Diabetes and hypertension in Mexican American families: relation to cardiovascular risk.
(25/2176)
There is a strong familial predisposition to type 2 diabetes, hypertension, and cardiovascular disease. The authors evaluated the association between a family history of these diseases and a large panel of cardiovascular risk factors in 1,431 Mexican American subjects who were enrolled in the San Antonio Family Heart Study in San Antonio, Texas. The baseline phase of the study covered 1992-1996. Diabetes and hypertension were diagnosed according to standard clinical criteria, while cardiovascular disease was defined as a history of heart attack or heart surgery. The prevalence of diabetes, hypertension, and cardiovascular disease in this population was 15%, 12%, and 3%, respectively. For each unaffected subject, the authors computed a family history score based on the presence or absence of disease in parents and older siblings, and correlations between cardiovascular risk factors and family history scores were estimated by using likelihood-based variance component methods. Diabetes family history score was significantly correlated with a broad panel of cardiovascular risk factors, including glucose and insulin, obesity, blood pressure, triglycerides, and total cholesterol. Hypertension family history score was significantly correlated with glucose, blood pressure, body mass index, waist circumference, total cholesterol, and triglycerides. These results support the idea that genes that confer a risk for diabetes, and to a lesser extent hypertension, adversely alter the cardiovascular risk profile long before the manifestation of clinical disease. (+info)
Influence of data display formats on physician investigators' decisions to stop clinical trials: prospective trial with repeated measures.
(26/2176)
OBJECTIVE: To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. DESIGN: Prospective, mixed model design with variables between subjects and within subjects (repeated measures). SETTING: Comprehensive cancer centre. PARTICIPANTS: 34 physicians, stratified by academic rank, who were conducting clinical trials. INTERVENTIONS: PARTICIPANTS were shown tables, pie charts, bar graphs, and icon displays containing hypothetical data from a clinical trial and were asked to decide whether to continue the trial or stop for an unplanned statistical analysis. MAIN OUTCOME MEASURE: Percentage of accurate decisions with each type of display. RESULTS: Accuracy of decisions was affected by the type of data display and positive or negative framing of the data. More correct decisions were made with icon displays than with tables, pie charts, and bar graphs (82% v 68%, 56%, and 43%, respectively; P=0.03) and when data were negatively framed rather than positively framed in tables (93% v 47%; P=0.004). CONCLUSIONS: Clinical investigators' decisions can be affected by factors unrelated to the actual data. In the design of clinical trials information systems, careful consideration should be given to the method by which data are framed and displayed in order to reduce the impact of these extraneous factors. (+info)
Illegal sales of cigarettes to minors--Ciudad Juarez, Mexico; El Paso, Texas; and Las Cruces, New Mexico, 1999.
(27/2176)
In 1996, the United States-Mexico Binational Commission (US-MBC) Health Working Group identified prevention of tobacco use, particularly among adolescents, as a priority and subsequently recommended joint efforts toward reducing illegal sales of cigarettes to minors. A 1997 survey of 561 commercial cigarette outlets in Mexico City found that 79% of retailers sold cigarettes to minors. To assess the illegal sale of cigarettes to minors in other regions of Mexico and on both sides of the U.S.-Mexico border, during January-February 1999 the General Directorate of Epidemiology in Mexico, the Chihuahua State Department of Health Services (CDH), the Ciudad Juarez Department of Health (CJDH), the Texas Department of Health (TDH), and the New Mexico Department of Health (NMDH) surveyed cigarette outlets in Ciudad Juarez, Mexico; El Paso, Texas; and Las Cruces, New Mexico. This report summarizes the results of these surveys, which indicate that almost all retailers in the surveyed outlets in Ciudad Juarez sold cigarettes to minors and that sales rates to minors were substantially lower in El Paso and Las Cruces. (+info)
Neural tube defects along the Texas-Mexico border, 1993-1995.
(28/2176)
In response to a 1991 anencephaly cluster in Cameron County, Texas, a surveillance and neural tube defect (NTD) recurrence prevention project for NTDs was implemented in the 14 Texas-Mexico border counties. For 1993-1995, NTD-affected pregnancies were identified at all gestational ages through active surveillance of multiple case-ascertainment sources. There were 87 cases of anencephaly, 96 cases of spina bifida, and 14 cases of encephalocele for respective rates of 6.4, 7.1, and 1.1 per 10,000 live births. Of the 197 NTD case-women, 93% were Hispanic. The overall, Hispanic, and Anglo NTD rates were, respectively, 14.6, 14.9, and 10.6 per 10,000 live births. The NTD rate for El Paso County (9.8 per 10,000), the most northwestern Texas county, was significantly lower (p = 0.001) than the aggregate rate for the rest of the Texas border (17.1 per 10,000). The overall Texas border rate was significantly higher (p < 0.001) than a recently estimated rate of 9.3 for California and minimally higher than a recently adjusted rate of 11.3 for the Metropolitan Atlanta Congenital Defects Program counties (p = 0.052), both of which now reflect all gestational ages. Of the 197 Texas border cases, 85% (168 cases) reached a gestational age of > or =20 weeks. Excluding cases of <20 weeks' gestation in the rate had a more marked effect on reducing the anencephaly rate (4.9 per 10,000) than the spina bifida rate (6.7 per 10,000). A country of birth was known for 153 (83%) of the 184 Hispanic case-women: 63% were born in Mexico; 24%, in Texas; and 11%, elsewhere in the United States. Rates for Mexico-born Hispanic women (15.1 per 10,000) were significantly higher than rates for United States-born Hispanic women (9.5 per 10,000) (p = 0.006). (+info)
Illnesses associated with occupational use of flea-control products--California, Texas, and Washington, 1989-1997.
(29/2176)
Dips, shampoos, and other insecticide-containing flea-control products can produce systemic illnesses or localized symptoms in the persons applying them. Although these products may pose a risk to consumers, they are particularly hazardous to pet groomers and handlers who use them regularly. Illnesses associated with flea-control products were reported to the California Department of Pesticide Regulation, the Texas Department of Health, and the Washington State Department of Health, each of which maintains a surveillance system for identifying, investigating, and preventing pesticide-related illnesses and injuries. This report describes cases of occupational illnesses associated with flea-control products, summarizes surveillance data, and provides recommendations for handling these products safely. (+info)
The epidemiology of viral hepatitis in children in South Texas: increased prevalence of hepatitis A along the Texas-Mexico border.
(30/2176)
An initial retrospective study of 194 children demonstrated a high prevalence of hepatitis A but not hepatitis B or C infection among children living along the Texas-Mexico border. A larger prospective study of hepatitis A was conducted with 285 children (aged 6 months to 13 years) living in 3 sociodemographically dissimilar areas of South Texas. Children living in colonias along the border had a significantly higher prevalence of hepatitis A virus infection (37%) than children living in urban border communities (17%) or in a large metropolitan area (San Antonio [6%]). Independent risk factors for hepatitis A infection included increased age, colonia residence, and history of residence in a developing country. Use of bottled water (vs. municipal or spring/well water) and years of maternal secondary education were protective. Improved sanitation or routine hepatitis A vaccination in early childhood may reduce the prevalence of hepatitis A in these areas. (+info)
Lymphatic and haematopoietic cancer mortality in a population attending school adjacent to styrene-butadiene facilities, 1963-1993.
(31/2176)
STUDY OBJECTIVE: To evaluate the risk of mortality from lymphatic and haematopoietic cancers and other causes among students. DESIGN: The study used school records, yearbooks, and Texas Department of Health records for the school years 1963-64 to 1992-93 to construct a cohort of 15,403 students. Three mortality databases were searched to identify deaths, and mortality rates in the cohort were compared with mortality rates from the United States and Texas. Computed standardised mortality ratios and 95% confidence intervals were used. SETTING: Eastern Texas high school adjacent to facilities that have been producing synthetic styrene-butadiene since 1943. MAIN RESULTS: 338 deaths were identified. The all causes standardised mortality ratio was 0.84 (95% confidence intervals 0.74, 0.95) for men and 0.89 (0.73, 1.09) for women. The standardised mortality ratio for all lymphatic and haematopoietic cancers was 1.64 (95% confidence intervals 0.85, 2.87) for men and 0.47 (0.06, 1.70) for women. The slight male excess in lymphatic and haematopoietic cancers was stronger among men who attended school for two years or less. CONCLUSIONS: The overall mortality from lymphatic and haematopoietic cancer among the students was little different from that of the United States as a whole. A moderate excess for men, predominantly among the shorter-term students, was offset by a deficit among women. These variations are compatible with random fluctuations; the overall pattern is not indicative of an effect of environmental exposure sustained while attending the high school. (+info)
Outbreak of histoplasmosis among cavers attending the National Speleological Society Annual Convention, Texas, 1994.
(32/2176)
In June 1994, 18 people developed serologically confirmed histoplasmosis following cave exploration associated with the annual National Speleological Society Convention in Bracketville, Texas. Six others had an undiagnosed illness suspected to be histoplasmosis. Two persons were hospitalized. We conducted a survey of convention attendees and a nested case-control study of those entering caves. We also conducted a histoplasmin skin test survey of a subgroup of the society, the Texas Cavers Association, who were attending a reunion in October 1994. Among the national convention attendees, exposure to two caves was identified as responsible for 22 (92%) of the 24 cases; 12 (75%) of 16 people exploring one cave (Cave A) and 10 (77%) of 13 exploring a separate cave (Cave B) developed acute histoplasmosis. Additional risk-factors included fewer years of caving experience, longer time spent in the caves, and entering a confined crawl space in Cave A. Of 113 participants in the separate skin test survey, 68 (60%) were found to be skin test positive, indicating previous exposure to Histoplasma capsulatum. A positive skin test was significantly associated with male sex and more years of caving experience. Those less experienced in caving associations should be taught about histoplasmosis, and health care providers should pursue histories of cave exposure for patients with bronchitis or pneumonia that does not respond to initial antibiotic therapy. (+info)