A survey of 1,965 equine colic cases was conducted from August 1985 to July 1986 at 10 equine referral centers located throughout the United States. The purpose of this study was to develop and validate a multivariable model for the need for surgery. Two-thirds of the cases were randomly selected for model development (1,336), whereas the remaining cases (629) were used only for subsequent validation of the model. If a lesion requiring surgical correction was found at either surgery or necropsy, the case for the horse was classified as surgical, otherwise the case was classified as medical. Only variables that were significant (P less than 0.05) in an initial bivariable screening procedure were considered in the model development. Because of the large number of missing values in the data set, only variables for which there were less than 400 missing values were considered in the multivariable analysis. A multivariable logistic regression model was constructed by use of a stepwise algorithm. The model used 640 cases and included variables: rectal findings, signs of abdominal pain, peripheral pulse strength, and abdominal sounds. The likelihood ratio for surgery was calculated for each horse in the validation data set, using the logistic regression equation. Using Bayes theorem, the posttest probability was calculated, using the likelihood ratio as the test odds and the prevalence of surgery cases (at each institution) as an estimate of the pretest odds. A Hosmer-Lemeshow goodness-of-fit chi 2 statistic indicated that the model fit the validation data set poorly, as demonstrated by the large chi 2 value of 26.7 (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
In a population-based case-control study, we examined relations between maternal and paternal occupations and the risk of infant craniosynostosis. Cases were 212 children born to Colorado residents and diagnosed during 1986-1989 with radiographically confirmed synostosis of unknown etiology. Controls were 291 children randomly selected from state birth records and frequency matched to cases on month and year of birth. Trained staff conducted telephone interviews of mothers of case and control children. Information was obtained about each job held by either parent during the pregnancy, and any job that the father held during the 3 months before the last menstrual period before conception. Jobs were coded using 1980 Census occupation and industry codes. We found no strong associations for maternal occupations. Of paternal occupations, two groups were associated with moderately increased odds ratios after adjustment for maternal smoking and altitude: agriculture and forestry (odds ratio = 2.3; 95% confidence interval = 1.0-5.2), and mechanics and repairmen (odds ratio = 2.7; 95% confidence interval = 1.2-6.1). For both, the odds ratios were higher for males.
To determine the extent of postdiagnosis counseling and to characterize behavior before and after diagnosis of hepatitis C infection.We interviewed 133 persons diagnosed with hepatitis C in Wyoming from 1999 to 2001.Approximately two thirds of cases received counseling at the time of diagnosis. Older and symptomatic patients were more likely to receive counseling. Counseling was significantly associated with increases in condom use, wound covering, and hepatitis A and hepatitis B vaccination, but not with changes in addictive behaviors.Counseling was an effective strategy for promoting several desirable behavior changes among persons with hepatitis C infection.
Elevated rates of adverse reproductive outcome among medical and dental personnel exposed to waste anesthetic gas and vapor have been noted in the literature. NIOSH issued recommended standards for occupational exposure to these agents in a criteria document published in 1977. This study was designed to investigate adverse reproductive outcome in veterinary personnel who are exposed to waste anesthetic gas and vapors at levels near the NIOSH recommended standards. This epidemiologic study employed case-control methodology using a national sample of male veterinarians, female veterinarians and female veterinary assistants. Occupational exposure to waste anesthetic gas and vapors was not found to be associated significantly with adverse reproductive outcome at the 95% confidence level for female veterinary personnel when adjustment was made for use of diagnostic x-rays. Use of diagnostic x-rays in veterinary practice was associated with a statistically significant increase in odds ratios for spontaneous abortion in female veterinarians and veterinary assistants.
Abstract A previously undescribed skin abnormality, referred to as “linear skin markings” (LSM), has been identified in free‐ranging common bottlenose dolphins ( Tursiops truncatus ) in the Indian River Lagoon, Florida (IRL). The lesions were identified during photo‐identification surveys conducted from 2002 and 2015. LSM presented as distinct, parallel lines running dorso‐ventrally on the torso and varied in length and width. The goals of this study were to determine (1) prevalence of the condition in IRL dolphins, (2) age and sex distribution of affected animals, (3) spatial and temporal distribution patterns, (4) duration of the condition, and (5) development of hypotheses regarding the etiology of the condition. Among 1,357 individual dolphins identified during the study period, 96 (7.0%) showed evidence of LSM. Nearly all (98.8%) cases with an established home range occurred in the northern and central regions of the IRL. The majority of cases of known sex were female (85%), of which 100% had given birth to one or more calves. The mean age of animals with LSM when first observed was 7.3 with a range of 1–20 years. The maximum observed duration of LSM was 15 years. Once observed, the condition persisted indefinitely. The etiology of LSM has not been established.
SUMMARY Attempts to infect horses with Legionella pneumophila were undertaken to determine pathogenicity and to evaluate the possibility that horses serve as a reservoir for the organism. A previous study showed that the prevalence of antibodies to L pneumophila in the equine population exceeded 30% of over 600 sera examined. Horses were infected experimentally with the Philadelphia 1 or Bloomington 2 strain of L pneumophila iv or by aerosolization. Signs of clinical illness were restricted to a transient febrile response. A transient decrease in circulating lymphocytes occurred 2 days after inoculation. At necropsy, only moderate generalized lymphadenopathy was noted. Histologically, the lungs contained evidence of a low-grade inflammatory response characterized by focal proliferation of alveolar lining cells, with few neutrophils and eosinophils. Lymph nodes had evidence of reactive hyperplasia. The tissue response to Bloomington 2 strain was slightly more pronounced than that to Philadelphia 1. Attempts to reisolate L pneumophila from blood and nasal or pharyngeal swabs were unsuccessful. The organism was not isolated by culturing tissues obtained at necropsy, nor was it demonstrated by tissue-staining techniques. However, all horses exhibited a marked increase in agglutinating antibodies to L pneumophila serogroups ( sg ) 1 and 3 as early as 4 days after inoculation. The serologic response was confirmed by indirect immunofluorescence and was shown to consist predominantly of immunoglobulin M by 2-mercaptoethanol treatment. Agglutinating antibodies persisted at least 4 months after infection. On the basis of these studies, the pathogenicity of L pneumophila sg 1 and 3 for the horse appears to be low. There is no evidence to support a role for the horse in the maintenance of these organisms in nature. Horses may be exposed in the environment and maintain a relatively long-lived serologic response to L pneumophila . However, it is also possible that they become infected with other strains of L pneumophila or Legionella -like organisms more pathogenic for horses, or other non- Lagionella bacteria, which elicit a cross-reacting serologic response to L pneumophila sg 1 to 4.
The inability to accurately assess exposure has been one of the major shortcomings of epidemiologic studies of disinfection by-products (DBPs) in drinking water. A number of contributing factors include a) limited information on the identity, occurrence, toxicity, and pharmacokinetics of the many DBPs that can be formed from chlorine, chloramine, ozone, and chlorine dioxide disinfection; b) the complex chemical interrelationships between DBPs and other parameters within a municipal water distribution system; and c) difficulties obtaining accurate and reliable information on personal activity and water consumption patterns. In May 2000, an international workshop was held to bring together various disciplines to develop better approaches for measuring DBP exposure for epidemiologic studies. The workshop reached consensus about the clear need to involve relevant disciplines (e.g., chemists, engineers, toxicologists, biostatisticians and epidemiologists) as partners in developing epidemiologic studies of DBPs in drinking water. The workshop concluded that greater collaboration of epidemiologists with water utilities and regulators should be encouraged in order to make regulatory monitoring data more useful for epidemiologic studies. Similarly, exposure classification categories in epidemiologic studies should be chosen to make results useful for regulatory or policy decision making.
Little is known about the environmental and public health impact of unconventional natural gas extraction activities, including hydraulic fracturing, that occur near residential areas.Our aim was to assess the relationship between household proximity to natural gas wells and reported health symptoms.We conducted a hypothesis-generating health symptom survey of 492 persons in 180 randomly selected households with ground-fed wells in an area of active natural gas drilling. Gas well proximity for each household was compared with the prevalence and frequency of reported dermal, respiratory, gastrointestinal, cardiovascular, and neurological symptoms.The number of reported health symptoms per person was higher among residents living < 1 km (mean ± SD, 3.27 ± 3.72) compared with > 2 km from the nearest gas well (mean ± SD, 1.60 ± 2.14; p = 0.0002). In a model that adjusted for age, sex, household education, smoking, awareness of environmental risk, work type, and animals in house, reported skin conditions were more common in households < 1 km compared with > 2 km from the nearest gas well (odds ratio = 4.1; 95% CI: 1.4, 12.3; p = 0.01). Upper respiratory symptoms were also more frequently reported in persons living in households < 1 km from gas wells (39%) compared with households 1-2 km or > 2 km from the nearest well (31 and 18%, respectively) (p = 0.004). No equivalent correlation was found between well proximity and other reported groups of respiratory, neurological, cardiovascular, or gastrointestinal conditions.Although these results should be viewed as hypothesis generating, and the population studied was limited to households with a ground-fed water supply, proximity of natural gas wells may be associated with the prevalence of health symptoms including dermal and respiratory conditions in residents living near natural gas extraction activities. Further study of these associations, including the role of specific air and water exposures, is warranted.
