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G M McQuillan

Publications and source records attributed to G M McQuillan.

At least 19 recordsLinked to original sources
PubMed2001

Rubella seropositivity in the United States, 1988-1994.

Data obtained in the third National Health and Nutrition Examination Survey (NHANES III), conducted during 1988-1994, were analyzed to determine the epidemiology of rubella seropositivity in the United States, including risk factors for low rubella seropositivity. Serological samples obtained from NHANES III study participants > or =6 years of age were tested for rubella IgG antibodies. "Rubella seropositivity" was defined as serum rubella IgG antibody level > or =10 IU by enzyme immunoassay. Overall, rubella seropositivity rates in the United States were 92% in persons aged 6-11 years, 83% in persons aged 12-19 years, 85% in persons aged 20-29 years, 89% in persons aged 30-39 years, and >or =93% in persons aged > or =40 years. The lowest rate (78%) of any United States birth cohort of the 20th century occurred among persons born from 1970-1974. Eliminating rubella and chronic rubella syndrome in the United States will require international efforts, including vaccination of preschool- and school-age children and all susceptible young adults.

Adolescent↗
PubMed2001

Prevalence of C282Y and H63D mutations in the hemochromatosis (HFE) gene in the United States.

CONTEXT: Population-based estimates of the prevalence of disease-associated mutations, such as hemochromatosis (HFE) gene mutations, are needed to determine the usefulness of genetic screening. OBJECTIVE: To estimate the prevalence of the HFE mutations C282Y and H63D in the US population. DESIGN: Cross-sectional population-based study of samples in the DNA bank from phase 2 of the Third National Health and Nutrition Examination Survey conducted from 1992 to 1994. SETTING AND PARTICIPANTS: Genotyped samples of cells from a total of 5171 participants, cross-classified by sex, age, and race/ethnicity in the analysis. MAIN OUTCOME MEASURES: Estimates of the prevalence of C282Y and H63D mutations. RESULTS: The prevalence of C282Y homozygosity is estimated to be 0.26% (95% confidence interval [CI], 0.12%-0.49%); 1.89% (95% CI, 1.48%-2.43%) for H63D homozygosity; and 1.97% (95% CI, 1.54%-2.49%) for compound heterozygosity. The prevalence estimates for C282Y heterozygosity (C282Y/wild type) are 9.54% among non-Hispanic whites, 2.33% among non-Hispanic blacks, and 2.75% among Mexican-Americans. The prevalence estimates of the C282Y mutation in the US population are 5.4% (95% CI, 4.7%-6.2%) and 13.5% (95% CI, 12.5%-14.8%) for the H63D mutation. CONCLUSIONS: Estimates of prevalence of HFE mutations are within the expected range for non-Hispanic whites and blacks but the estimated prevalence of the C282Y mutation among Mexican-Americans is less than expected. Mutation data now need to be linked to clinically relevant indices, such as transferrin saturation level.

Genotype↗
PubMed2001

Incidence of herpes simplex virus type 2 infection in the United States.

Between the time that two large, national surveys were conducted, the Second National Health and Nutrition Examination Survey (1976-1980) and the Third National Health and Nutrition Examination Survey (1988-1994), prevalence of herpes simplex virus type 2 (HSV-2) infection in the United States increased by 30%. From these survey data, the authors estimated the incidence of HSV-2 infection in the civilian, noninstitutionalized population aged > or = 12 years by means of a mathematical model that allowed overall incidence to increase linearly with time but required the shape of the age-specific incidence curve to remain constant. From 1970 to 1985, annual incidence of HSV-2 infection in HSV-2-seronegative persons increased by 82%, from 4.6 per 1,000 (95% confidence interval: 4.2, 5.0) to 8.4 per 1,000 (95% confidence interval: 7.7, 9.1). Incidence in 1985 was higher in women than in men (9.9 vs. 6.9 per 1,000), higher in Blacks than in Whites (20.4 vs. 6.3 per 1,000), and highest in the group aged 20-29 years (14.6 and 22.5 per 1,000 in men and women, respectively). Thus, by 1985, approximately 1,640,000+/-150,000 persons (730,000 men and 910,000 women) were being infected annually with HSV-2.

Adolescent↗
PubMed2001

National serologic survey of measles immunity among persons 6 years of age or older, 1988-1994.

CONTEXT: Measles incidence in the United States is at a record low, and indigenous transmission has been interrupted in each year since 1996, suggesting that measles is no longer endemic. A national estimate of measles immunity and an understanding of predictors of measles susceptibility are essential for assuring sustained elimination of endemic disease. OBJECTIVE: To assess patterns of immunity and to determine predictors of susceptibility to measles. DESIGN/SETTING: Sera and data on participants from the third National Health and Nutrition Examination Survey (1988-1994) (NHANES III) were examined. NHANES III was a cross-sectional survey of a representative sample of the civilian, noninstitutionalized population of the United States. POPULATION: 20,100 persons 6 years of age or older were tested for measles-specific immunoglobulin G (IgG) antibody by an enzyme immunoassay. MAIN OUTCOME MEASURE: Participants with serum positive for measles antibody were considered protected or immune to measles disease. RESULTS: Prevalence of measles immunity was 93%. Nearly all persons (99%) born in the prevaccine era (before 1957) were immune. Immunity declined among persons born in the vaccine era (after 1956) to 81% among those born in 1967-1976, and increased again to 89% among those born in 1977-1988. Among persons born in the vaccine era, independent predictors of measles susceptibility varied by birth cohort and included birth in the United States, residence in a noncrowded household, residence in a nonmetropolitan area, and, among males, non-Hispanic white and Mexican American race/ethnicity. Among adults 17 years of age or older, additional predictors of susceptibility included living at or above the poverty line and not currently being married. CONCLUSIONS: Population immunity among persons 6 years of age or older is very high; however, as many as 15 million persons across the United States may lack humoral immunity. While it is unclear that the susceptible population can support continuous, indigenous transmission of measles, providers should follow current recommendations to evaluate the measles susceptibility of patients born in the vaccine era and vaccinate eligible patients.

Adolescent↗
PubMed2001

Low-grade systemic inflammation in overweight children.

OBJECTIVE: Human adipose tissue expresses and releases the proinflammatory cytokine interleukin-6, potentially inducing low-grade systemic inflammation in persons with excess body fat. To limit potential confounding by inflammation-related diseases and subclinical cardiovascular disease, we tested the hypothesis that overweight is associated with low-grade systemic inflammation in children. DESIGN AND SETTING: The third National Health and Nutrition Examination Survey, 1988-1994, a representative sample of the US population. PARTICIPANTS: A total of 3512 children 8 to 16 years of age. OUTCOME MEASURES: Elevated serum C-reactive protein concentration (CRP; >/=.22 mg/dL) and white blood cell count (10(9) cells/L). RESULTS: Elevated CRP was present in 7.1% of the boys and 6.1% of the girls. Overweight children (defined as having a body mass index or a sum of 3 skinfolds (triceps, subscapula, and supra-iliac) above the gender-specific 85th percentile) were more likely to have elevated CRP than were their normal-weight counterparts. After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) was 3.74 (95% confidence interval [CI]: 1.66-8.43) for overweight boys and the OR was 3.17 (95% CI: 1.60-6.28) for overweight girls, based on the body mass index. Based on the sum of 3 skinfolds, these ORs were 5.11 (95% CI: 2.36-11.06) and 2.89 (95% CI: 1.49-5.59) for boys and girls, respectively. Overweight was also associated with statistically significant higher white blood cell counts. The results were similar when restricted to healthy, nonsmoking, nonestrogen-using children. CONCLUSIONS: In children 8 to 16 years of age, overweight is associated with higher CRP concentrations and higher white blood cell counts. These findings suggest a state of low-grade systemic inflammation in overweight children. inflammation, obesity, children.

Adipose Tissue↗
PubMed2000

The past incidence of hepatitis C virus infection: implications for the future burden of chronic liver disease in the United States.

Because chronic liver disease may develop many years after acute hepatitis C virus (HCV) infection, the past incidence of acute infections is a major determinant of the future burden of HCV-associated complications. We estimated past incidence of acute HCV infection using national seroprevalence data and relative age-specific incidence data from a sentinel counties surveillance system. Projections of the future prevalence of HCV-infected patients were derived from models that included an 85% drop in HCV infection incidence as observed for reported cases in the early 1990s. The models showed a large increase in the incidence of HCV infections from the late 1960s to the early 1980s. The degree of increase was dependent on the assumed rate of antibody loss; a model with 2.5% annual antibody loss showed annual incidence increasing from 45,000 infections (95% confidence interval [95% CI]: 0-110,000) in the early 1960s to 380,000 infections (95% CI: 250,000 to 500, 000) in the 1980s. Projections showed that although the prevalence of HCV infection may be declining currently because of the decline in incidence in the 1990s, the number of persons infected for >/=20 years could increase substantially before peaking in 2015. If the incidence of new HCV infections does not increase in the future, persons born between 1940 and 1965 will be at highest lifetime risk of acquiring the infection.

Adolescent↗
PubMed2000

Estimating future hepatitis C morbidity, mortality, and costs in the United States.

OBJECTIVES: This study estimated future morbidity, mortality, and costs resulting from hepatitis C virus (HCV). METHODS: We used a computer cohort simulation of the natural history of HCV in the US population. RESULTS: From the year 2010 through 2019, our model projected 165,900 deaths from chronic liver disease, 27,200 deaths from hepatocellular carcinoma, and $10.7 billion in direct medical expenditures for HCV. During this period, HCV may lead to 720,700 years of decompensated cirrhosis and hepatocellular carcinoma and to the loss of 1.83 million years of life in those younger than 65 at a societal cost of $21.3 and $54.2 billion, respectively. In sensitivity analysis, these estimates depended on (1) whether patients with HCV and normal transaminase levels develop progressive liver disease, (2) the extent of alcohol ingestion, and (3) the likelihood of dying from other causes related to the route of HCV acquisition. CONCLUSIONS: Our results confirm prior Centers for Disease Control and Prevention projections and suggest that HCV may lead to a substantial health and economic burden over the next 10 to 20 years.

Adolescent↗
PubMed2000

The influence of age, sex, and race on the upper reference limit of serum C-reactive protein concentration.

OBJECTIVE: The recommended reference range for serum C-reactive protein (CRP) concentrations is usually not adjusted for age and sex. We sought to determine if age, sex, and race or ethnicity influence the distribution of CRP values, and if upper reference limits of CRP should be adjusted by demographic factors. METHODS: Interviews, physical examinations, and blood draws were performed on > 22,000 individuals age > or = 4 yrs representative of the noninstitutionalized population of the United States, as part of the Third National Health and Nutrition Evaluation Survey (NHANES III). Serum CRP concentrations were measured by nephelometric immunoassay. RESULTS: The 95th percentile value of CRP in the overall population was 0.95 mg/dl for males and 1.39 mg/dl for females, and varied with age and race. For ages 25-70 yrs, the age adjusted approximate upper reference limit (mg/dl) was CRP = age/50 for males, and CRP = age/50 + 0.6 for females. The upper limits for Mexican-Americans and non-Hispanic whites were similar, whereas for non-Hispanic black adults the approximate upper limit was CRP = age/30 for males and CRP = age/50 + 1.0 for females. Even after accounting for identified inflammatory conditions, demographic factors influenced the reference limits of CRP. The 95th percentile values were uniformly lower in children than in older adults. CONCLUSION: Demographic factors, including age, sex, and race, should be used to adjust the upper reference limit for CRP. Clinicians should be aware of these factors when using CRP values to assess inflammatory diseases.

Adolescent↗
PubMed1999

Elevated C-reactive protein levels in overweight and obese adults.

CONTEXT: Human adipose tissue expresses and releases the proinflammatory cytokine interleukin 6, potentially inducing low-grade systemic inflammation in persons with excess body fat. OBJECTIVE: To test whether overweight and obesity are associated with low-grade systemic inflammation as measured by serum C-reactive protein (CRP) level. DESIGN AND SETTING: The Third National Health and Nutrition Examination Survey, representative of the US population from 1988 to 1994. PARTICIPANTS: A total of 16616 men and nonpregnant women aged 17 years or older. MAIN OUTCOME MEASURES: Elevated CRP level of 0.22 mg/dL or more and a more stringent clinically raised CRP level of more than 1.00 mg/dL. RESULTS: Elevated CRP levels and clinically raised CRP levels were present in 27.6% and 6.7% of the population, respectively. Both overweight (body mass index [BMI], 25-29.9 kg/m2) and obese (BMI, > or =30 kg/m2) persons were more likely to have elevated CRP levels than their normal-weight counterparts (BMI, <25 kg/m2). After adjustment for potential confounders, including smoking and health status, the odds ratio (OR) for elevated CRP was 2.13 (95% confidence interval [CI], 1.56-2.91) for obese men and 6.21 (95% CI, 4.94-7.81) for obese women. In addition, BMI was associated with clinically raised CRP levels in women, with an OR of 4.76 (95% CI, 3.42-6.61) for obese women. Waist-to-hip ratio was positively associated with both elevated and clinically raised CRP levels, independent of BMI. Restricting the analyses to young adults (aged 17-39 years) and excluding smokers, persons with inflammatory disease, cardiovascular disease, or diabetes mellitus and estrogen users did not change the main findings. CONCLUSION: Higher BMI is associated with higher CRP concentrations, even among young adults aged 17 to 39 years. These findings suggest a state of low-grade systemic inflammation in overweight and obese persons.

Adult↗
PubMed1999

The prevalence of hepatitis C virus infection in the United States, 1988 through 1994.

BACKGROUND: Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts. METHODS: We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing. RESULTS: The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection. CONCLUSIONS: In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection.

Adolescent↗
PubMed1999

Prevalence of hepatitis B virus infection in the United States: the National Health and Nutrition Examination Surveys, 1976 through 1994.

OBJECTIVE: Data from 2 National Health and Nutrition Examination Surveys (NHANES), NHANES II (1976-1980) and NHANES III (1988-1994), were analyzed to examine trends in the prevalence of hepatitis B infection in the United States. METHODS: Serum specimens were tested for markers of hepatitis B virus infection, and risk factors were determined from questionnaires. RESULTS: The overall age-adjusted prevalence of hepatitis B virus infection was 5.5% (95% confidence interval [CI] = 4.8, 6.2) in NHANES II, as compared with 4.9% (95% CI = 4.3, 5.6) in NHANES III. In both surveys, Black participants had the highest prevalence of infection (NHANES II, 15.8%; NHANES III, 11.9%). No differences in infection were found in the major racial groups between surveys, except for a decrease among those older than 50 years. Black race, increasing number of lifetime sexual partners, and foreign birth had the strongest independent associations with hepatitis B virus infection. CONCLUSIONS: Testing of participants in 2 national surveys demonstrates no significant decrease in hepatitis B virus infection, despite the availability of hepatitis B vaccine.

Adolescent↗
PubMed1998

Serum creatinine levels in the US population: third National Health and Nutrition Examination Survey.

This report describes the distribution of serum creatinine levels by sex, age, and ethnic group in a representative sample of the US population. Serum creatinine level was evaluated in the third National Health and Nutrition Examination Survey (NHANES III) in 18,723 participants aged 12 years and older who were examined between 1988 and 1994. Differences in mean serum creatinine levels were compared for subgroups defined by sex, age, and ethnicity (non-Hispanic white, non-Hispanic black, and Mexican-American). The mean serum creatinine value was 0.96 mg/dL for women in the United States and 1.16 mg/dL for men. Overall mean creatinine levels were highest in non-Hispanic blacks (women, 1.01 mg/dL; men, 1.25 mg/dL), lower in non-Hispanic whites (women, 0.97 mg/dL; men, 1.16 mg/dL), and lowest in Mexican-Americans (women, 0.86 mg/dL; men, 1.07 mg/dL). Mean serum creatinine levels increased with age among both men and women in all three ethnic groups, with total US mean levels ranging from 0.88 to 1.10 mg/dL in women and 1.00 to 1.29 mg/dL in men. The highest mean creatinine level was seen in non-Hispanic black men aged 60+ years. In the total US population, creatinine levels of 1.5 mg/dL or greater were seen in 9.74% of men and 1.78% of women. Overall, among the US noninstitutionalized population, 10.9 million people are estimated to have creatinine values of 1.5 mg/dL or greater, 3.0 million have values of 1.7 mg/dL or greater, and 0.8 million have serum creatinine levels of 2.0 mg/dL or greater. Mean serum creatinine values are higher in men, non-Hispanic blacks, and older persons and are lower in Mexican-Americans. In the absence of information on glomerular filtration rate (GFR) or lean body mass, it is not clear to what extent the variability by sex, ethnicity, and age reflects normal physiological differences rather than the presence of kidney disease. Until this information is known, the use of a single cutpoint to define elevated serum creatinine values may be misleading.

Adolescent↗
PubMed1998

Incidence of hepatitis B virus infection in the United States, 1976-1994: estimates from the National Health and Nutrition Examination Surveys.

Precise estimates of the incidence of hepatitis B virus (HBV) infection are required to assess the impact of immunization and other prevention strategies in the United States. Race- and age-specific prevalence data obtained from the second and third National Health and Nutrition Examination Surveys (NHANES II, 1976-1980, and NHANES III, 1988-1994) were used to estimate the annual incidence of HBV infection by catalytic modeling. During the period covered by NHANES II, an estimated 323,462 persons were infected annually, and 334,863 were infected annually during the period covered by NHANES III. No statistically significant declines in prevalence of HBV infection occurred between the two surveys, a period during which hepatitis B vaccination targeted only limited numbers of high-risk adults.

Adolescent↗
PubMed1998

A pilot study of the prevalence of chlamydial infection in a national household survey.

BACKGROUND: The prevalence of Chlamydia trachomatis genital infection in the United States population is unknown. Using a new urine test for C. trachomatis, we conducted a pilot survey as part of the National Health and Nutrition Examination Survey III (NHANES III). GOAL: To determine whether the prevalence of chlamydial infection in a convenience sample of NHANES participants was high enough to justify testing for C. trachomatis in a national survey. STUDY DESIGN: NHANES III, conducted from 1988 to 1994, was based on a stratified multistage probability sample of the United States population. Non-Hispanic blacks and Mexican-Americans were oversampled. Using the ligase chain reaction assay for C. trachomatis, we tested urine from participants 12 to 39 years of age from 10 of the 89 sites of NHANES III. The prevalence of infection was calculated by racial or ethnic group. RESULTS: We tested 1,144 study participants, of whom 65% were female, 30% were non-Hispanic blacks, and 30% were Mexican-American. Prevalence was higher for non-Hispanic blacks (7%) than for Mexican-Americans (3%) and non-Hispanic whites (2%). Prevalence was higher for women than men in non-Hispanic blacks (7% vs. 6%), Mexican-Americans (5% vs. 2%), and non-Hispanic whites (2% vs. 1%). In 15- to 19-year-old women, prevalence was 13% in non-Hispanic blacks, 11% in Mexican-Americans, and 5% in non-Hispanic whites. CONCLUSION: The prevalence of C. trachomatis genital infection was high enough to suggest that a reliable national prevalence estimate could be obtained in a national probability sample survey.

Adolescent↗
PubMed1997

Herpes simplex virus type 2 in the United States, 1976 to 1994.

BACKGROUND: Herpes simplex virus type 2 (HSV-2) infection is usually transmitted sexually and can cause recurrent, painful genital ulcers. In neonates the infection is potentially lethal. We investigated the seroprevalence and correlates of HSV-2 infection in the United States and identified changes in HSV-2 seroprevalence since the late 1970s. METHODS: Serum samples and questionnaire data were collected during the National Health and Nutrition Examination Surveys (NHANES) II (1976 to 1980) and III (1988 to 1994). HSV-2 antibody was assessed with an immunodot assay specific for glycoprotein gG-2 of HSV-2. RESULTS: From 1988 to 1994, the seroprevalence of HSV-2 in persons 12 years of age or older in the United States was 21.9 percent (95 percent confidence interval, 20.2 to 23.6 percent), corresponding to 45 million infected people in the noninstitutionalized civilian population. The seroprevalence was higher among women (25.6 percent) than men (17.8 percent) and higher among blacks (45.9 percent) than whites (17.6 percent). Less than 10 percent of all those who were seropositive reported a history of genital herpes infection. In a multivariate model, the independent predictors of HSV-2 seropositivity were female sex, black race or Mexican-American ethnic background, older age, less education, poverty, cocaine use, and a greater lifetime number of sexual partners. As compared with the period from 1976 to 1980, the age-adjusted seroprevalence of HSV-2 rose 30 percent (95 percent confidence interval, 15.8 to 45.8 percent). The seroprevalence quintupled among white teenagers and doubled among whites in their twenties. Among blacks and older whites, the increases were smaller. CONCLUSIONS: Since the late 1970s, the prevalence of HSV-2 infection has increased by 30 percent, and HSV-2 is now detectable in roughly one of five persons 12 years of age or older nationwide. Improvements in the prevention of HSV-2 infection are needed, particularly since genital ulcers may facilitate the transmission of the human immunodeficiency virus.

Adolescent↗
PubMed1997

Update on the seroepidemiology of human immunodeficiency virus in the United States household population: NHANES III, 1988-1994.

To update the estimate of seroprevalence of HIV from the third National Health and Nutrition Examination Survey (NHANES III), data from the second phase of the survey were combined with previously published data to produce a more precise estimate. The testing was performed anonymously on 11,203 individuals 18-59 years of age examined from 1988 to 1994. Fifty-nine individuals were HIV positive, for an overall prevalence of 0.32%. The number of individuals living in households with HIV infection based on this estimate was 461,000, with a 95% confidence interval of 290,000-733,000. Analysis of nonresponse demonstrated that white and black men 40-59 years of age were least likely to participate in the survey. A sensitivity analysis demonstrated that this nonresponse may have biased the NHANES III estimate downward by 190,000 persons. Data from the second phase of the survey were used to analyze the association between drug use and HIV infection. Black women who used cocaine were 12 times more likely to be HIV positive compared with all tested black women (6.5% vs. 0.55%). This survey provides an estimate of HIV prevalence for individuals who reside in households but excludes some persons who are at higher risk for HIV infection, including prisoners and the homeless not residing in shelters.

Adolescent↗
PubMed1996

A population-based serologic survey of Helicobacter pylori infection in children and adolescents in the United States.

To provide more accurate estimates of Helicobacter pylori infection in the US population, IgG antibody levels were measured in serum from 2581 persons aged 6-19 years examined during phase 1 of the third National Health and Nutrition Examination Survey. Overall, 24.8% of participants had evidence of H. pylori infection. Infection was strongly associated with increasing age (chi 2 trend, P < .01) and being nonwhite (17.0% of non-Hispanic whites vs. 40.1% of non-Hispanic blacks and 42.0% of Mexican Americans infected). In a multivariate logistic regression model, H. pylori infection was significantly associated with increasing age (odds ratio [OR] = 1.07/year), being nonwhite (non-Hispanic black OR = 2.6 or Mexican American OR = 1.8), poverty (OR = 1.5), crowding (OR = 5.6), and head of household education level (OR = 1.8). In Mexican Americans, infection was associated with birth outside the United States or Canada in the univariate analyses but was not significantly associated after adjustment for age, poverty, crowding, and head of household education level.

Adolescent↗