Connecticut's Medicare B assignment rate. Council of the Connecticut State Medical Society.
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Connecticut↗
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The Individual Practice Association comes to Connecticut: Connecticut's first IPA--HMO.
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California↗
Impact of an aging population on utilization and bed needs of Connecticut hospitals. Connecticut Hospital Association.
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Adolescent↗
Civil commitment in Connecticut. What the physician should know about Connecticut's new commitment laws.
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Commitment of Persons with Psychiatric Disorders↗
Principles for dentist-pharmacist relationships: guidelines developed in Connecticut.
The "Guiding principles for dentist-pharmacist relationships in Connecticut" was prepared under the auspices of the Connecticut Joint Dental-Pharmaceutical Committee of the Connecticut State Dental Association and the Connecticut Pharmaceutical Association. The committee is made up of six dentists and six pharmacists who represent their respective state associations. The committee provides a forum in which practicing, academic licensing, and supervisory representatives of both professions meet voluntarily to discuss scientific objects of mutual interest, make pertinent recommendations on matters of professional and public concern and, on request, attempt to resolve occasional differences that arise between responsible pharmacists and dentists. The "Guide" was prepared because of the significant increase in prescription writing by practicing dentists in Connecticut. Further, with the increased involvement of third party programs, the committee thought that the relationship between dentists and pharmacists should be formalized to establish that prescription writing is a significant part of dental practice. The "Guide" was approved by the executive committee of the Connecticut Pharmaceutical Association in January 1975 and the house of delegates of the Connecticut State Dental Association in May 1975.
Connecticut↗
Uterine cervical carcinoma in Connecticut, 1935-1973: evidence for two classes of invasive disease.
The Connecticut Tumor Registry recorded 5,781 women with carcinoma in situ (CIS) and 7,614 with invasive cervical cancer from 1935 to 1973. True incidence rates for invasive disease were calculated. CIS rates indicated newly diagnosed cases, but true CIS incidence is unknown. Starting in 1945-49, the incidence of invasive cervical declined about 20% in Connecticut before CIS screening could have influenced the disease to that extent. Continuing declines in invasive disease rates after 1955 in Connecticut were probably attributable largely to screening. The persistent occurrence of invasive disease in screened populations and the rapid progression of cancer, with early death among some women with apparently localized disease at diagnosis, suggested that a second class of invasive cervical cancer may exist. Cancers in this class may develop and progress rapidly without a practical possibility of detection in the premalignant stage by cytologic methods. Other screening methods, e.g., metabolic, hormonal, immunologic, or virologic, may be required to control this disease.
Adult↗
Rocky mountain spotted fever in Connecticut: human cases, spotted-fever group rickettsiae in ticks, and antibodies in mammals.
Three parameters were used in 1976 and 1977 to assess the status of Rocky Mountain spotted fever (RMSF) in Connecticut--compilation and review of clinical data on suspected human cases for the 13-year period 1965--1977, examination of tick tissues for spotted fever-group rickettsiae by the hemolymph test and direct immunofluorescence, and analyses of mammalian sera for antibodies against Rickettsia rickettsii. There were six presumptive RMSF cases which probably originated in Connecticut. Four of these cases occurred in areas where the American dog tick, Dermacentor variabilis, abounds. A total of 2994 ticks were examined by the hemolymph test. Rickettsia-like organisms were observed in 67 (2.9%) of 2330 D. variabilis and two (0.6%) of 351 Ixodes sp. near scapularis. Fewer than one-half of these organisms stained positively with spotted fever-group conjugate. Microagglutination tests on 1093 mammalian sera indicated that eight (16%) of 49 raccoons, 14 (2.6%) of 549 white-tailed deer, eight (1.7%) of 470 white-footed mice, and one of two gray squirrels had agglutinins in titers greater than or equal to 1:8 against R. rickettsii. Spotted fever-group rickettsiae are present at low frequency in inland as well as coastal regions of Connecticut.
Adult↗
Photochemical air pollution: transport from the New York City area into Connecticut and Massachusetts.
Photochemical air pollution resulting from primary emissions in the New York City metropolitan area is transported by prevailing winds on a 300-kilometer northeast trajectory through Connecticut and as far as northeastern Massachusetts. As a result, southwestern Connecticut has the highest ozone concentrations in the region and there is a substantial increase in ozone concentrations in Massachusetts. The ozone concentrations of air entering the New York City metropolitan area are often already above the federal standard of 0.08 part per million, but the concentration distribution is well below concentration distributions at downwind sites in Connecticut.
Air Pollution↗
A comparison of Hodgkin's disease in Alameda County, California, and Connecticut: histologic subtype and age distribution.
A comparison of the histologic patterns of Hodgkin's disease in Alameda County, California and Connecticut was made in relation to age. All Hodgkin's disease cases from the Alameda County Cancer Registry diagnosed between 1960 and 1969 for which adequate material was available for evaluation were reviewed and histologically subtyped according to the Rye classification (159 cases). The age-specific relative frequencies and incidence rates for the histologic subtypes of Hodgkin's disease in Alameda County were estimated and compared to those estimated for Hodgkin's disease in Connecticut. The morphologic ex pression of Hodgkin's disease in both areas was similar and characteristic of economically developed regions with high living standards. The comparison supports the hypothesis that the host immune capacity, influenced by socioeconomic factors, has a strong and measurable effect on the pathogenesis of Hodgkin's disease.
Adolescent↗
Lyme arthritis: an epidemic of oligoarticular arthritis in children and adults in three connecticut communities.
An epidemic form of arthritis has been occurring in eastern Connecticut at least since 1972, with the peak incidence of new cases in the summer and early fall. Its identification has been possible because of tight geographic clustering in some areas, and because of a characteristic preceding skin lesion in some patients. The authors studied 51 residents of three contiguous Connecticut communities -- 39 children and 12 adults -- who developed an illness characterized by recurrent attacks of asymmetric swelling and pain in a few large joints, especially the knee. Attacks were usually short (median: 1 week) with much longer intervening periods of complete remission (median: 2.5 months), but some attacks lasted for months. To date the typical patient has had three recurrences, but 16 patients have had none. A median of 4 weeks (range: 1-24) before the onset of arthritis, 13 patients (25%) noted an erythematous papule that developed into an expanding, red, annular lesion, as much as 50 cm in diameter. Only 2 of 159 family members of patients had such a lesion and did not develop arthritis (P less than 0.000001). The overalll prevalence of the arthritis was 4.3 cases per 1,000 residents, but the prevalence among children living on four roads was 1 in 10. Six families had more than 1 affected member. Nine of 20 symptomatic patients had low serum C3 levels, compared to none of 31 asymptomatic patients (P less than 0.005); no patient had iridocyclitis or a positive test for antinuclear antibodies. Neither cultures of synovium and synovial fluid nor serologic tests were positive for agents known to cause arthritis. "Lynne arthritis" is thought to be a previously unrecognized clinical entity, the epidemiology of which suggests transmission by an arthropod vector.
Adult↗
The Model Postmortem Examinations Act in the State of Connecticut, 1969-1974.
Five years following the 1969 passage of legislation patterned after the Model Postmortem Examinations Act, Connecticut has a central laboratory with administrative, autopsy, and toxicology facilities; 24-hour statewide reporting deaths; a records and data-processing system; and affiliation with a university health center. The state's population density, number and size of municipalities and police departments, absence of county government, and judicial appointment of coroner's were unique geographic-political features confronting implementation of the legislation. To effect a transition from the preexisting system, and because of the number of deaths reported and physicians involved, a dual system was developed for examinations and certification of deaths which differentiated autopsies performed at the central laboratory from those at community hospitals. Dissemination of procedures and forms for medicolegal autopsies conducted at community hospitals is planned in the near future. Although educational programs for graduates and law enforcement personnel have been initiated, there still exists a need for more active undergraduate and postgraduate training and a program of research and statistical reporting. Implementation of the statutes during a five-year period in which supplemental legislation and regulations were passed, changes that occurred in state administration, and budgetary restrictions mandated by economic recession has, however, resulted in the nucleus of a modern state medicolegal investigative system--a separately budgeted medical examiner's office, supervised by an independent administrative commission and located on the grounds of the University of Connecticut Health Center in Farmington.
Administrative Personnel↗
Multiple primary malignant neoplasms. The Connecticut experience, 1935-1964.
Results for non-simultaneously diagnosed malignant tumors from Connecticut indicate that individuals with one malignant neoplasm have 1.29 times the risk of developing a new independent primary tumor when compared to individuals who never had cancer (P less than 0.01). However, the increased risk of multiple primary tumors is highly selective on a site-specific basis. Table 135 presents Connecticut Registry data indicating the risk of a subsequent primary malignancy by anatomic site of the later primary in patients with a first primary cancer. Tables 136 and 137 present tabulations for anatomic sites with statistically significant excesses and deficiencies, with an analysis by time interval between the two malignancies. Finally, Table 138 presents figures showing histologic confirmation for site-group paris with significant excesses of observed-over-expected later primary malignant neoplasms. The reader should bear in mind that just as the risk of subsequent primaries varies with the anatomic site of the subsequent primary (Table 135), the risk is also highly dependent upon the anatomic site of the first primary cancer (Chapters 6-12).
Aged↗
Productivity of ospreys in Connecticut--Long Island increases as DDE residues decline.
Nesting success of ospreys (Pandion haliaetus) breeding in the Connecticut--Long Island area has increased since 1973 and is now approaching the levels recorded prior to the 1950's. Simultaneously, DDE and dieldrin residues have declined in unhatched eggs. Levels of polychorinated biphenyls have shown no changes over the period 1969 to 1976. The increase in productivity is attributed primarily to lower levels of DDE contamination. Detrimental effects in the past on ospreys in the Connecticut River estuary are attributed to local contamination with dieldrin.
Animals↗
Changes in site distribution of colorectal carcinoma in Connecticut, 1940-1973.
The proportion of colorectal cancer occurring above the rectosigmoid junction has been increasing over time. The 40,771 cases of colorectal carcinoma reported to the Connecticut Tumor Registry from 1940 through 1973 were analyzed to determine the incidence in the ascending colon, the transverse, descending, and sigmoid colon, and the rectum. The numbers of cases, the proportion, and incidence rates of cancer in the ascending colon and sigmoid have increased over the 34 years. The increases were greatest among people over 65 years old. Only about half of colorectal cancer can now be identified with the rigid sigmoidoscope. Other tests must be used for early diagnosis of the increased numbers of cancers in the upper parts of the colon.
Adolescent↗
Epidemiology of renal cell carcinoma in Connecticut, 1935-1973.
Data on over 3,700 patients with renal cell carcinoma, reported to the Connecticut Tumor Registry from 1935 through 1973, were used to assess incidence, survival, and associations of risk with demographic characteristics. Incidence increased over time among men, but not among women; a birth cohort effect suggesting increasing incidence rate over time was demonstrated for men. A comparison of male and female age-specific incidence rates indicated that, in the 15- to 39-year-old age group, men were three times more likely than women to develop the disease; after age 40, renal cell carcinoma was diagnosed in men twice as often as in women. Survival probability has increased from 1940 to the present time. A high density of persons per square mile was associated with a higher-than-expected incidence. No trends in incidence according to socioeconomic status were observed.
Adenocarcinoma↗
Community studies of lung disease in Connecticut: organization and methods.
We have obtained data on respiratory symptoms, enviornmental exposures, and lung function in 3730 residents, aged seven years and over, of a rural and an urban community in Connecticut. We used newly developed computerized techniques of data acquisition. The respondents represent 66.3% of the total populations available for study in the defined geographic areas (75.2% in the rural and 54.7% in the urban community). Door-to-door surveys in defined areas within each community provided information on the nonrespondents. Data on 92% of all residents were obtained in the door-to-door survey areas. Comparisons of respiratory symptoms and smoking habits between respondents and nonrespondents in the door-to-door survey areas, and between respondents living in the door-to-door survey areas and elsewhere in the two towns, led to the conclusion that the data on the respondents are an accurate reflection of the lung disease experienced by the total populations of the two communities.
Adolescent↗
The descriptive epidemiology of primary intracranial neoplasms: the Connecticut experience.
The age-specific incidence pattern for tumors of the brain and cranial meninges in Connecticut over a 30-year period shows an early peak followed by a taller and sharper peak with a maximum in the 55-65 year age group. This overall curve reflects the pattern shown for glioblastoma, the tumor accounting for the majority of the histologically confirmed cases. The reported rates are probably underestimates of the actual rates. The various histologic types of brain tumors reveal sufficiently distinct epidemiologic patterns to be considered as separate diseases.
Adolescent↗
An investigation of the use of asbestos cement pipe for public water supply and the incidence of gastrointestinal cancer in Connecticut, 1935-1973.
The age adjusted sex specific incidence data for stomach, colon, and rectal cancer for Connecticut townships for the period 1935 to 1973 were used to investigate whether asbestos cement pipe usage for domestic drinking water is associated with gastrointestinal cancer. The townships were grouped according to the Assessment of Exposure (AOE) and Risk Factor (RF) for asbestos. These are composite indices of asbestos exposure including factors relating to the age of the pipe, the ability of water to leach asbestos from the pipe, and the length of pipes used by the population. No association was noted between these asbestos risk scores and gastrointestinal tumor incidence.
Asbestos↗