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Invasive group B streptococcal (GBS) infection is a major health problem among infants and adults. The formulation of GBS vaccines depends on knowledge of the GBS serotype distribution. Serotype V GBS infection appears to have recently emerged, suggesting that the serotype distribution changes over time. GBS isolates from 210 pediatric patients, 23 pregnant women, and 314 nonpregnant adults with invasive infection in Maryland were studied. The predominant serotypes from infants with early-onset disease were as follows: serotype III, 38% of isolates; serotype Ia, 36%; serotype V, 13%; and serotype II, 11%. Although the majority (60%) of isolates among infants with late-onset infection were serotype III, serotype Ia (23%) was also common. The predominant serotype among isolates from nonpregnant adult patients was serotype V, accounting for 29% of the isolates. The serotype distribution differs between pediatric patients and adults and is changing over time. The inclusion of a relatively small number of serotypes in a GBS vaccine could provide protection against the vast majority of isolates.
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OBJECTIVES: To determine the effects of a 1988 Maryland law that banned "Saturday night special" handguns on the types of guns used in crime. To determine if controls on the lawful market for handguns affect the illegal market as well. SETTING: Baltimore, Maryland, and 15 other US cities participating in a crime gun tracing project. METHODS: Cross sectional comparison of the proportion of crime guns that are banned by the Maryland law, comparing Baltimore, MD with 15 other cities outside of Maryland. Multivariate linear regression analysis to determine if observed differences between Baltimore and 15 other cities are explained by demographic or regional differences among the cities rather than Maryland's law. RESULTS: Among crime guns, a gun banned by Maryland's law is more than twice as likely (relative risk (RR) 2.3, 95% confidence interval (CI) 2.0 to 2.5) to be the subject of a crime gun trace request in 15 other cities combined, than in Baltimore. Among homicide guns, a crime especially relevant for public safety, a comparable difference (RR 2.1, 95% CI 1.1 to 4.2) was observed. The proportion of Baltimore's crime guns that are banned is 12 percentage points lower than would be expected based on its demographic and regional characteristics alone. Among crime guns purchased after 1990, a much smaller proportion in Baltimore are banned models than in 15 other cities. CONCLUSIONS: Maryland's law has reduced the use of banned Saturday night specials by criminals in Baltimore. Contrary to the claims of some opponents of gun control laws, regulation of the lawful market for firearms can also affect criminals.
For many years, Maryland has ranked among the top states in cancer mortality. This study analyzed mortality data from the National Center for Health Statistics (CDC-Wonder) to help explain Maryland's cancer rate and rank. Age-adjusted rates are based on deaths per 100,000 population from 1991 through 1995. Rates and ranks overall, and stratified by age, are calculated for total cancer mortality, as well as for four major sites: lung, breast, prostate, and colorectal. Because states differ in their racial/gender mix, race/gender rates among states are also compared. Although Maryland ranks seventh in overall cancer mortality, its rates and rank by race and gender subpopulation are less high. For those under 75, white men ranked 26th, black men ranked 20th, and black and white women ranked 12th and 10th, respectively. Maryland's overall rank, as with any state, is a function of the rates of its racial and gender subpopulations and the relative size of these groups in the state. Many of the disparities between Maryland's overall high cancer rank and its lower rank by subpopulation also characterize the major cancer sites. Although a stratified presentation of cancer rates and ranks may be more favorable to Maryland, it should not be used to downplay the attention cancer mortality in Maryland deserves.
INTRODUCTION: A comprehensive state-wide emergency medical services and helicopter transport system has been developed in the State of Maryland on the principle that early definitive care improves patient outcomes. The purpose of this study was to determine if empirical data exist to support the theory that air medical transportation services provided by the Maryland State Police (MSP) Aviation Division contribute to an improved trauma patient survival rate in Maryland. METHODS: A retrospective study was conducted on the records of all patients transported by helicopter or ground ambulance and admitted to the R Adams Cowley Shock Trauma Center (STC) of the University of Maryland Medical System. Data were obtained from the Maryland Institute of Emergency Medical Services Systems (MIEMSS) Shock Trauma Clinical Registry for the period January 1988 through July 1995, covering 23,002 patients. Patients included those transported directly from the scene of injury to the STC as well as those from interfacility transfers. All patients were stratified by injury severity and compared by outcome (mortality) using Mantel-Haenszel statistics. RESULTS: During the study period, 11,379 patients were transported by ground and 11,623 were transported by MSP helicopter. The mean Injury Severity Score (ISS) for patients transported by ground was 12.7 (SD = 12.52) and the mean ISS for patients transported by air was 14.6 (SD = 13.42), p < 0.001. Among patients classified as having a high index of injury severity, the mortality rate was lower among those transported by MSP helicopter than among those transported by ambulance. The mortality rate was significantly lower for air transported patient with an ISS higher than 31. CONCLUSION: The State of Maryland has demonstrated a commitment to its citizenry and invested heavily in its public safety air medical service. This study suggests the rapid air transport of victims of traumatic events by specialized personnel in Maryland has a positive effect on the outcome of severely injured patients. Further research is necessary to clarify the causal relationships in order to more fully elucidate the value of this resource.