Methicillin-resistant Staphylococcus aureus skin or soft tissue infections in a state prison--Mississippi, 2000.
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On October 25, 2000, the Mississippi State Department of Health (MSDH) notified CDC that, since November 1999, 31 inmates had acquired methicillin-resistant Staphylococcus aureus (MRSA) skin or soft tissue infections at a state prison. During November 1998-October 1999, no MRSA infections had been reported at the prison, which houses approximately 1,200 female and 1,800 male inmates. This report summarizes the case investigation and the nasal culture prevalence survey conducted by MSDH and CDC during November 2000. Findings indicate that MRSA infections were transmitted person-to-person within the prison, and that the number of asymptomatic carriers was unexpectedly high for a nonhealth-care setting. Correctional facilities can reduce the increasing prevalence of MRSA disease by identifying and appropriately treating infected persons and by instituting prevention measures. (+info)
Coronary heart disease trends in four United States communities. The Atherosclerosis Risk in Communities (ARIC) study 1987-1996.
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OBJECTIVE: The objective of this paper is to report trends in mortality due to coronary heart disease (CHD), rates of first and recurrent hospitalized myocardial infarction, and survival after myocardial infarction in the Atherosclerosis Risk in Communities (ARIC) Study from 1987 through 1996. METHOD: The ARIC study used retrospective community surveillance to monitor admissions to acute care hospitals and deaths due to CHD (both in- and out-of-hospital) among all residents 35-74 years of age. The surveillance areas included over 360 000 men and women in four communities: Forsyth County, North Carolina; the city of Jackson, Mississippi; eight northern suburbs of Minneapolis, Minnesota; and Washington County, Maryland. RESULTS: The annual age-adjusted mortality rate of CHD fell 3.2% (95% CI: 2.0, 4.3) among men and 3.8% (95% CI: 1.9, 5.6) among women. The greater part of the decline took place between 1987 and 1991. Significant declines were observed for both in-hospital and out-of-hospital CHD death. Significant improvements in case-fatality were also observed. Recurrent hospitalized myocardial infarction event rate fell an average of 1.9% per year among men (95% CI: 0.7, 3.1) and 2.1% (95% CI: 0.3, 3.9) among women. Average annual per cent change in incident hospitalized myocardial infarction was not statistically significant, except in blacks where there was evidence of an increase over time. CONCLUSION: Factors associated with the occurrence of recurrent hospitalized myocardial infarction, as well as those creating a better chance of survival after an event (including reductions in sudden death), were likely the prominent components in the recent decline in CHD mortality in ARIC communities. (+info)
Factor XIIIA Val34Leu polymorphism does not predict risk of coronary heart disease: The Atherosclerosis Risk in Communities (ARIC) Study.
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Factor XIII catalyzes the cross-linking of fibrin. Cross-sectional studies have suggested that a common polymorphism site at residue 34 of the A subunit of factor XIII (FXIIIA) with a substitution of Leu for Val (FXIIIA Val34Leu) was associated with reduced coronary heart disease (CHD). This association has not been examined in prospective studies. Healthy subjects (n=15 792) were recruited from 4 US communities into the Atherosclerosis Risk in Communities (ARIC) study from 1987 to 1989. They were followed, and incident CHD events were identified and verified. For the present study, we included 423 patients with CHD as cases and 479 noncases. FXIIIA Val34Leu polymorphism was determined by the single-strand conformational polymorphism method. There were no significant differences in the genotype frequencies between cases and noncases. The genotypes showed little association with known CHD risk factors. A weighted proportional hazards regression analysis adjusting for other risk factors confirmed no association of the genotypes with risk of CHD. This prospective study did not provide evidence of a reduced CHD risk for the FXIIIA 34Leu allele. (+info)
Common deletion of SMAD4 in juvenile polyposis is a mutational hotspot.
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Juvenile polyposis (JP) is an autosomal dominant syndrome in which affected patients develop upper- and/or lower-gastrointestinal (GI) polyps. A subset of families with JP have germline mutations in the SMAD4 (MADH4) gene and are at increased risk of GI cancers. To date, six families with JP have been described as having the same SMAD4 deletion (1244-1247delAGAC). The objective of the present study is to determine whether this deletion is a common ancestral mutation or a mutational hotspot. DNA from members of four families with JP, from Iowa, Mississippi, Texas, and Finland, that had this 4-bp deletion was used to genotype 15 simple tandem repeat polymorphism (STRP) markers flanking the SMAD4 gene, including 2 new STRPs within 6.3 and 70.9 kb of the deletion. Haplotypes cosegregating with JP in each family were constructed, and the distances of the closest markers were determined from the draft sequence of the human genome. No common haplotype was observed in these four families with JP. A 14-bp region containing the deletion had four direct repeats and one inverted repeat. Because no common ancestor was suggested by haplotype analysis and the sequence flanking the deletion contains repeats frequently associated with microdeletions, this common SMAD4 deletion in JP most likely represents a mutational hotspot. (+info)
Environmental injustice and the Mississippi hog industry.
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The recent growth and restructuring of the swine industry in the state of Mississippi has raised various environmental and socioeconomic concerns. We spatially examined the location and attributes of 67 industrial hog operations to determine if African American and low-income communities have a high prevalence of industrial hog operations located near their neighborhoods at the census block group level. We used spatial data and cross-classification analysis to compare the prevalence of industrial hog operations in neighborhoods that are primarily African American and low income with the prevalence in neighborhoods that are African American and affluent. We also used logistic regression to evaluate the relationship between the environmental justice variables and the location of the industrial hog operations. The block group characterization showed a high prevalence of hog operations in the four highest quintiles compared with the lowest quintile for percentage African American and percentage poverty. At increasing levels of percentage African Americans and percentage of persons in poverty, there are 2.4-3.6 times more operations compared with the referent group; additionally, scale adjustment to only the hog counties reduces this to 1.8-3.1 more operations compared with the referent group. The inequitable distribution of hog-confined agricultural feeding operations in these communities may have adverse environmental impacts associated with industrial hog production, such as increased health risks and quality of life degradation, as have occurred in other areas having similar facilities. (+info)
The relationship of performance on the dental admission test and performance on Part I of the National Board Dental Examinations.
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Although many schools use scores on the Dental Admission Test (DAT) to evaluate applicants, the association of these scores with students' performance on Part I of the National Board Dental Examinations (NBDE) has not been recently evaluated. In this study, the hypothesis that the DAT scores would be a significant predictor of Part I of the NBDE scores was tested. We analyzed by multiple regression the scores on both examinations for the 114 students matriculating in the University of Mississippi School of Dentistry in 1992, 1993, 1994, and 1995. The results indicate that DAT reading comprehension was a statistically significant predictor (p value less than or equal to 0.05) of all four subtests of Part I of the NBDE. The DAT biology and organic chemistry scores were statistically significant predictors of NBDE biochemistry-physiology, and the DAT quantitative analysis score was a statistically significant predictor of NBDE dental anatomy and occlusion. DAT perceptual ability and general chemistry were not significant predictors. (+info)
Nursing home case-mix reimbursement in Mississippi and South Dakota.
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OBJECTIVE: To evaluate the effects of nursing home case-mix reimbursement on facility case mix and costs in Mississippi and South Dakota. DATA SOURCES: Secondary data from resident assessments and Medicaid cost reports from 154 Mississippi and 107 South Dakota nursing facilities in 1992 and 1994, before and after implementation of new case-mix reimbursement systems. STUDY DESIGN: The study relied on a two-wave panel design to examine case mix (resident acuity) and direct care costs in 1-year periods before and after implementation of a nursing home case-mix reimbursement system. Cross-lagged regression models were used to assess change in case mix and costs between periods while taking into account facility characteristics. DATA COLLECTION: Facility-level measures were constructed from Medicaid cost reports and Minimum Data Set-Plus assessment records supplied by each state. Resident case mix was based on the RUG-III classification system. PRINCIPAL FINDINGS: Facility case-mix scores and direct care costs increased significantly between periods in both states. Changes in facility costs and case mix were significantly related in a positive direction. Medicare utilization and the rate of hospitalizations from the nursing facility also increased significantly between periods, particularly in Mississippi. CONCLUSIONS: The case-mix reimbursement systems appeared to achieve their intended goals: improved access for heavy-care residents and increased direct care expenditures in facilities with higher acuity residents. However, increases in Medicare utilization may have influenced facility case mix or costs, and some facilities may have been unprepared to care for higher acuity residents, as indicated by increased rates of hospitalization. (+info)
Retinal microvascular abnormalities and cognitive impairment in middle-aged persons: the Atherosclerosis Risk in Communities Study.
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BACKGROUND AND PURPOSE: Cerebral microvascular disease has been hypothesized to contribute to cognitive impairment, but few clinical data are available. Here, we examine the relation of retinal microvascular abnormalities with cognitive function in middle-aged persons free of stroke. METHODS: The Atherosclerosis Risk in Communities Study is a population-based study with examinations every 3 years from 1987 through 1998. At visit 3, when participants were 51 to 70 years of age, retinal photographs were obtained and evaluated for retinal microvascular abnormalities according to standardized protocols. Cognitive function was assessed with standardized tests (Delayed Word Recall Test, Digit Symbol Subtest, and Word Fluency Test) at visits 2 and 4 and averaged for analysis. Persons with stroke or taking central nervous system-relevant medications were excluded, leaving 8734 with data for this study. RESULTS: After education, diabetes mellitus, blood pressure, carotid intima-media thickness, and other risk factors were controlled for, retinopathy was associated with lower cognitive test scores. The adjusted odds ratios for persons with Delayed Word Recall scores 2 SD or lower than the mean were 2.60 [95% confidence interval (CI), 1.30 to 2.91] for any retinopathy, 3.00 (95% CI, 1.81 to 4.98) for microaneurysms, 3.39 (95% CI, 1.99 to 5.78) for retinal hemorrhage, and 3.07 (95% CI, 1.53 to 6.17) for soft exudates. Results were similar for the other 2 cognitive tests and in people with and without diabetes and hypertension. CONCLUSIONS: Retinopathy is independently associated with poorer cognitive function in middle-aged persons without stroke, suggesting that cerebral microvascular disease may contribute to the development of cognitive impairment. (+info)