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Biomedical subjects

M Scott

Publications and source records attributed to M Scott.

At least 19 recordsLinked to original sources
PubMed2007

Telephonic management of rectal bleeding in young adults: a prospective randomized controlled trial.

OBJECTIVE: The majority of young adults referred with rectal bleeding to a colorectal specialist clinic have a very low risk of serious disease such as cancer, and a high chance of gaining symptom relief by simple dietary changes. To determine whether young low-risk patients with rectal bleeding can be managed with a structured telephonic interview and dietary advice, rather than an outpatient visit. METHOD: A single-blinded, prospective, randomized controlled trial was performed in two stages. Patients under 40 years with rectal bleeding only were offered inclusion. Part-I trial: Patients were interviewed on telephone by the colorectal nurse specialist (CNS) and randomized to receive dietary advice (Advice Group) or not (Control Group). All patients were seen in clinic 6 weeks later by a doctor 'blinded' to their trial status. Part-II trial: Patients were interviewed on telephone by the CNS and again randomized to an Advice Group or a Control Group. The Control Group were seen in clinic 6 weeks later. The Advice Group were telephoned again 6 weeks later, and if their bleeding had stopped, were not brought to clinic. All patients were tracked for a year after the study to ensure no adverse diagnoses came to light. RESULTS: Part-I trial: 63 of 89 eligible patients were contactable and none refused the study. Seventy per cent of the Advice Group compared with 33% (P = 0.001) of the Control Group had symptomatic improvement when seen in clinic. Approximately 30% of each group required further treatment. Part-II trial: 54 of 94 eligible patients were contactable. However a further nine declined to enter the trial; 90% of patients in the Advice Group had improved at 6 weeks as judged by telephone interview compared with 56% of patients in the Control Group (P = 0.024) who were seen in clinic. The 90% of patients who improved in the Advice Group did not need to come to clinic to be seen. In both parts of the trial, the CNS identified a small number of patients with urgent symptoms at interview and brought them to clinic. The majority had anal fissures or haemorrhoids although in Part-II, one patient had ulcerative colitis and one had colorectal cancer. CONCLUSION: Telephonic consultation is an effective way of identifying those patients with urgent symptoms among a cohort of young adults referred to the hospital with rectal bleeding. Telephonic dietary advice leads to resolution of rectal bleeding in the majority of patients without urgent symptoms.

Adult↗
PubMed2006

Balance marks cognitive changes in old age because it reflects global brain atrophy and cerebro-arterial blood-flow.

In healthy old age biomarkers such as Balance robustly correlate with measures of mental abilities such as scores on tests of intelligence, reaction times and memory. A plausible explanation is that balance reflects general physiological fitness and so also neurophysiological integrity, but direct evidence is lacking. Brain scans measured age-associated loss of brain volume and cerebro-arterial blood flow (CBf) in 69 volunteers aged from 62 to 81 years who also took the Tinetti Balance test battery, 3 tests of fluid intelligence, 3 tests of decision speed and a memory test. Balance, but not atrophy or CBf, predicted intelligence test scores. Balance, atrophy, and CBf all independently predicted speed and memory scores but, after variance in atrophy and CBf had been considered, predictions from Balance were no longer significant. It appears that in these tests Balance marks cognitive performance in old age because it reflects gross age-related neurophysiological changes.

Aged↗
PubMed2006

TP53 and progression from Barrett's metaplasia to oesophageal adenocarcinoma in a UK population cohort.

BACKGROUND AND AIMS: Oesophageal adenocarcinoma frequently develops on a background of metaplastic Barrett's epithelium. The development of malignancy is accompanied by genetic alterations, which may be promising biomarkers of disease progression. METHODS: A case control study was conducted nested within a large unselected population based cohort of Barrett's patients. Incident oesophageal malignancies and high grade dysplasias were identified. For each case up to five controls were matched on age, sex, and year of diagnosis. Biopsies from the time of diagnosis of Barrett's epithelium were stained immunohistochemically for TP53, cyclin D1, cyclooxygenase 2 (COX-2), and beta-catenin proteins. RESULTS: Twenty nine incident oesophageal malignancies and six cases of high grade dysplasia were identified. The odds of diffuse or intense TP53 staining were substantially elevated in biopsies from patients who developed oesophageal adenocarcinoma compared with controls (odds ratio (OR) 11.7 (95% confidence interval (CI) 1.93, 71.4)). This difference was also present when all cases were considered (OR 8.42 (95% CI 2.37, 30.0). Despite the association with TP53 staining, only 32.4% of cases had an initial biopsy showing diffuse/intense TP53 staining. There were no significant associations between cyclin D1, COX-2, or beta-catenin staining and case control status. The OR for positive staining for both TP53 and COX-2 was markedly increased in cases compared with controls (OR 27.3 (95% CI 2.89, 257.0)) although only 15% of cases had positive staining for both markers. CONCLUSIONS: Immunohistochemical detection of TP53 expression is a biomarker of malignant progression in Barrett's oesophagus but sensitivity is too low to act as a criterion to inform endoscopic surveillance strategies. Additional biomarkers are required which when combined with TP53 will identify, with adequate sensitivity and specificity, Barrett's patients who are at risk of developing cancer.

Adenocarcinoma↗
PubMed2006

Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI.

OBJECTIVE: To compare the efficacy of step training with body weight support on a treadmill (BWSTT) with over-ground practice to the efficacy of a defined over-ground mobility therapy (CONT) in patients with incomplete spinal cord injury (SCI) admitted for inpatient rehabilitation. METHODS: A total of 146 subjects from six regional centers within 8 weeks of SCI were entered in a single-blinded, multicenter, randomized clinical trial (MRCT). Subjects were graded on the American Spinal Injury Association Impairment Scale (ASIA) as B, C, or D with levels from C5 to L3 and had a Functional Independence Measure for locomotion (FIM-L) score < 4. They received 12 weeks of equal time of BWSTT or CONT. Primary outcomes were FIM-L for ASIA B and C subjects and walking speed for ASIA C and D subjects 6 months after SCI. RESULTS: No significant differences were found at entry between treatment groups or at 6 months for FIM-L (n = 108) or walking speed and distance (n = 72). In the upper motor neuron (UMN) subjects, 35% of ASIA B, 92% of ASIA C, and all ASIA D subjects walked independently. Velocities for UMN ASIA C and D subjects were not significantly different for BWSTT (1.1 +/- 0.6 m/s, n = 30) and CONT (1.1 +/- 0.7, n = 25) groups. CONCLUSIONS: The physical therapy strategies of body weight support on a treadmill and defined overground mobility therapy did not produce different outcomes. This finding was partly due to the unexpectedly high percentage of American Spinal Injury Association C subjects who achieved functional walking speeds, irrespective of treatment. The results provide new insight into disability after incomplete spinal cord injury and affirm the importance of the multicenter, randomized clinical trial to test rehabilitation strategies.

Adolescent↗
PubMed2006

An International Standard for specifying the minimum potency of anti-D blood-grouping reagents: evaluation of a candidate preparation in an international collaborative study.

BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate a lyophilized monoclonal immunoglobulin M (IgM) anti-D preparation for use as an International Standard to specify a recommended minimum acceptable potency of anti-D blood-grouping reagents. MATERIALS AND METHODS: The candidate International Standard (99/836) for specifying the minimum potency of anti-D blood-grouping reagents was evaluated against a wide range of commercial anti-D blood-grouping reagents in an international collaborative study involving 20 laboratories in 13 countries. Laboratories titrated reconstituted 99/836, in parallel with as many commercial anti-D blood-grouping reagents as were available to them, in tube tests according to specified haemagglutination methodology for low-protein (e.g. monoclonal IgM) and high-protein (e.g. polyclonal) reagents. The ratios of the mean end-point titres of the reagents to that of 99/836 within each laboratory were calculated. RESULTS: The ratios of the mean titres of the low-protein reagents to the mean titre of 99/836 within a laboratory fell between 0.25 and 2 for 43 of the 45 low-protein anti-D reagents tested (i.e. the potencies of the low-protein reagents compared with 99/836 were between a 1:4 dilution of 99/836 to twice as potent as 99/836). The ratios of the mean titres of the high-protein reagents to the mean titre of 99/836 within a laboratory fell within 0.125 and 1 for eight out of the 10 high protein reagents tested. CONCLUSIONS: By international consensus, a 1:3 dilution of reconstituted 99/836 was deemed appropriate to define a recommended minimum acceptable potency of low-protein anti-D blood-grouping reagents. A 1:8 dilution of reconstituted 99/836 was deemed appropriate to define a recommended minimum acceptable potency of high-protein anti-D blood-grouping reagents. On the basis of the results presented here, 99/836 was established by the World Health Organization as the 1st International Standard for specifying the minimum potency of anti-D blood-grouping reagents, in tube tests.

Antibodies, Monoclonal↗
PubMed2006

International standards for minimum potency of anti-A and anti-B blood grouping reagents: evaluation of candidate preparations in an international collaborative study.

BACKGROUND AND OBJECTIVES: The aim of the study was to evaluate lyophilized monoclonal IgM anti-A and anti-B preparations for use as international standards (IS) to specify recommended minimum potencies of anti-A and anti-B blood grouping reagents in tube tests. MATERIALS AND METHODS: The candidate IS for minimum potency of anti-A and anti-B blood grouping reagents, codes 03/188 and 03/164, respectively, were evaluated against a wide range of commercial anti-A and anti-B blood grouping reagents in an international collaborative study involving 16 laboratories in nine countries. Laboratories titrated 03/188 and 03/164 in parallel with as many commercial anti-A and anti-B blood grouping reagents, respectively, as were available to them, in tube tests according to specified haemagglutination methodology. Three of these laboratories and a further laboratory also titrated 03/188 and 03/164 in parallel with currently available reference preparations for anti-A and anti-B. The ratios of the mean endpoint titres of the anti-A and anti-B reagents to those of 03/188 and 03/164, respectively, within each laboratory were calculated. RESULTS: The ratios of the mean titres of the anti-A reagents to the mean titre of 03/188 within a laboratory fell within 0.062 and 4, i.e. the potencies of the anti-A reagents were between a sixteenth to four times as strong as 03/188. The ratios of the mean titres of the anti-B reagents to the mean titre of 03/164 within a laboratory also fell within 0.062 and 4, with one outlier. CONCLUSIONS: By international consensus, a 1 in 8 dilution of the candidate IS for anti-A, 03/188, and a 1 in 4 dilution of the candidate IS for anti-B, 03/164, were considered appropriate to define the recommended minimum potencies of anti-A and anti-B blood grouping reagents, respectively, in tube tests. On the basis of these results, preparations 03/188 and 03/164 were established by the World Health Organization as International Standards for Minimum Potency of Anti-A and Anti-B Blood Grouping Reagents respectively, and by the US Food and Drug Administration Center for Biologics Evaluation and Research as Minimum Potency Reference Reagents.

ABO Blood-Group System↗
PubMed2006

Current concepts in ovarian epithelial tumorigenesis: correlation between morphological and molecular data.

Ovarian carcinoma is the most lethal gynaecological malignancy, most tumours being advanced at presentation. However, little is known about precursor lesions and the cell of origin of epithelial ovarian malignancy. In this review, the proposed cell of origin is discussed as well as recent molecular data relating to ovarian cancers of different morphological types. It is stressed that ovarian carcinoma is a heterogeneous group of neoplasms with several different morphological types, each with their own underlying molecular genetic events. Recent data suggest that mucinous ovarian cancers and a small subset of serous cancers (low grade ovarian serous carcinoma) develop through a well-defined adenoma-carcinoma sequence while the much more common high grade ovarian serous carcinoma develops de novo from the ovarian surface epithelium or the epithelium of cortical inclusion cysts. The realisation that various morphological types of epithelial ovarian cancer are associated with different molecular genetic events is a major advance in the study of ovarian cancer. It can be anticipated that this will lead to the development of specific therapeutic agents of value against a specific tumour type.

Adenocarcinoma↗
PubMed2005

Concentration-dependent effects of waterborne zinc on population dynamics of Gyrodactylus turnbulli (Monogenea) on isolated guppies ( Poecilia reticulata ).

The effect of waterborne zinc (Zn) on Gyrodactylus population dynamics was studied on isolated guppies maintained at concentrations ranging from 0 to 240 microg Zn/l. After 1 week pre-exposure to Zn, each fish was experimentally infected with 3 gyrodactylids and parasite numbers were recorded daily on each fish until the fish either died or recovered from infection. Parasite establishment was most successful at 0 and 240 microg Zn/l (97%) compared with the intermediate Zn concentrations. Low to moderate concentrations of Zn were beneficial to the parasite, as evidenced by the concentration-dependent increase in peak parasite burden on recovered fish up to 120 microg Zn/l. In contrast, 240 microg Zn/l may have been toxic to the parasite, as both peak parasite burden (in fish that recovered from infection), and maximum rate of increase of the parasite population (in fish that died) declined at this concentration. The combined effect of infection and Zn is harmful to the fish, because mortality of infected fish (but not uninfected fish) increased with increasing Zn concentrations. We suggest that the observed mortality occurs because of the inability of fish to continuously produce mucous that is a key factor for protecting fish from both waterborne Zn and ectoparasites.

Analysis of Variance↗
PubMed2005

Particle analysis for the determination of UHMWPE wear.

Three types of ultrahigh molecular weight polyethylene (UHMWPE) acetabular liners were tested against cobalt-chrome (CoCr) femoral heads on a hip simulator to approximately 20 million cycles. The materials included (1) conventional, nonirradiated liners (C-PE); (2) 5 Mrad gamma-irradiated, remelted, and artificially aged liners (5-XPE); and (3) 10 Mrad gamma-irradiated, remelted, and artificially aged liners (10-XPE). Wear was quantified by gravimetric analysis and wear particle characterization. Particle number and morphology were quantified by scanning electron microscopy (SEM) and compared between groups. Atomic force microscopy (AFM) was used to measure particle height in an effort to improve the total wear volume estimation. The wear debris, as characterized by SEM, was predominantly submicron and round, with occasional fibrils documented in the C-PE material. AFM analysis showed that particle height was approximately one-third of the particle equivalent circular diameter for all three materials. This correlation was used to improve the estimation of volumetric wear rate through SEM particle analysis. This technique is particularly useful for high-dose crosslinked UHMWPE, such as 10-XPE, which show weight gain due to fluid absorption during wear testing. This study has shown that particle analysis provides additional particle morphology and quantity information that cannot be obtained through gravimetric analysis.

Biocompatible Materials↗
PubMed2005

Stem-like cells traffic from heart ex vivo, expand in vitro, and can be transplanted in vivo.

BACKGROUND: Cells with stem cell surface markers have been identified in heart tissue. Early indications suggest that these are cardiac progenitor cells that could contribute to cardiac repair/regeneration. Clinically relevant therapeutic strategies based on these cells will require improved methods for their isolation and characterization of determinants of their mobilization, proliferation and differentiation. METHODS: An ex vivo culture system was developed that promotes trafficking of progenitor-like cells from mouse ventricles to a culture surface. Cells that "trafficked" from cardiac tissue were phenotyped by flow cytometry and immunohistochemistry. RESULTS: Morphologically distinct cells spontaneously trafficked from mouse ventricular tissue, adhered in culture, and proliferated for up to 4 weeks in Dulbecco's minimal essential media supplemented with fetal calf serum. After 4 weeks in culture, cell number declined. Co-culture with unfractionated bone marrow restored the proliferation of these trafficked cells. A significant population of the trafficked cells expressed a phenotype consistent with that of a myogenic progenitor such as: c-kit+, Sca-1+, CD45-, CD34-, CD90.2-, MyoD1-, desmin-, muscle-specific actin-, and, infrequently, myogenin+. An expanded population of trafficked cells from ventricles of mice expressing green fluorescent protein (GFP+) and containing cardiac-derived progenitor cells were injected into the pericardial space of GFP- mice. GFP+ cells trafficked throughout the heart but retained a primitive undifferentiated morphology. However, when injected into the pericardial space of Apo-E-deficient mice with coronary vasculopathy, progenitor-like cells trafficked into myocardium, and GFP+ cells differentiated into vessel-lining endothelial cells and, rarely, smooth muscle and cardiomyocytes. CONCLUSIONS: Progenitor-like cells in the heart can be mobilized by tissue injury to spontaneously traffic from cardiac tissue and can expand in culture by co-culture with bone marrow. When re-infused by pericardiocentesis, these primitive cells traffic into heart, retain immature morphology, but are capable of undergoing injury-induced differentiation. The novel method described herein permits further characterization of cardiac-derived progenitor cells, which are a candidate for cardiac regeneration strategies.

Animals↗
PubMed2005

Anatomical and gene expression mapping of the ventral pallium in a three-dimensional model of developing human brain.

Combining gene expression data with morphological information has revolutionized developmental neuroanatomy in the last decade. Visualization and interpretation of complex images have been crucial to these advances in our understanding of mechanisms underlying early brain development, as most developmental processes are spatially oriented, in topologically invariant patterns that become overtly distorted during brain morphogenesis. It has also become clear that more powerful methodologies are needed to accommodate the increasing volume of data available and the increasingly sophisticated analyses that are required, for example analyzing anatomy and multiple gene expression patterns at individual developmental stages, or identifying and analyzing homologous structures through time and/or between species. Three-dimensional models have long been recognized as a valuable way of providing a visual interpretation and overview of complex morphological data. We have used a recently developed method, optical projection tomography, to generate digital three-dimensional models of early human brain development. These models can be used both as frameworks, onto which normal or experimental gene expression data can be mapped, and as objects, within which topological morphological relationships can be investigated in silico. Gene expression patterns and selected morphological structures or boundaries can then be visualized individually or in different combinations in order to study their respective morphogenetic significance. Here, we review briefly the optical projection tomography method, placing it in the context of other methods used to generate developmental three dimensional models, and show the definition of some CNS anatomical domains within a Carnegie stage 19 human model. We also map the telencephalic EMX1 and PAX6 gene expression patterns to this model, corroborating for the first time the existence of a ventral pallium primordium in the telencephalon of human embryos, a distinct claustroamygdaloid histogenetic area comparable to the recently defined mouse primordium given that name [Puelles L, Kuwana E, Puelles E, Bulfone A, Shimamura K, Keleher J, Smiga S, Rubenstein JLR (2000) Pallial and subpallial derivatives in the embryonic chick and mouse telencephalon, traced by the expression of the genes Dlx-2, Emx-1, Nkx-2.1, Pax-6, and Tbr-1. J Comp Neurol 424:409-438; Puelles L, Martínez S, Martínez-de-la-Torre M, Rubenstein JLR (2004) Gene maps and related histogenetic domains in the forebrain and midbrain. In: The rat nervous system, 3rd ed (Paxinos G, ed), pp 3-25. San Diego: Academic Press].

Brain↗
PubMed2005

Radiation risk and cost-benefit analysis of a paediatric radiology procedure: results from a national study.

A national study was performed to investigate radiation doses and associated risks to patients during X-ray fluoroscopy-guided small intestinal biopsies in the investigation of coeliac disease. Thermoluminescent dosemeters (TLD) and questionnaires were sent to 42 of the 43 paediatric departments in Sweden performing these biopsies. During the study period (2 x 3 weeks) 257 biopsies were recorded, representing about 10% of annually performed paediatric investigations. The results show that the absorbed dose during biopsy ranged from 0.04 mGy to 23.8 mGy (mean 1.87 mGy). The fluoroscopy time ranged from 2 s to 663 s (mean 60 s). The collective dose from the procedure amounts to 4.7 manSv year(-1). Thus, the annual excess cancer mortality, including severe hereditary effects, can be estimated at 0.6-0.7 cases per year. However, significant dose saving can be obtained by proper choice of sedation and biopsy equipment.

Adolescent↗
PubMed2005

Development of the Safe Tractor Assessment Rating System.

We describe the development of the Safe Tractor Assessment and Rating System (STARS), a design-based tractor safety rating system that can be applied to new or used tractors to provide an objective assessment of their inherent safety features. A predictive rating system model, based on technical inspection, was used. Key principles underlying the system included the potential for design features to reduce the risk of an injury event occurring, and to reduce the risk of injury if such an event did occur. The rating system was based on current standards, research literature, injury and fatality data, and farmer input via focus groups. Development was an iterative process involving field, pilot, and inter-rater reliability tests. The final system was divided into six domains: rollover protection, runover protection, user protection, information and controls, pedestrian protection, and options. Within each domain, optimum design features were described for the common or serious potential injury risks, and a score was assigned for each feature. Scores were translated into a star rating, from zero stars for virtually no inherent safety features to five stars for the highest inherent safety, for each of the six domains. STARS distinguished well between older tractor models known to have few inherent safety features and newer tractor models known to have higher levels of inherent safety. STARS can provide tractor manufacturers, dealers, and users with information critical for managing tractor-associated injury risk. In Australia, it is initially being implemented within the curriculum of the technical education and training sector.

Accidents, Occupational↗
PubMed2004

The Hera database and its use in the characterization of endoplasmic reticulum proteins.

MOTIVATION: Information concerning endoplasmic reticulum (ER) proteins is widely dispersed and cannot be easily and rapidly processed by the biological community. We present a comprehensive database of human ER proteins, called Human ER Aperçu (Hera). The Hera database was constructed by exhaustively searching through public databases and the scientific literature for ER proteins. RESULTS: Hera was used for the analysis of characteristics common to all human ER proteins. Our results show that a high proportion of ER proteins (59%) have at least one transmembrane domain and display physical characteristics consistent with this observation. In addition, one-third of ER proteins contain known ER retrieval or retention signals and 70% of ER proteins contain a signal peptide or anchor. Finally, 85% of ER proteins contain at least one InterPro motif. The most abundant InterPro motifs in ER proteins represent many of the most well-characterized functions of the ER.

Amino Acid Motifs↗
PubMed2004

Radial scar, complex sclerosing lesion and risk of breast cancer. Analysis of 175 cases in Northern Ireland.

BACKGROUND: Controversy exists over the nomenclature and clinical significance of radial scar/complex sclerosing lesion (RS/CSL) of the breast. A retrospective analysis of cases diagnosed from 1988 to 2001 in Northern Ireland was performed to determine if any clinical difference exists between the diagnoses of radial scar and complex sclerosing lesion, and establish if lesions suggestive of RS/CSL require excision and/or follow-up. PATIENTS: Patients with a diagnosis of RS/CSL from 1988 to 2001 were identified from the databases of the pathology laboratories serving specialist breast surgical units and the Northern Ireland Breast Screening Programme. RESULTS: True RS/CSL was confirmed in 175 of 230 cases. There was no difference between RS and CSL regarding associated pathology in the specimen. 16.9% of cases identified at symptomatic clinics were associated with carcinoma in situ, and 15.7% with invasive breast carcinoma, compared to 4.7 and 2.3%, respectively in the screen detected group. One later carcinoma was found. CONCLUSIONS: There is no clinical difference between the entities radial scar and complex sclerosing lesion. RS/CSL require excision due to their association with malignancy. In the absence of any independent risk factor for carcinoma no further follow-up of patients with RS/CSL is required.

Adult↗
PubMed2004

Treatment response in late-onset depression: relationship to neuropsychological, neuroradiological and vascular risk factors.

BACKGROUND: Late-onset depressive disorder is associated with white matter lesions and neuropsychological deficits that in some studies are linked to a poorer outcome for depression. Some white matter lesions may be vascular in origin. This study investigated the relationship between response or non-response to antidepressant monotherapy and neuropsychological function, structural brain measures and vascular factors. METHOD: This was a case control study. Fifty patients with late-onset major depressive disorder (29 who were responders to antidepressant monotherapy and 21 who were not) were compared with 35 non-depressed control subjects. Measures included assessment of vascular risk factors, neuropsychological testing and a magnetic resonance imaging (MRI) scan. RESULTS: After adjustment for depressed mood and medication at evaluation, both patient groups had significantly more impairment compared to control subjects on verbal learning tasks involving immediate or delayed recall. Patients who did not respond to antidepressant monotherapy had significantly poorer performance than controls on tests involving visuospatial ability, language, word recognition and tests of executive function, whereas there were no differences between control subjects and responders. On two tests of executive function (verbal fluency and the Stroop test) non-responders scored significantly worse than responders. There were no significant group differences on MRI measures of atrophy or of white matter lesions apart from a higher periventricular hyperintensity score in non-responders compared to controls. There were no group differences on measures of vascular disease. CONCLUSION: The results lend support to the emerging evidence that resistance to treatment in late-onset depression may be associated with impaired executive function. Subtle cerebrovascular mechanisms may be involved.

Age of Onset↗
PubMed2004

E-mail surveys assist investigation and response: a university conjunctivitis outbreak.

A conjunctivitis outbreak affecting more than 200 individuals occurred on a university campus in Evanston, Illinois, USA, in spring 2002. An investigation was conducted jointly by the Evanston Department of Health and the Illinois Department of Public Health. A combination of e-mail and traditional telephone-based surveys demonstrated that wearing contact lenses was a risk factor for any conjunctivitis and bilateral conjunctivitis, whereas using glasses was protective. Laboratory and epidemiological evidence suggested that the outbreak was caused by a viral pathogen that eluded characterization despite extensive culture and PCR-based laboratory testing. Enhanced laboratory surveillance could help clinicians and public-health officials to identify relevant secular changes in the spectrum of causes of conjunctivitis. During institutional outbreaks, e-mail surveys can help public-health officials to efficiently access information not easily collected by traditional case-control studies, and can provide an effective conduit for providing prevention recommendation, such as the need for improved hand and contact-lens hygiene during outbreaks.

Adult↗