Defects in cell-mediated immunity have been implicated as one of the underlying causes for the appearance and progression of neoplasms. One approach toward correcting these defects employs immune ...potentiators for the purpose of stimulating cell-mediated immunity. BCG is the immune potentiator which has been used most frequently in the experimental and clinical situation. A preliminary study directed toward ascertaining the local histologic changes and systemic serum response to BCG injection in the dog bladder was undertaken in anticipation of its possible application in the treatment of bladder neoplasm. Local response was predictable and was associated with low morbidity. The appearance of serum precipitin bands to culture filtrates of Mycobacteria tuberculosis strains strongly suggests systemic absorption and reaction to BCG administered intravesically.
Rabies Surveillance, United States, 1988 Eng, Thomas R.; Hamaker, Tedd A.; Dobbins, James G. ...
MMWR. Surveillance summaries
38, Številka:
SS-1
Journal Article
The primary purpose of the annual report on rabies surveillance is to assist local and state public health officials in the planning of rabies control programs and to guide health professionals in ...evaluating the need for rabies postexposure prophylaxis in patients who are exposed to animals that may be rabid. In 1988, a total of 4,724 cases of animal rabies were reported by 47 states, the District of Columbia, and Puerto Rico, similar to the total (4,729) for 1987. No human cases of rabies were reported. The South Atlantic, South Central, North Central, and Middle Atlantic states reported 81% of the cases. Pennsylvania, Texas, California, Maryland, and Virginia each reported over 300 rabid animals. Delaware (61 cases), New Mexico (15), Alaska (34), Connecticut (8), and South Carolina (127) each reported an increase in animal rabies cases ≥ 100% in 1988 compared with 1987. Smaller but significant increases also were reported from Florida (66% increase), Pennsylvania (68%), and Georgia (40%). Eighty-eight percent of rabies cases were in wild animals, and 12% were in domestic animals. Skunks, raccoons, and bats accounted for 82% of all rabid animals. Cats became the most commonly reported domestic species for the first time since reporting to CDC began in 1960. The most effective methods of reducing the number of people exposed to rabies are to educate the public to avoid unfamiliar, especially wild, animals and to vaccinate susceptible pets against rabies. Rabies vaccination programs should target cats as well as dogs. Two cases of imported canine rabies emphasized the need to educate travelers of the risk of canine rabies in developing countries. Caution should be used when pets are imported from these countries.
Bloodstream infection (BSI) rates are used as comparative clinical performance indicators; however, variations in definitions and data-collection approaches make it difficult to compare and interpret ...rates. To determine the extent to which variation in indicator specifications affected infection rates and hospital performance rankings, we compared absolute rates and relative rankings of hospitals across 5 BSI indicators.
Multicenter observational study. BSI rate specifications varied by data source (clinical data, administrative data, or both), scope (hospital wide or intensive care unit specific), and inclusion/exclusion criteria. As appropriate, hospital-specific infection rates and rankings were calculated by processing data from each site according to 2-5 different specifications.
A total of 28 hospitals participating in the EPIC study.
Hospitals submitted deidentified information about all patients with BSIs from January through September 1999.
Median BSI rates for 2 indicators based on intensive care unit surveillance data ranged from 2.23 to 2.91 BSIs per 1000 central-line days. In contrast, median rates for indicators based on administrative data varied from 0.046 to 7.03 BSIs per 100 patients. Hospital-specific rates and rankings varied substantially as different specifications were applied; the rates of 8 of 10 hospitals were both greater than and less than the mean. Correlations of hospital rankings among indicator pairs were generally low (rs=0-0.45), except when both indicators were based on intensive care unit surveillance (rs = 0.83).
Although BSI rates seem to be a logical indicator of clinical performance, the use of various indicator specifications can produce remarkably different judgments of absolute and relative performance for a given hospital. Recent national initiatives continue to mix methods for specifying BSI rates; this practice is likely to limit the usefulness of such information for comparing and improving performance.
Screening for Lung Cancer Gohagan, John K; Marcus, Pamela M; Fagerstrom, Richard M ...
Evidence‐based Oncology,
05/2003
Book Chapter
This chapter contains sections titled:
How important is lung cancer in public health terms?
How much is known about the natural history of the disease and the potential of early intervention?
What ...are the possible treatment options following screening?
How effective are screening/treatment options in terms of mortality and morbidity?
Extended follow up and reanalysis of the Mayo Lung Project
Low dose spiral computed tomography as a lung cancer screening modality
New initiatives to evaluate spiral CT
How acceptable are screening methods?
What are the costs of screening and subsequent work‐up?
What is the cost‐effectiveness of screening?
Unresolved issues
Narrowing and other changes in retinal arterioles may reflect damage due to hypertension, which may predict stroke and other cardiovascular diseases independently of blood pressure level. Newly ...developed quantitive methods of assessing retinal narrowing are used to determine whether this sign is related only to current blood pressure or whether it also independently reflects the effects of previous blood pressure. Retinal photography was performed at the third examination of Atherosclerosis Risk in Communities (ARIC) Study in 1993–1995, and results are presented for the 9, 300 nondiabetic participants aged 50–71 years. Generalized narrowing of smaller arterioles was strongly and monotonically related to current blood pressure in men and women, whether they wer taking antihypertensive medications or not, and, independent of current blood pressure, was consistently and mononically related to blood pressure levels measured 3 and 6 years before the retinal assessment. Arteriovenous nicking was also independently related to both current and previous blood pressures. The patterns of association suggested that these signs reflect both transient and persisting structural effects of elevated blood pressure, in agreement with the scant pathologic literature available. The findings suggest that retinal assessment may be useful for research on the microvascular contributions to clinical cardiovascular diseases. Am J Epidemio 1999; 150; 263-70.
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