart Study, which uses standardized methodology, is designed to estimate cardiovascular disease mortality and morbidity rates and the prevalence of known and suspected cardiovascular disease risk factors in American Indians. The study population consists of 12 tribes in three geographic areas: an area near Phoenix, Arizona, the southwestern area of Oklahoma, and the Aberdeen area of North and South Dakota. The study includes three components. The first is a mortality survey to estimate cardiovascular disease mortality rates for 1984-1988 among tribal members aged 35-74 years, and the second is a morbidity survey to estimate incidence of both first and first or recurrent hospitalized myocardial infarction and stroke (cerebrovascular disease) among tribal members aged 45-74 years in 1984-1988, and the third is a clinical examination of 4,500 tribal members aged 45-74 years in order to estimate the prevalence of cardiovascular disease and its associations with risk factors. Family history, diet, alcohol and tobacco consumption, physical activity, degree of acculturation, and socioeconomic status are assessed in personal interviews. The physical examination includes measurements of body fat, body circumferences, and blood pressure, an examination of the heart and lungs, an evaluation of peripheral vascular disease, and a 12-lead electrocardiogram. Laboratory measurements include fasting and postload glucose, insulin, fasting lipids, apoproteins, fibrinogen, and glycated hemoglobin. Also measured are serum and urine creatinine and urinary albumin. DNA from lymphocytes is isolated and stored for future genetic studies.

Adult↗
PubMed2004

Recent advances in dosimetry using the optically stimulated luminescence of Al2O3:C.

This paper presents an overview of some very recent developments in optically stimulated luminescence (OSL) dosimetry using aluminium oxide (Al(2)O(3):C), with special emphasis given to the work of the research group at Oklahoma State University. Some of the advances are: (i) the development of a real-time optical fibre system for in vivo dosimetry applied to radiotherapy; (ii) the development of a fibre dosimetry system for remote detection of radiological contaminants in soil; (iii) the characterisation of Al(2)O(3):C in heavy charged particle fields and the study of ionisation density dependence of the OSL from Al(2)O(3):C; and (iv) fast and separate assessment of beta and gamma components of the natural dose rate in natural sediments. These achievements highlight the versatility of the OSL technique associated with the high-sensitivity of Al(2)O(3):C for the development of new dosimetry applications.

Aluminum Oxide↗
PubMed1989

Histopathology of congenital pigmented nevi.

Between 1982 and 1985, a total of 39 congenital pigmented nevi (CN) were removed from patients in the Oklahoma Children's Memorial Hospital. Multiple sections were examined from each of the lesions removed. The histologic patterns were recorded with special note of those features traditionally associated with CN. These include nevus cells in the lower reticular dermis and subcutaneous tissue, association of nevus cells with and in appendageal structures, and infiltration of nevus cells between collagen bundles. These features were primarily observed in larger CN (greater than 3 cm). Most small nevi do not show these features. The histologic patterns were consistent throughout multiple sections of the nevi. It is concluded that the histology traditionally associated with CN relates primarily to the size of the nevus rather than to the time of its appearance.

Adipose Tissue↗