Cytomegalovirus infection in England and Wales: 1992 and 1993

Cytomegalovirus causes illness through primary infection but also remains latent within the host and may be reactivated, especially if immunity is impaired. We have examined reports of cytomegalovirus infection from laboratories in England and Wales received by the PHLS Communicable Disease Surveillance Centre in 1992 and 1993. A total of 2938 reports were received, and 103 people had recurrent infections within the study period. The age distribution had peaks in infants (< 1 year of age) and in people aged 25 to 34 years. In almost a half of the patients (1371; 49%) factors were reported that indicated impaired immunity. Eighty-three of the 103 with recurrent infection (81%) were also reported to have impaired immunity. Children under 5 years accounted for 18% (543/2938) of reports. There were 930 reports of infections in people over 5 years of age who were not reported as immunocompromised. The data presented confirm that cytomegalovirus causes substantial morbidity in young children and people with impaired immunity. Cytomegalovirus infection causes considerable morbidity, especially hepatic, in patients whose immunity is thought to be normal.     

Report of the Australian Malaria Register for 1992 and 1993

Australia is free from endemic malaria but several hundred imported cases occur each year. Notification and screening data on malaria cases are collected by State and Territory health authorities and laboratories and forwarded to the Australian Malaria Register (AMR) for national collation and analysis. This report provides information on 758 malaria cases with 5 deaths reported in Australia in 1992 and 712 cases with 1 death in 1993. In both years, just over 70% of cases were male and the modal age group was 20 to 29 years. Cases were reported from all States and Territories, with Queensland reporting the greatest number of cases in both years. The predominant species was Plasmodium vivax, although P. falciparum accounted for just over a quarter of the cases each year. Papua New Guinea (PNG) was the most common source of cases in both years, reflecting the number of people who move between Australia and PNG and the high endemicity of malaria in PNG. The incidence of malaria was also high in travellers from the Solomon Islands in both years and from Ghana in 1992 and Nigeria in 1993. The six deaths over two years highlight the need for medical practitioners to consider malaria as a diagnosis in patients with a history of travel to malarious countries and to provide appropriate advice on malaria prophylaxis to intending travellers.     

An epidemic of tuberculosis in an elementary school, Sanremo, Italy, 1993

In late 1992, three cases of tuberculosis were identified in school children attending a small elementary school in Sanremo, Italy. In order to identify further cases and determine the source, an epidemiologic investigation was undertaken. Tine test and X rays were performed on all students and school personnel. A total of 80% of the 59 students in the school had positive tine test reactions, as did 100% of the 12 teachers. All but one of the positive students had converted since last tested, as had the nine teachers who had been previously negative. The source of the outbreak was a teacher who had been in direct classroom contact with two of the five classes and had worked closely with the rest in building of a Christmas creche for the school. This outbreak suggests that increasing attention should be paid to school as potential foci for the spread of tuberculosis and that greater attention be paid to teacher screening, particularly in areas of higher tuberculosis prevalence.     

State- and sex-specific prevalence of selected characteristics--Behavioral Risk Factor Surveillance System, 1992 and 1993

PROBLEM/CONDITION: Much chronic disease and injury morbidity and mortality is associated with high-risk behaviors (e.g., cigarette smoking, excessive alcohol consumption, and physical inactivity) and with lack of preventive health care (e.g., screening for cancer). States use the Behavioral Risk Factor Surveillance System (BRFSS) to collect data about these modifiable health behaviors and to monitor trends and significant changes in their populations over time. REPORTING PERIOD: 1992 and 1993. DESCRIPTION OF SYSTEM: The BRFSS is a state-based telephone survey of the civilian, noninstitutionalized, adult (persons > or = 18 years of age) population. In 1992, 48 states and the District of Columbia participated in the BRFSS; in 1993, 49 states and the District of Columbia participated. Several questions were added to the BRFSS in 1993. RESULTS: As in previous years, state-specific variations occurred in the prevalence of high-risk behaviors, awareness of certain medical conditions, use of preventive health services, and health-care coverage. In 1993, 4.0% (range: 1.4% - 6.4%) of adults reported riding with a driver who had had too much alcohol to drink. The percentage of persons > or = 50 years of age who had ever had a proctoscopic examination ranged from 25.6% to 51.5% (median: 36.8%). Among adults > or = 65 years of age, 27.4% (range: 18.5 % - 40.0%) had ever had a pneumococcal vaccination, and 49.9% (range: 28.7% - 66.2%) had had an influenza vaccination within the past 1 year. INTERPRETATION: The variations in prevalence across states likely reflect socioeconomic differences, differences in state laws enacted to discourage risky behaviors, different levels of effort to screen for certain types of cancer or risk factors for other diseases, and other factors. ACTION TAKEN: States will continue to use the BRFSS to collect data about health behaviors. Analysis of these data will enable states to monitor factors that may affect the rate of chronic disease and injury mortality and morbidity and to develop public health policies to address these problems.     

First recorded outbreak of yellow fever in Kenya, 1992-1993. I. Epidemiologic investigations

Outbreaks of yellow fever (YF) have never been recorded in Kenya. However, in September 1992, cases of hemorrhagic fever (HF) were reported in the Kerio Valley to the Kenya Ministry of Health. Early in 1993, the disease was confirmed as YF and a mass vaccination campaign was initiated. Cases of suspected YF were identified through medical record review and hospital-based disease surveillance by using a clinical case definition. Case-patients were confirmed serologically and virologically. We documented 55 persons with HF from three districts of the Rift Valley Province in the period of September 10, 1992 through March 11, 1993 (attack rate = 27.4/100,000 population). Twenty-six (47%) of the 55 persons had serologic evidence of recent YF infection, and three of these persons were also confirmed by YF virus isolation. No serum was available from the other 29 HF cases. In addition, YF virus was isolated from a person from the epidemic area who had a nonspecific febrile illness but did not meet the case definition. Five patients with confirmed cases of YF died, a case-fatality rate of 19%. Women with confirmed cases of YF were 10.9 times more likely to die than men (P = 0.010, by Fisher's exact test). Of the 26 patients with serologic or virologic evidence of YF, and for whom definite age was known, 21 (81%) were between 10 and 39 years of age, and 19 (73%) were males. All patients with confirmed YF infection lived in rural areas. There was only one instance of multiple cases within a single family, and this was associated with bush-clearing activity. This was the first documented outbreak of YF in Kenya, a classic example of a sylvatic transmission cycle. Surveillance in rural and urban areas outside the vaccination area should be intensified.     

First recorded outbreak of yellow fever in Kenya, 1992-1993. II. Entomologic investigations

OBJECTIVES: The physiology of the female sexual response and its molecular mediators remain poorly understood. Nitric oxide (NO) is synthesized in neurons and is a potent relaxor of vascular and nonvascular smooth muscle. In this study, we hypothesize that vaginal atrophy and declining sexual function during menopause may be NO dependent. Using the rat as an experimental model, we examined the expression and topologic localization of vaginal NO synthase (NOS) and the concomitant induction of apoptosis under normal and estrogen-depleted conditions. METHODS: Thirty rats were categorized into six groups on the basis of phase of the estrous cycle or estrogen status after oophorectomy. The expression and cellular localization of NOS was examined in frozen sections using specific antibodies against neuronal (N-NOS) and endothelial NOS (E-NOS). Apoptotic cells were identified in situ using the terminal transferase technique (TUNEL). Trichome staining was performed in all specimens to determine smooth muscle/collagen ratios. RESULTS: N-NOS immunoreactivity was localized to nerve fibers supplying vaginal smooth muscle, perivascular nerve plexuses, and lamina propria. E-NOS was localized to vascular endothelium and perivascular smooth muscle fibers. Both E-NOS and N-NOS expression in intact cycling animals was highest during proestrous and lowest during metestrous. After oophorectomy, levels of both N-NOS and E-NOS declined substantially compared with those of intact animals, and there was a parallel induction of apoptosis. Estrogen withdrawal also resulted in increased vaginal atrophy, intramural collagen accumulation, and perivascular wall thickening, as identified by trichome staining. Estrogen replacement resulted in a significant increase in E-NOS and N-NOS expression, as well as diminished apoptosis and vaginal atrophy. CONCLUSIONS: This cellular distribution of NOS in the rat vagina suggests that NO may modulate both vaginal blood supply and vaginal smooth musculature. Estrogen appears to play a critical role in concomitantly regulating vaginal NOS expression and apoptosis in nerves, smooth muscle, vascular endothelium, and epithelium of the rat vagina. These findings may have significant clinical implications for the pathophysiology of postmenopausal female sexual dysfunction.     

Creativity tests and achievement in high school science.

This study investigated the relative validities of a battery of "creativity tests" and an IQ tests for predicting several indices of achievement in high school science. Criteria included grade-point average in science courses, percentile rank on the STEP Science Achievement Test, teacher rating of overall scientific potential, number of high school science courses taken, and a measure of involvement with science. Results indicated that the creativity tests did have considerable predictive validity against each criterion for each sex and that the criterion variance accounted for by the creativity tests is to a substantial degree independent of IQ. Contrary to findings of other investigators, teachers did not discriminate against highly creative pupils in their ratings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender-related differences on the College Board's Advanced Placement and Achievement tests, 1982–1992.

This study explored gender-related differences in participation in and scores on the College Board's Advanced Placement Program and Achievement examinations. In both sets of tests, the numbers of male and female high school students were unequal for several subject areas. The French, Spanish, and Modern Hebrew examinations attracted many more female than male students, whereas many more male than female students took the Physics, Chemistry, and Computer Science examinations. There was little change in most of the patterns of enrollment from 1982 through 1992. Male students had moderately higher scores on the Physics, Chemistry, and Computer Science tests, whereas female students had a slight advantage on some of the language examinations. Although the patterns of gender-related score differences were stable, there were some indications that gender differences are narrowing, especially in the areas of American history and computer science. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use of alcohol by Miami''s adolescent public school students 1992: peers, risk-taking, and availability as central forces

We explore the equilibrium properties of a series of compartmental, ODE models describing the interaction between different strains of pathogen. The interaction is conceptualized as acting through shared antigens: infection and recovery from one strain leaves the host with a primed immune response against subsequent strains. The models consider the effect of this priming on susceptibility (the ability to be infected) and transmission (the ability to infect) in an SIR model. In these models, the specific past history of infection is encapsulated in different susceptible compartments within the model. In a third, SIS, model, specific past history is not included, but strains have differential abilities to infect previously infected hosts. Equilibrium results include criteria for the coexistence of strains. For the SIR models, the region of coexistence defined by parameters shrinks as the effect of strains on each other (increased antigenic similarity) increases. For the SIS model, coexistence depends critically on the rate at which complete susceptibility is recovered following infection, and coexisting strains must have differential abilities to infect completely and partially susceptible hosts. Interestingly, this model provides analogies to commensalism (the first species gains from the presence of the second; the second neither gains nor loses from the interaction) and symbiosis (the presence of both species benefits the other). Additionally, we show that the maximum number of coexisting strains is two in this model. The effect of vaccination depends on the initial strain structure, the ability of vaccination to mount protection to both strains and the coverage. Vaccination may allow a previously excluded strain to coexist or exist alone, and may allow a previously rarer strain to become more common with the possibility of increasing incidence of disease. We discuss the dynamics of these models, compare model results to observed patterns and consider additional model structures. The importance of these results to specific multi-strain pathogens, in particular rotavirus, is considered.     

High school tests and measurements as predictors of occupational status.

Tests and measurements collected in 1943 on 97 male high school students were correlated with occupational status in 1953. Included in the measures were high-school grade-point average, Kuhlman-Anderson Intelligence Test, Stanford Achievement Test, Detroit Mechanical Aptitude Test, Minnesota Paper Form Board, and Bell Adjustment Inventory. The best single predictor was high-school grade-point average. The best battery included HSGPA and the Bell Adjustment Inventory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proceedings of the American Psychological Association, Incorporated, for the year 1992: Minutes of the Annual Meeting of the Council of Representatives: August 13 and 16, 1992, Washington, DC, and February 26-28, 1993, Washington, DC.

Reports the minutes of the American Psychological Association (APA) for 1992, reflecting the official record of the actions of the Board of Directors and the Council of Representatives. Topics addressed include the minutes of meetings; elections, awards, membership, and human relations; ethics; the Board of Directors; divisions and state and provincial associations; organization of the APA; publications and communications; the Board of Convention affairs; educational affairs; professional affairs; scientific affairs; public interest; ethnic minority affairs; international affairs; the Central Office; financial affairs; and communications concerning outside organizations. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The epidemiological features of invasive mycotic infections in the San Francisco Bay area, 1992-1993: results of population-based laboratory active surveillance

Population-based active laboratory surveillance for invasive mycotic infections was conducted during 1992 and 1993 in three California counties: Alameda, Contra Costa, and San Francisco (population, 2.94 million). The cumulative incidence of invasive mycotic infections was 178.3 per million per year. Invasive mycoses were most commonly caused by Candida (72.8 per million per year), Cryptococcus (65.5), Coccidioides (15.3), Aspergillus (12.4), and Histoplasma (7.1). The clinical significance of other, less common fungi was determined by detailed chart review. The cumulative incidence was determined for zygomycosis (1.7 per million per year), hyalohyphomycosis (1.2), and phaeohyphomycosis (1.0). The most common underlying conditions were human immunodeficiency virus infection (47.4%), nonhematologic malignancy (14.7%), diabetes mellitus (9.9%), and chronic lung disease (9.3%). This represents the first population-based epidemiological assessment of invasive mycoses in the United States.     

Child and adolescent psychiatric services in the canton of Zurich: a comparison of outpatients, day clinic, and inpatient referral populations

Findings in intervention research are an important basis for the discussion of issues pertaining to quality control. In Switzerland such findings have been rare. The present study of the entire 1988-1995 referred child and adolescent population of the Child and Adolescent Psychiatric Service of the Canton of Zurich (N = 7538 treated patients) concentrated on the demographic, diagnostic, and therapeutic attributes of the outpatient, day clinic, and inpatient populations that comprised the referred population. Marked differences are found in comparable studies from Germany with regard to patients treated in an inpatient setting. For example, the mean age of the patients in the Zurich sample is lower and patients with conduct disorders are more frequently represented. On the other hand, patients with psychotic illness are missing and, on the average, the duration of treatment is considerably longer. The reasons for these differences are to be found in the various structural attributes of the cantonal services that are provided in Zurich. In the area of inpatient care, where in comparison to outpatient settings and also day care settings patients with severe disorders are treated, there is a lack of places for the short-term care of acutely ill patients--for example, psychotic patients. This is especially true for adolescent patients. The limitations of traditional outpatient settings are frequently marked by unsatisfactory treatment results in outpatients with conduct disorders, developmental disorders, and a high impact of abnormal psychosocial circumstances.     

Gambling among Minnesota public school students from 1992 to 2007: Declines in youth gambling.

The specific aims of this study are twofold. First, measure 2007 rates of gambling and underage gambling among public school students. Second, compare rates of gambling, frequent gambling, and underage gambling from 1992 to 2007. The 2007 sample includes 40,605 male and 42,655 female Minnesota public school students enrolled in the 9th and 12th grades and similar sample sizes from 1992, 1995, 1998, 2001, and 2004. Students were administered the Minnesota Student Survey, a 126-item, anonymous, self-administered, paper-and-pencil questionnaire that inquires about multiple health-related content domains, including gambling behavior. In 2007, most students gambled at least once during the past year, however, most did not gamble frequently. Gambling participation has shown a gradual and consistent decline from 1992 to 2007 for both boys and girls. Underage gambling has also shown declines over time. Conversely, rates of frequent gambling (weekly or more often) have remained fairly stable over time. There have been two fluctuations of note, a peak in lottery play in 1998 and a peak in card playing in 2004 with subsequent declines in both. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Epidemiological, viral and serological studies concerning the evolution of some acute respiratory diseases between November 1992 and March 1993 in nine districts of the south-east area of Romania

Alterations in core lipid composition of lipoproteins in noninsulin-dependent diabetes mellitus (NIDDM) patients have suggested that the heteroexchange of neutral lipids between HDL and the apo B-containing lipoproteins may be enhanced. For this reason, we studied cholesteryl ester transfer (CET) in ten sulfonylurea-treated patients with stable NIDDM. CET measured in all NIDDM subjects with an assay of mass transfer was significantly greater than that of controls at 1 and 2 h (P < 0.001); the transfer of radiolabeled CE also was increased in a subset of four of the NIDDM group (NIDDM k = 0.21 +/- 0.04 vs. control k = 0.10 +/- 0.05; P < 0.05). A weak correlation was demonstrable between the mass of CE transferred at 1 h and diabetic control expressed as plasma fructosamine (r = 0.58, P < 0.09). To characterize this disturbance in CET further, the donor (HDL + VHDL) and acceptor (VLDL + LDL) lipoprotein fractions were isolated by ultracentrifugation at d 1.063 g/ml from NIDDM and control plasma and a series of recombination experiments were performed. Combining NIDDM acceptor with control donor fractions that contained HDL and CETP and not the combination of NIDDM donor and control acceptor lipoproteins resulted in an accelerated CET response identical to that observed in NIDDM whole plasma. This observation indicated that the abnormality in CET in NIDDM was associated with the VLDL + LDL fraction.(ABSTRACT TRUNCATED AT 250 WORDS)     

National survey of mammographic facilities in 1985, 1988, and 1992

PURPOSE: To determine trends in mammography in the United States. MATERIALS AND METHODS: A sample of mammographic facilities was selected for each year of the Nationwide Evaluation of X-ray Trends. The same protocol was followed for the 1985, 1988, and 1992 surveys. Data were collected with use of the same imaging phantom for all three surveys and also with a different phantom in the 1988 and 1992 surveys. RESULTS: Of the 356 facilities surveyed in 1992, 59% claimed to be in compliance with the Health Care Financing Administration (HCFA) mammography requirements, 42% were accredited by the American College of Radiology (ACR), and 23% did not hold credentials from either the HCFA or the ACR. Since 1985, there has been a 34% improvement in acceptable phantom image quality score and a 20% decrease in the mean glandular dose. CONCLUSION: Mammography as practiced today is essentially a screen-film technique. Mammographic phantom image quality has improved considerably. The overall mean glandular dose has decreased primarily because of the elimination of xeroradiography.     

Menstruation, menarche, and sexuality in the public school curriculum: school nurses' perceptions

Nurses employed by schools and health departments have varying responsibilities for curricula related to menstruation, menarche, and sexuality. Nevertheless, the school nurse is usually a source of information on these subjects whether employed full-time in school health or also participating in other nursing roles in the community. This survey examines the involvement of school nurses in curricula related to human reproduction including contraception. Data about their involvement in these classroom topics provides a basis for evaluating their roles and making recommendations for subsequent continuing education programs for school health nurses.