PubMed Health⌕ Search

Biomedical subjects

E F Fitzgerald

Publications and source records attributed to E F Fitzgerald.

At least 19 recordsLinked to original sources

Tandem mass spectrometric analysis for amino, organic, and fatty acid disorders in newborn dried blood spots: a two-year summary from the New England Newborn Screening Program.

BACKGROUND: Tandem mass spectrometry (MS/MS) is rapidly being adopted by newborn screening programs to screen dried blood spots for >20 markers of disease in a single assay. Limited information is available for setting the marker cutoffs and for the resulting positive predictive values. METHODS: We screened >160 000 newborns by MS/MS. The markers were extracted from blood spots into a methanol solution with deuterium-labeled internal standards and then were derivatized before analysis by MS/MS. Multiple reaction monitoring of each sample for the markers of interest was accomplished in approximately 1.9 min. Cutoffs for each marker were set at 6-13 SD above the population mean. RESULTS: We identified 22 babies with amino acid disorders (7 phenylketonuria, 11 hyperphenylalaninemia, 1 maple syrup urine disease, 1 hypermethioninemia, 1 arginosuccinate lyase deficiency, and 1 argininemia) and 20 infants with fatty and organic acid disorders (10 medium-chain acyl-CoA dehydrogenase deficiencies, 5 presumptive short-chain acyl-CoA dehydrogenase deficiencies, 2 propionic acidemias, 1 carnitine palmitoyltransferase II deficiency, 1 methylcrotonyl-CoA carboxylase deficiency, and 1 presumptive very-long chain acyl-CoA dehydrogenase deficiency). Approximately 0.3% of all newborns screened were flagged for either amino acid or acylcarnitine markers; approximately one-half of all the flagged infants were from the 5% of newborns who required neonatal intensive care or had birth weights <1500 g. CONCLUSIONS: In screening for 23 metabolic disorders by MS/MS, an mean positive predictive value of 8% can be achieved when using cutoffs for individual markers determined empirically on newborns.

Amino Acid Metabolism, Inborn Errors↗

Local fish consumption and serum PCB concentrations among Mohawk men at Akwesasne.

A study was conducted to assess local fish consumption patterns and their relationship to concentrations of total polychlorinated biphenyls (PCBs) in the serum of Mohawk men residing near three hazardous waste sites. From 1992 to 1995, 139 men were interviewed and donated a 20-ml venous blood sample. The results indicated that the men ate a mean of 21.2 local fish meals during the past year, compared with annual means of 27.7 meals 1-2 years before and 88.6 meals more than 2 years before (P<0.001 for test of trend). This change is probably a consequence of advisories issued against the consumption of local fish, since 97% of the men were aware of the advisories and two-thirds had changed their behavior as a result. Multiple regression analysis revealed that serum PCB levels increased with age (beta=0.036, P<0.001) and local fish consumption (beta=0.088, P=0.006). The data suggest that local fish consumption has contributed to body burdens in this population and that the advisories have been effective in modifying local fish consumption habits.

Adolescent↗

Assessing environmental exposure to PCBs among Mohawks at Akwesasne through the use of geostatistical methods.

The Mohawk Nation at Akwesasne is a Native American community located along the St. Lawrence River in New York State, Ontario, and Quebec. One component of a multiphase human health study was to assess the impact of different pathways of human exposure resulting from the off-site migration of polychlorinated biphenyl (PCB) contamination in this area. This paper illustrates how mapped residential information and environmental sampling data can be united to assist in exposure assessment for epidemiologic studies using geographic information system (GIS) technology and statistical methods. A proportional sampling scheme was developed to collect 119 surface soils. Using a method of cross validation, the average estimated error can be computed and the best estimator can be selected. Seven spatial methods were examined to estimate surface soil PCB concentrations; the lowest relative mean error was 0.42% for Inverse 3 nearest neighbor weighted according to the inverse distance, and the highest relative mean error was 4.4% for Voronoi polygons. Residual plots indicated that all methods performed well except near some of the sampling points that formed the outer boundaries of the sampling distribution.

Environmental Exposure↗

Fish consumption and breast milk PCB concentrations among Mohawk women at Akwesasne.

A study was conducted to determine the relation between the consumption of contaminated local fish and concentrations of total polychlorinated biphenyls (PCBs) and 68 PCB congeners in the milk of nursing Mohawk women residing near three hazardous waste sites. From 1986 to 1992, 97 Mohawk women were interviewed and donated at least 50 ml of breast milk. The comparison population consisted of 154 Caucasians. After adjustment for potential confounders, Mohawk mothers who gave birth in 1986-1989 had a geometric mean milk total PCB concentration of 0.602 ppm (fat basis) compared with 0.375 ppm for the control group (p = 0.009). These Mohawk women also had significantly higher geometric mean concentrations of nine congeners. Beginning in 1990, however, there were no significant differences between the Mohawk women and the comparison group. Estimated cumulative lifetime exposure from local fish consumption was significantly related to milk total PCB and to three congeners only among those Mohawks who gave birth from 1986 to 1989. The reduction in breast milk PCB concentrations parallels a corresponding decrease in local fish consumption and may be the result of the advisories that have been issued over the past decade recommending against the consumption of local fish by pregnant and nursing Mohawk women.

Adult↗

Environmental pollution and child health in central and Eastern Europe.

For the last 50 years, the economic and industrial development of the nations of Central and Eastern Europe has been achieved at the cost of environmental degradation. The health risks posed by this pollution to children and the steps necessary to ameliorate such risks are only beginning to be investigated. At a recent conference in Poland, sponsored in part by the National Institute of Environmental Health Sciences, participants from 11 countries in the region, together with scientists from Western Europe and the United States, met to share information regarding pediatric environmental health in Central and Eastern Europe, to consider methodologic issues in the design and conduct of such studies, and to discuss preventive strategies. This report summarizes the deliberations, outlines problem areas such as heavy metals and air pollution, delineates research and training needs to help Central and Eastern Europeans deal more effectively with such problems, and recommends specific future actions and collaborative efforts.

Air Pollution↗

Growth and development and other risk factors for osteosarcoma in children and young adults.

BACKGROUND: Risk factors for osteosarcoma in young people were investigated in a population-based case-control study among residents of New York State, excluding New York City. METHODS: Cases (n = 130) were diagnosed between 1978 and 1988 at < or = 24 years of age. Controls were randomly selected from birth certificates and were pair matched to cases on year of birth and sex. Exposure information was obtained by telephone interview with a subject and/or parent, and from birth certificates and school and medical records. RESULTS AND CONCLUSIONS: A significant positive association was observed with height one year before diagnosis (P-value for trend = 0.02). No significant associations were observed between osteosarcoma and weight of body mass index one year before diagnosis, birth length, birthweight, gestational age, having reached puberty, having begun growth spurt, age at puberty, age growth spurt began, medical x-rays, antenatal exposures, family history of cancer, birth defects, or parental occupation.

Adolescent↗

Mortality among New York State highway maintenance workers: 1958-1980.

The mortality profile of 9585 male New York State Department of Transportation (NYSDOT) highway maintenance workers was examined by calculating age-era standard mortality ratios (SMRs), using the general male population of upstate New York as a reference group, for the period 1958-1980. The SMR for all workers was 1.14 (95% CI = 1.09, 1.18), with the greatest all-cause mortality among laborers (SMR = 1.23, 95% CI = 1.16, 1.29). The major contributors to this increase among laborers were circulatory system diseases (SMR = 1.18, 95% CI = 1.10, 1.27), diseases of the respiratory system (SMR = 1.34, 95% CI = 1.09, 1.64), digestive system diseases (SMR = 1.57, 95% CI = 1.26, 1.94), genitourinary system diseases (SMR = 1.61, 95% CI = 1.02, 2.41) and accidents, poison, and violence (SMR = 1.44, 95% CI = 1.19, 1.74). Some of the elevated risks observed may be attributed to cigarette smoking and other life-style factors that could not be assessed with the data available. However, the mortality risks for laborers increased with length of employment and latency, suggesting that occupational exposures may be contributing to the elevated risk in this cohort. Further studies should include information on life-style variables and other confounders as well as more detail on specific occupational exposures.

Adult↗

Fluoride exposure and childhood osteosarcoma: a case-control study.

OBJECTIVES: This study tests the hypothesis that fluoride exposure in a nonoccupational setting is a risk factor for childhood osteosarcoma. METHODS: A population-based case-control study was conducted among residents of New York State, excluding New York City. Case subjects (n = 130) were diagnosed with osteosarcoma between 1978 and 1988, at age 24 years or younger. Control subjects were matched to case subjects on year of birth and sex. Exposure information was obtained by a telephone interview with the subject, parent, or both. RESULTS: Based on the parents' responses, total lifetime fluoride exposure was not significantly associated with osteosarcoma among all subjects combined or among females. However, a significant protective trend was observed among males. Protective trends were observed for fluoridated toothpaste, fluoride tablets, and dental fluoride treatments among all subjects and among males. Based on the subjects' responses, no significant associations between fluoride exposure and osteosarcoma were observed. CONCLUSIONS: Fluoride exposure does not increase the risk of osteosarcoma and may be protective in males. The protective effect may not be directly due to fluoride exposure but to other factors associated with good dental hygiene. There is also biologic plausibility for a protective effect.

Adolescent↗

A prospective comparison of laparoscopy and imaging in the staging of esophagogastric cancer before surgery.

OBJECTIVE: To carry out a prospective comparison of laparoscopy and combined imaging (CT and ultrasound) in the preoperative staging of distal esophageal and gastric cancer in patients who were selected for surgery. METHODS: Patients with clinically overt metastases or a contraindication to major surgery were excluded. One hundred and forty-five patients underwent chest radiography, CT of mediastinum and abdomen, and ultrasonography of abdomen and laparoscopy. The primary diagnoses were adenocarcinoma of the esophagogastric region in 110 cases, squamous cell carcinoma of the distal esophagus in 30 patients, and five miscellaneous. RESULTS: Thirty nine (27%) patients had metastatic disease outside the potential field of resection. Metastases were detected preoperatively by laparoscopy in 30 patients (sensitivity 77%) and by combined imaging in 15 (sensitivity 38%) (p < 0.01). Twenty four patients with adenocarcinoma had metastases to the peritoneal cavity, which were detected preoperatively by laparoscopy in 23 (sensitivity 96%) and by combined imaging in five (sensitivity 21%) (p < 0.01). Peritoneal metastases were not seen in patients with squamous cell carcinoma. Fifteen patients had hepatic metastases, which were detected preoperatively by laparoscopy in nine (sensitivity 60%) and by combined imaging in seven (sensitivity 47%). Laparoscopy was more sensitive than combined imaging in detecting metastases in patients with adenocarcinoma [laparoscopy 28, combined imaging 10 (p < 0.01)]. CONCLUSION: Addition of laparoscopy to the staging protocol prevented unbeneficial thoraco-abdominal exploration in 20 patients with adenocarcinoma. Thus, laparoscopy should be used in the assessment of patients with adenocarcinoma of the esophagogastric region before performing excisional surgery.

Adult↗

Mono-ortho- and non-ortho-substituted polychlorinated biphenyls in human milk from Mohawk and control women: effects of maternal factors and previous lactation.

Fifty-four individual human milk samples from 50 mothers (20 Mohawks and 30 controls) were analyzed for four non-ortho- and eight mono-ortho-substituted polychlorinated biphenyls (PCBs). Mean total coplanar PCBs concentrations were 49 ng/g and 55 ng/g lipid for Mohawk and control women, respectively. A statistical evaluation of all analytical data reveals no significant difference of total coplanar PCB level between Mohawk and control women. The level of these contaminants is influenced by the age of the mother, number of breastfed children, and length of nursing period. Older women, primiparae, and cigarette smokers had higher levels of coplanar PCBs. In general, women had higher levels of coplanar PCBs in the first lactation and in the earlier samples of a given lactation, while levels declined both with duration of breast-feeding and with number of children nursed. The contribution of individual non-ortho- and mono-ortho-substituted PCB congeners to the total calculated toxic equivalent values (sigma TEQ) was assessed for the breast milk samples. The levels of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) in human milk of pooled specimens from Los Angeles, California and Binghamton, New York, widely separate cities in the United States (Schecter et al. 1989), were presented for reference purpose. The main contributions to the sigma TEQ were PCB congeners #118 (25.8 pg/g lipid), #126 (25 pg/g lipid), #105 (10.8 pg/g lipid), and #156 (7.4 pg/g lipid). Collectively, these compounds accounted for 70% of the sigma TEQ values.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

A case-control study of malignant melanoma of the trunk among white males in upstate New York.

To address the increase in the incidence of cutaneous melanoma in upstate New York in recent decades, a case-control study was conducted of the constitutional and environmental risk factors for malignant melanoma of the trunk among white males. Cases were identified from the New York Cancer Registry from 1977 through 1979 (the period of the greatest relative increase in incidence), and controls were selected using random digit dialing methods. A total of 324 cases or their next-of-kin and 415 controls were interviewed regarding physical and sociodemographic characteristics, lifestyle habits, and medical histories. The following variables were statistically significant in the final logistic regression analysis: birthmarks (O.R. = 3.87); sunburn easily (O.R. = 1.83); fair skin tone (O.R. = 1.63); northern European ancestry (O.R. = 1.51); blue eye color (O.R. = 1.46); and participation in water sports (O.R. = 2.02). Interaction terms between constitutional and environmental variables resulted in a significant relationship between the presence of freckles and bathing two or more times per day. Among freckled individuals, those who bathed more than once per day had a sixfold elevation in the risk compared to those who bathed less often. In comparison, the odds ratio for frequent bathing among men without freckles was only 1.24. The data suggest the following hypothesis for further study: the possibility that frequent bathing may be deleterious, especially among freckled individuals or those with pigmented nevi.

Case-Control Studies↗

Familial clustering of neural tube defects and gastric cancer.

A retrospective cohort study was conducted to determine whether producing an offspring with a neural tube defect (NTD) is associated with the development of unusual patterns of cancer among the parents in subsequent years. Mothers and fathers who had a child with an NTD in Upstate New York from 1945 to 1955 were followed through 1979 and compared to a control group of parents with normal offspring. Overall mortality and site-specific cancer incidence were not significantly different for case parents versus control parents, with the exception of gastric cancer, which occurred significantly more frequently in case parents. The finding of a familial association between NTDs and gastric cancer, coupled with a parallel decline in rates of these two diseases, suggests a common aetiology, perhaps related to dietary factors.

Adult↗

Crowding in prison: the relationship between changes in housing mode and blood pressure.

The relationship between change in mode of housing and corresponding blood pressure (BP) change was investigated among 568 male prisoners as an analogue to animal studies which have shown that crowding elevates BP. The transfer from single occupancy cells to multiple occupancy dormitories was associated with a statistically significant mean increase in systolic blood pressure (SBP). In contrast, men who remained in single cells had little mean change in SBP over time. Inmates who were retransferred to cells after a short stay in dormitories experienced a mean decline in SBP, which suggests that crowding may be reversible in its early stages. SBP also decreased after continued stay in the dormitories, indicating that adaptation may occur. The implications of these findings for crowding theory and their contribution to an understanding of response to the prison environment are discussed.

Adult↗

Fingerprinting PCB patterns among Mohawk women.

This study examined the association of contaminated fish consumption and polychlorinated biphenyl (PCB) body burden by comparing the similarity of the congener pattern in yellow perch, caught near the point source of industrial pollution, and in other local fish to the pattern found in the breast milk of Mohawk women from Akwesasne, a Native American community located along the St. Lawrence River in New York, Ontario, and Quebec. The similarity is defined by the weighted Euclidean distance between two congener patterns. Ninety-seven Mohawk mothers participated and provided samples of breast milk. One hundred fifty-four nursing women from the Supplemental Nutrition Program for Women, Infants and Children (WIC) of Warren and Schoharie counties, New York, who gave birth during the same time period, were used as the comparison group. Results revealed that the breast milk of the Mohawk women, who ate the most local fish, had a congener pattern that more closely resembled that of perch caught near the waste site or average sampled fish caught in the Reserve than Mohawk women who ate less fish or the controls. The outcome demonstrates how PCBs may be "fingerprinted" as they migrate offsite from industrial sources and ultimately result in human exposure.

Animals↗