Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CONNECTICUT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,729 records · Page 96Linked to original sources
PubMed1984

Increased prevalence of polycythemia vera in parents of patients on polycythemia vera study group protocols.

An investigation of relatives of 652 patients entered on studies of the Polycythemia Vera Study Group yielded five documented cases of the disease among the parents of patients. When compared with expected values based on the Connecticut Tumor Registry and other population studies a significant increase was found in the lifetime incidence of polycythemia vera in parents of these patients.

Adult↗
PubMed2002

The hypersensitivity pneumonitis diagnostic index: use of non-invasive testing to diagnose hypersensitivity pneumonitis in metalworkers.

BACKGROUND: Since 1993, several outbreaks of hypersensitivity pneumonitis (HP) have been reported in metalworkers. We report the largest outbreak of HP in metalworkers yet known. It occurred in a Connecticut factory that produces precision parts for the aerospace industry. The workers typically presented with systemic and respiratory problems ("sick fatigue," myalgias, cough, dyspnea, wheezing, and chest tightness). They had variable findings on clinical tests, which complicated diagnosis. An HP diagnostic index was developed to help reduce the uncertainties in case identification. METHODS: Data from 16 biopsy-confirmed cases and 14 non-HP patients were compared, and the HP diagnostic index was derived using variables that best discriminated between the two groups. The index is based on (a) work-related symptoms, (b) dry crackles on auscultation, (c) restrictive spirometry, (d) decreased diffusion capacity and/or increased A-a oxygen gradient, (e) elevated erythrocyte sedimentation rate, (f) abnormal radiographic images, and (g) abnormal gallium scans. We then applied the HP diagnostic index and, for comparison, the "Kenosha epidemiological case criteria" (developed during a recent HP outbreak in an automobile factory) to our data set. RESULTS: The HP diagnostic index and the Kenosha criteria confirmed HP in overlapping sets of 36 and 34 patients, respectively, that were both in good agreement with the clinical diagnoses. CONCLUSIONS: The HP diagnostic index relies less heavily on symptoms, subjective evaluations, and invasive tests than the Kenosha criteria, but both identified similar subsets of the 61 patients as having HP. The HP diagnostic index could provide a useful tool in future HP outbreaks, which are increasingly being recognized in metalworking facilities.

Alveolitis, Extrinsic Allergic↗
PubMed2004

Prevalence and reporting of occupational illness by company size: population trends and regulatory implications.

BACKGROUND: Reports of occupational disease using the Bureau of Labor Statistics (BLS)/OSHA survey have shown increasing rates with larger establishment size. The literature is divided on whether this pattern is an artifact of under-reporting in smaller businesses or is the result of differences in underlying risk factors. METHODS: A population-based survey [the Connecticut Upper-Extremity Surveillance Project (CUSP)] assessing prevalence of likely work related musculoskeletal disorders (MSD) in CT, coded by establishment size, is compared to CT MSD incidence rates based on the BLS/OSHA survey. RESULTS: When analyses were controlled for age, gender, physical risks, and occupation, there was a marginally significant association between business size and the rate of MSD [odds ratio (OR) = 0.91, CI 0.82-1.01], but in the opposite direction of the BLS/OSHA rates, with larger businesses having somewhat lower rates of MSD. Reported risk factors varied in a similar direction, though with mid-sized companies having the highest physical risks. CONCLUSIONS: The increased rates of occupational illness in larger businesses reported in the BLS/OSHA survey does not appear to be due to actual incidence or distribution of risk factors, but appears more likely to be due to under-reporting in smaller businesses. Estimates based on the assumption that the ORs based on size are actually similar to the CUSP population survey results suggest that MSD incidence is approximately 3.6-times the reported rates.

Connecticut↗
PubMed2005

Trends in work-related musculoskeletal disorder reports by year, type, and industrial sector: a capture-recapture analysis.

BACKGROUND: Musculoskeletal disorders (MSD) are thought to be declining based on Bureau of Labor Statistics survey data, but there is also evidence of MSD under-reporting, raising the possibility of contrary trends. The magnitude of MSD under-reporting over time, and its industry distribution have not been adequately described. METHODS: Capture-recapture analysis of 7 years of Connecticut MSD (1995-2001), utilizing Workers' Compensation and physician reporting data was performed. RESULTS: Only 5.5%-7.9% of MSD cases appear to be reported to Workers Compensation annually. The capture-recapture estimated average annual rate for upper-extremity MSD was 133.1 per 10,000 employed persons, far above BLS rates. By industry, Manufacturing, State Government, and the Finance/Insurance/Real Estate sectors all had significantly higher MSD rates than Wholesale/Retail Trade. CONCLUSIONS: Upper-extremity MSD appears to be significantly under-reported, and rates are not decreasing over time. Capture-recapture methods provide an improved surveillance method for monitoring temporal trends in injury rates.

Adult↗
PubMed1981

Mortality and cancer morbidity among workers in the rubber tire industry.

A retrospective follow-up study was conducted to evaluate mortality and cancer incidence between 1954 and 1976 among 1,792 white male production workers employed for at least 2 years at a tire manufacturing plant. There were no marked excesses in overall or site-specific cancer deaths or incident cases. Compared to U.S. white males, men employed for at least 10 years experienced small increases in deaths from cancers of the large intestine, pancreas, and lung. Results obtained by comparing observed incident cancer cases to the numbers expected based on age- and calendar time-specific incidence rates of Connecticut males also suggested excesses of these three malignancies. These findings were based on small numbers and therefore do not necessarily indicate causal associations between cancer excesses and employment in the rubber tire industry. However, because the workers studied comprised a relatively young population that may not have experienced the full impact of carcinogenic occupational exposures, further follow-up is warranted.

Adult↗
PubMed1990

Methyl bromide intoxication in four field-workers during removal of soil fumigation sheets.

Methyl bromide is a highly toxic and penetrating compound used extensively as an insecticide for dry foodstuffs and as a soil fumigant (in greenhouses and fields) for the control of nematodes, fungi, and weeds. More than 300 cases of systemic poisoning and 60 fatalities attributable to methyl bromide have been reported [Alexeeff and Kilgore, 1983], resulting in substantial regulations concerning its handling, storage, application, and disposal. A recent exposure incident at a Connecticut nursery represents to our knowledge the first report of toxicity stemming from exposures in the field during removal of plastic sheets days after injection of methyl bromide into soil. Following removal of polyethylene sheets covering soil fumigated with methyl bromide, four field-workers developed fatigue and light-headedness and 3 workers noted progressive respiratory, gastrointestinal (GI), and neurologic symptoms. The acute systemic symptoms improved over several days, but later-onset neuropsychiatric symptoms persisted for several weeks. This incident stresses the need for improved worker education and strict adherence to safety precautions during all stages of methyl bromide fumigation and raises the possibility of an increased risk of toxicity associated with methyl bromide fumigation during a cool season.

Adult↗
PubMed2006

Promoting physicians' self-assessment and quality improvement: the ABIM diabetes practice improvement module.

INTRODUCTION: The American Board of Internal Medicine (ABIM) recognized that certification and recertification must be based on an assessment of performance in practice as well as an examination of medical knowledge. Physician self-assessment of practice performance is proposed as one method that certification boards may use to evaluate competence in practice-based learning and improvement and systems-based practice. METHODS: Sixteen practicing general internists and endocrinologists with 10-year time-limited certification participated in a beta test of the ABIM's diabetes practice improvement module (PIM) as part of their recertification program. A PIM consists of a self-directed medical record audit, practice system survey, and patient survey. A quality improvement education specialist from the Connecticut Quality Improvement Organization provided on-site and distance consultation on quality improvement methods and tools. An independent audit assessed the reliability of physician self-audit. Qualitative interviews were conducted at 2 time points to assess for physician satisfaction and behavioral change in quality improvement. RESULTS: Fourteen physicians completed the diabetes PIM. All but 1 physician found the medical record audit to provide important information about the practice. Of the 11 physicians who completed a follow-up interview, 10 stated that the quality improvement education specialist helped improve their practice. DISCUSSION: Self-assessment using the ABIM diabetes PIM as part of recertification provides valuable practice information and can lead to meaningful behavioral change by physicians. Collaboration with an educator in quality improvement appears to facilitate the effects of the practice improvement module. Future work should investigate the effect on patient outcomes.

Adult↗
PubMed2003

Race independently predicts prostate specific antigen testing frequency following a prostate carcinoma diagnosis.

BACKGROUND: The goals of the current study were to describe patterns of prostate specific antigen (PSA) surveillance for prostate carcinoma progression in a community-based cohort of patients and to identify independent clinical and sociodemographic factors that predict the frequency of surveillance. METHODS: Patients diagnosed with localized prostate carcinoma from October 1, 1991 to December 31, 1992 in New Haven and Hartford, Connecticut, were identified. Data were collected through standardized outpatient medical record review. Multivariate statistical methods were used to determine the factors that independently predicted the frequency of surveillance. RESULTS: Six hundred fifty-eight men with localized prostate carcinoma were included in the cohort. Forty-five percent of all patients were tested at least once annually, and 69% were tested at least once every 2 years. Multivariate models indicated that African American men were half as likely as Caucasian men to receive annual testing (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.24-0.97). Men diagnosed at age 70 years or older were 38% less likely to have annual testing than men diagnosed between the ages of 65 and 69 (OR, 0.62; 95% CI, 0.41-0.94). A higher Gleason score and PSA at presentation also were associated independently with higher rates of annual PSA surveillance. CONCLUSIONS: Postdiagnosis PSA surveillance is common, although not universal. African American men were at significantly greater risk for receiving less frequent testing compared with Caucasian men. This disparity in access to care may explain, in part, previously observed racial differences in survival in prostate carcinoma. Further research is needed to identify the reasons for the racial disparity in PSA surveillance and to design interventions to lessen these differences.

Adult↗
PubMed1996

Cancer incidence in the rural community of Tecumseh, Michigan: a pattern of increased lymphopoietic neoplasms.

BACKGROUND: The Tecumseh Community Health Study (TCHS), initiated in 1959 at the University of Michigan School of Public Health, has provided a resource for long term prospective studies of the incidence of cancer in the setting of a midwestern rural farming community. METHODS: A survey of total and site specific cancer incidence among 7016 male and female adult residents from 1959-1987 was conducted, and the observed number compared with the expected number, based on the age-sex-race-calendar period-and site-specific cancer incidence rates reported by the Connecticut tumor registry. Based on the results of this survey, a hypothesis was advanced concerning the potential risks of exposures to insecticides and herbicides. This was pursued by analyzing for each county in Michigan the comparative annual number of acres and percentage of acreage treated with agricultural chemicals in 1978 and for the period 1982-1987. Finally, because of the availability of information on lifestyle risk factors that had been collected in the 1960s on all participants, a nested case-control study was implemented. RESULTS: The standardized incidence ratio (SIR), based on the observed number divided by the expected number of invasive cancer cases (all sites combined [excluding nonmelanoma skin cancer]), was not significant in females (SIR, 0.95; 95% confidence interval [CI], 0.86-1.05) nor males (SIR, 0.91; 95% CI, 0.81-1.01). A significant increase was demonstrated for males and females combined in the incidence of lymphopoietic neoplasms, namely non-Hodgkin's lymphoma, Hodgkin's disease, and chronic lymphocytic leukemia; the combined SIR was 1.40 (95% CI, 1.03-1.86; P = 0.03). In the Department of Commerce surveys of counties in Michigan, the Tecumseh area (Lenawee County) was ranked highest with respect to the average annual number of acres (240,000 or more) and the percent of acreage (40%) sprayed with herbicides and insecticides. A comparison of temporal trends for cancer incidence since 1973 was reviewed for the Wayne-Oakland-Macomb tricounty area, in which the survey estimated that less than 80,000 acres per year, or less than 8% of acreage, were treated with pesticides. The comparison of the Tecumseh cohort, for all sites combined, was not significantly different from expectation in females (SIR, 1.01; 95% CI, 0.89-1.14), and was decreased by more than 10% in males (SIR, 0.88; 95% CI, 0.77-1.00). However, the SIR for non-Hodgkin's lymphoma in females was significantly elevated (SIR, 1.92; 95% CI, 1.07-3.11, P = 0.02); the trend for increased risks of lymphomas and leukemias was also evident in males. In the nested case-control study, based on risk factor information documented prior to diagnosis, the relative risk of a family history of lymphoma, leukemia, or multiple myeloma was significantly increased among patients with lymphoproliferative neoplasms (odds ratio, 3.81; 95% CI, 1.49-9.79; P = 0.005). CONCLUSIONS: This prospective epidemiologic study conducted in a rural farming community in Michigan has found significant increases in the incidence dence of lymphoproliferative cancers. A plausible hypothesis, consistent with the preliminary findings, is that the reported cancer pattern is an expression of risk resulting from sustained environmental exposures to agricultural chemicals, perhaps in conjunction with familial or genetic factors.

Adult↗
PubMed1994

Changing trends. An overview of breast cancer incidence and mortality.

The incidence of breast cancer rose about 1% per year between 1940 and 1980 according to data in the Connecticut Tumor Registry. A sharp increase of 32% was reported between 1980 and 1987 in the Surveillance, Epidemiology and End Results Program of the National Cancer Institute. Data from this program shows that the increase in incidence was due to localized cases and cancers of less than 2 cm in greatest dimension. In addition, a sharp increase in carcinoma in situ was observed. The increase in breast cancer incidence coincides with an increased use of mammography in asymptomatic women in the 1980s. Mortality from breast cancer has changed little since the 1930s, but the increases in localized and small-size tumors and decreases in the rate of tumors of 3 cm or larger at diagnosis indicates that breast cancer mortality may start to decrease. Evidence from provisional breast cancer monthly mortality data suggests that there was a 3-6% drop in 1991 compared to 1990.

Adult↗
PubMed2002

Familial correlates of extreme weight control behaviors among adolescents.

OBJECTIVE: To identify familial factors associated with extreme weight control among adolescents. METHOD: Analysis of a comprehensive 1996 health survey of Connecticut students. Familial factors among extreme dieters who deliberately vomited, took diet pills, laxatives, or diuretics were compared with youth reporting none of these behaviors, using logistic regression controlling for age and body mass index. RESULTS: Nearly 7% of adolescents reported engaging in extreme weight control behaviors. Boys' risk factors included high parental supervision/monitoring and sexual abuse history. Protective factors included high parental expectations, maternal presence, and connectedness with friends and other adults. The only significant risk factor for girls was sexual abuse history. Protective factors included family connectedness, positive family communication, parental supervision/monitoring, and maternal presence. CONCLUSIONS: Extreme dieting appears to be less an expression of body composition than of psychosocial issues. That connectedness to family, other adults, and friends is protective further demonstrates interrelationships of extreme weight control behaviors with family/social issues.

Adolescent↗
PubMedDate not supplied

The neglected laboratory test. The semen analysis.

Sixty-four laboratories from Connecticut, Massachusetts, and California were involved in a comparison of the types of semen analyses offered. The collected data indicate that there is a wide range of normal values for each parameter considered in a semen analysis. Very few laboratories gave simple and precise instructions for collection of the specimen. In many instances there was no record of the collection time or of the arrival time of the specimen at the laboratory. Most laboratories did not report motility or forward progression at time intervals, and abnormal morphology was not broken down according to the types of abnormalities involved. These data indicate the absolute need for adequate standardization of this important test, which is the basis upon which the clinician makes the important decision of implicating the male partner in the couple's infertility problem.

California↗
PubMed1984

An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc.

An epidemiologic case-control study undertaken in Connecticut during 1979-1981 indicated that persons with jobs requiring lifting objects of more than 11.3 kg (25 lb) an average of more than 25 times per day had over three times the risk for acute prolapsed lumbar intervertebral disc as people whose jobs did not involve lifting objects of this weight. If the body was usually twisted while the lifting was done, this elevation in risk was apparent with less frequent lifting. An especially high risk for prolapsed lumbar disc was associated with jobs involving lifting objects of more than 11.3 kg with the body usually twisted and the knees not bent while the lifting was done. Neither lifting objects of less than 11.3 kg nor twisting without lifting was associated with an increase in risk.

Adult↗
PubMed2006

Approaches to fitting age-period-cohort models with unequal intervals.

Age-period-cohort models have provided useful insights into the analysis of time trends for disease rates, in spite of the well known identifiability problem. Unique parameter estimates that avoid arbitrary constraints are provided by estimable functions of the parameter estimates. For data that are generated using equal interval widths for age and period, the identifiability issue may be expressed in terms of the age, period and cohort slopes. However, when the interval widths are not the same for age and period, additional identifiability problems arise. These may be represented in terms of macro-trends, which have the identical identifiability problem seen in the equal interval case, and micro-trends, which are the source of the additional problems. A framework for testing estimability is presented, and a variety of potentially interesting functions of the parameters considered. Unlike the equal interval case, drift is not estimable for unequal intervals, but local drift may be. In addition, the available functions for forecasting are much more restrictive in the latter case. This estimability problem induces cyclical patterns in the estimates of trend as is demonstrated using data on leukaemia in Connecticut males, but this can be avoided through the use of smoothing splines. These methods of are illustrated for three-year period and five-year age intervals using data on lung cancer mortality in Californian women.

Adult↗
PubMed1994

Estimating age, period and cohort effects using the multistage model for cancer.

To understand cancer aetiology better, epidemiologists often try to investigate the time trends in disease incidence with year of diagnosis (period) and birth cohort. Unfortunately, one cannot identify these factors uniquely in the usual regression model owing to a linear dependence between age, period and cohort, so that one requires additional information about the underlying biology of the disease. Carcinogenesis models provide one type of information that can result in a unique set of parameters for the effects of age, period and cohort. We use the multistage carcinogenesis model and its extensions to obtain a unique set of parameters for an age-period-cohort model of lung cancer trends of Connecticut males and females from 1935 to 1988. Some of these models do not seem to provide a reasonable set of model parameters, but we found that a model that included second-order terms and a multistage mixture model both gave a good fit to the data and realistic parameter estimates.

Age Factors↗
PubMedDate not supplied

A method for evaluating needle exchange programmes.

This paper details a statistical method for evaluating needle exchange programmes. The approach relies only on needle exchange operations data and the results of HIV tests conducted on needles. We develop statistical models describing the needle infection process and how needle exchange interrupts this process. The method is illustrated using 20 months of data collected in conjunction with the evaluation of New Haven, Connecticut's needle exchange programme, and the results suggest that needle-borne HIV transmission among participating clients has been reduced by at least 33 per cent.

Connecticut↗
PubMedDate not supplied

Verification of information in a large medical database using linkages with external databases.

Efforts to utilize Uniform Hospital Discharge Data Sets (UHDDS) for epidemiological studies have been hampered by the limitations of those databases. The purpose of this paper is to illustrate that linking to external databases can provide the verification necessary to overcome many of those limitations. This method has dramatically altered study design at the Connecticut Hospital Research and Education Foundation and has provided an efficient method for specifying data collection weaknesses within the resident databases.

Cause of Death↗
PubMed1999

Sociodemographic and personal characteristics of adolescents engaged in weight loss and weight/muscle gain behaviors: who is doing what?

BACKGROUND: Prevalence rates of behaviors aimed at weight loss and weight/muscle gain among adolescents were examined across sociodemographic and personal anthropometric variables to provide insight into these behaviors and identify high-risk subgroups. METHODS: A statewide representative sample of 7th, 9th, and 11th grade public school students from Connecticut completed a classroom-administered survey on adolescent health in 1995-1996. The study sample in the present analysis included 9,118 adolescents. RESULTS: The most frequently reported weight control behavior was exercise followed by dieting. Disordered eating (vomiting, diet pills, laxatives, or diuretics) over the previous week was reported by 7.4% of the girls and 3.1% of the boys. Steroids were used by 0.5% of the girls and 2.3% of the boys. Girls in the highest BMI category were at greatest risk for disordered eating behaviors while boys in the lowest BMI category were at greatest risk for steroid use. African American and Hispanic girls were less likely than Caucasians to diet and exercise, but were more likely to report behaviors aimed at weight gain. Relatively high rates of disordered eating behaviors were reported by African American and Hispanic boys. Older girls reported slightly more dieting and disordered eating and less exercise than younger girls. Youth from low socioeconomic backgrounds were at greater risk for disordered eating than youth from high socioeconomic backgrounds. CONCLUSIONS: The findings suggest a need to widen our scope of thinking with regard to who is concerned with their body shape/size and at risk for engaging in potentially dangerous behaviors aimed at either weight loss or muscle gain.

Adolescent↗