Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis

OBJECTIVES: Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHODS: Bivariate rank correlations and multivariate, backward stepwise elimination linear regressions were performed. Mean annual incidence of primary- and secondary-stage syphilis in a county was the dependent variable, and county sociodemographic characteristics (from census data) were the independent variables. RESULTS: In the multivariate regression model, sociodemographic characteristics accounted for 71% of the variation in syphilis rates among counties. With other factors accounted for, the most highly correlated characteristics were percentage non-Hispanic Black population, county location in the South, percentage of the population that was urban, percentage Hispanic population, and percentage of births to women younger than 20 years. CONCLUSIONS: Most of the variation in syphilis rates among counties is accounted for by sociodemographic characteristics. Identification and remediation of modifiable health determinants for which these factors are markers are needed to improve the health status of these populations.     

Isolation of a pentraxin-like protein from rainbow trout serum

To investigate the outcome of Graves' thyrotoxicosis after antithyroid drug management, data from 81 patients, treated in Chang Gung Memorial Hospital at Taipei and Linkou from October 1981 to March 1990, were analyzed. The gender ratio of female to male was 59:22. The mean age of onset was 33.1 +/- 10.5(15-60) year-old. All the patients were treated with antithyroid drug (Thionamide group) for a duration of 11 to 63 months (mean +/- SD = 28.1 +/- 9.8 months). Forty of 81 patients (49.4%) were remained remission after up to 2 years of follow-up. Those patients relapse usually occurred within 2 years after discontinuation of treatment (34/41), and only one exceptional case relapsed after 3 years. Three conditions affected the relapse rate. Patients with larger goiter (grade II-III) and shorter duration of treatment (< 23 months) had a higher relapse rate than those-with smaller goiter (grade O-I) [29/46 vs. 12/35; chi 2 = 6.576, p = 0.010; p = 0.015 in stepwise logistic regression (LR)] and longer duration of treatment (> or = 23 months) (15/20 vs. 26/61; chi 2 = 6.316, p = 0.012; p = 0.020 in LR). Patients with higher pre-treated serum triiodothyronine (T3) level (T3 > or = 300 ng/dl) had a higher relapse rate than those with lower T3 level (T3 < 300 ng/dl) in univariate analysis (30/50 vs. 11/31, chi 2 = 4.601, p = 0.032), but no significant difference by LR (P = 0.094). Other clinical parameters including age, sex, past history, family history, thyroxine (T4) level, T3/T4 ratio, thyroid autoantibodies, staging of ophthalmopathy, responsiveness to thyrotropin-releasing hormone stimulation test at the end of treatment, and whether combined treatment with thyroxine had no significant difference between the relapse and remission groups. These data suggest: (a) patients with larger goiter (grade II-III had higher relapse rate; (b) most of the recurrent thyrotoxicosis patients relapsed within two years after drug withdrawal; (c) continuing treatment for more than twenty-three months produces better outcome; (d) patients with Graves' thyrotoxicosis should be followed up for at least three years after withdrawal of antithyroid drug.     

The amylose and lipid contents,dimensions, and gelatinisation characteristics of some wheat starches and their A- and B-granule fractions

Starches isolated from 23 bread wheats (Triticum aestivum) and 26 durum wheats (T. durum) contained 26.3-30.6% (mean 29.1%) total amylose, 19.3–25.1% (mean 22.9%) apparent amylose and 783–1144mg 100g^?1 (mean 977 mg 100g^?1) lysophos-pholipids. Gelatinisation temperatures were 57.3–64.9°C (mean 61.8°C) and enthalpies 6.4–11.8 Jg^?1 (mean 9.7Jg^?1) in excess water, measured by differential scanning calorimetry. There were no correlations between any of these parameters. Starch granule size distributions were determined with a Coulter Counter and 100–channel analyser. A-granule mean volumes were 1235–2585μm³ (av. 1778), modal volumes 863–1804μm³ (av. 1264), mean diameters 13.9–16.0μm (av. 13.99), and specific surface areas 0.236–0.302m²g^?1. B-granule mean volumes were 35.4–100.4μm³ (av. 55.9), modal volumes 16.5–54.5μm³ (av. 27.7), mean diameters 3.66–5.07μm (av. 4.09), and specific surface areas 0.684–0.920m²g^?1. The B-granule contents of the starches were 12.8–34.6% (av. 27.3) by weight (sedimentation method) and 13.0–37.3% (av. 24.0) by volume (Coulter method), the latter being the more accurate method.     

Cell cultures and nephrolithiasis

Large bone flaps for free transfer can be successfully and safely harvested based on the deep branch of the superior gluteal artery. The anatomy is consistent, the vessels are large, and the complications of this technique are minimal.     

Mass chemotherapy for intestinal Taenia solium infection: effect on prevalence in humans and pigs

Mass treatment of the human population with niclosamide was carried out in 2 villages in rural Guatemala where Taenia solium was endemic, to determine how this would affect the epidemiology of the parasite. Intestinal taeniasis was diagnosed by microscopy and coproantigen testing, and porcine cysticercosis by a specific Western blot. Before mass treatment, the prevalence of human taeniasis was 3.5%; 10 months after treatment it was 1%, a significant decrease (P < 10(-4)). All tapeworms that could be identified to the species level were T. solium. Similarly, the seroprevalence of antibodies to cysticercosis in pigs declined from 55% before treatment to 7% 10 months after treatment, once again a significant decrease (P < 10(-6)). These effects were seen in both villages. The possible use of mass chemotherapy as a tool in the control of T. solium is discussed.